Public health medicine education and training in the Netherlands

Background
Public health medicine is a medical specialty focusing on the relationship between societal conditions and the health of the population. The Dutch specialty-training programme for public health medicine takes according to European rules 4 years and combines medical knowledge, clinical experience and knowledge and skills of public health, administration and research. In 2007, 1000 doctors were registered as a public health physician.
Objectives
The Royal Dutch Medical Association (KNMG) accepted the CANMEDS framework as a general framework for all postgraduate medical training in the Netherlands. The framework described the essential roles and key competencies of specialist physicians (medical expert, communicator, collaborator, manager, health advocate, scholar and professional).  All specialty associations were asked to add specific competences and to define Entrustable Professional Activities (well described critical professional activities entrusted to a trainee). After this descriptions the Netherlands School of Public and Occupational Health (NSPOH) was able to develop the training programmes.
Results
A framework with General and Specific competences was developed for public health medicine with a specific focus on prevention, monitoring, advice (solicited and unsolicited), cooperation, management and research in public health for individuals and population. Furthermore assignments for integrated theoretical and practical tutorials were developed, including assessment tools, like short assessment for practical skills, Multiple source feedback and knowledge exams. Training sessions were organized for public health physician supervisors with a focus on role-modelling, giving feedback and counselling of the trainee. This new education program started in 2006.
Conclusion
The competency framework of public health medicine gives a guideline for public health medical specialty training, and the new education program will lead to a new generation of public health physicians who are well equipped for the future challenges in public health.
In our opinion this framework could be used as a Global Framework to compare and strengthen the different education programs for Public Health.