Driven by the pandemic and ‘the Fauci effect,’ applicants flood public health schools

The Covid-19 pandemic has tested the public health and medical workforces like never before. And yet people in those fields say they see emerging signs that the crisis will inspire the next generation of doctors, nurses, and public health professionals to join the ranks.

Public health schools, for example, saw a 23% jump in applicants for master’s and doctoral programs from fall 2019 to fall 2020, and are reporting an even bigger increase so far in this application cycle, according to the Association of Schools and Programs of Public Health.

One reason is what Laura Magaña, the CEO of the association, called “the Fauci effect,” after the now-famous U.S. health official Anthony Fauci.

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“This has really thrust public health into the spotlight like we’ve never seen before,” said Darleen Peterson, the associate dean for academic affairs at Claremont Graduate University’s School of Community and Global Health, which saw a 66% increase in applicants for its master’s in public health program from March 2020 to March 2021.

It’s too soon to say much more about the pandemic’s impact on the fields of public health and medicine. This Friday is Match Day, when graduating medical students find out where they’re headed for their residencies, but most soon-to-be doctors had likely already chosen what type of program they were pursuing ahead of the pandemic, physicians say. Similarly, many people who might be moved to become a health care worker by Covid-19 wouldn’t have had time to take all the necessary requirements and enter training programs yet.

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It’s also clear that the pandemic has had something of an opposite effect on those already in their careers: Covid-19 has been a crucible for so many. Health authorities have been threatened and harassed by a public who bristled at measures meant to keep them safe, and many quit. There is widespread fatigue and concerns about burnout among public health officials and clinicians alike. They’ve seen colleagues get sick and die. While nurses, doctors, and other providers were initially greeted by global applause, their pleas for the public to keep up with precautions encountered more apathy as the months dragged on.

“The whole country is tired — they’re tired of thinking about the pandemic with every move they make,” said infectious disease physician Wendy Armstrong of Emory University. “But for us in the medical profession, not only is everyone exhausted because the workload has been high, the stress has been tremendously high, but there’s a sense of sadness because it feels like you’re in this fight and half the world doesn’t care.”

One reason public health programs are drawing more people, officials say, is because young people committed to social justice now view the field as an avenue for addressing racial inequities, given the disparate toll of the pandemic on people of color in the United States. Brown University’s public health school, for example, last week said applications for its MPH program had jumped 116% from this point last year, and were up 187% among Black candidates and 137% among Latino candidates.

The pandemic is also shifting what people want to focus on. Caroline Basil, an MPH student at Claremont, had been planning to work with college students and young adults after getting her degree. Now, after seeing the impact of Covid-19 on older people, she intends to specialize in the health of the aging population. Some of her peers, she said, have been more drawn to policy because of the pandemic.

“Public health went from a backstage position to really being front and center,” she said. “It’s been really cool to see what epidemiologists do, and how important data science is, and how science and policy work together.”

There’s a question, however, about what kinds of jobs will be waiting for those public health graduates devoted to the public side of the field. State health departments estimate they lost 10% of positions from 2012 to 2019 amid declining funding, while city and county health departments saw a 23% loss in workforce from 2008 to 2019.

A study published last month, for example, found that the number of open jobs for people with public health training increased from an eight-month period before the pandemic compared to the first eight months of the pandemic. But hiring among nonprofits and academia was down, while the private sector — like drug and insurance companies — were increasingly searching for talent.

“I now have graduates who are working as consultants for TV and movie productions to make sure people are following the right protocols,” said Heather Krasna, an author of the study and the assistant dean of career services at Columbia’s Mailman School of Public Health. “That definitely was not a job not long ago.”

The $1.9 trillion American Rescue Plan, signed by President Biden last week, includes $7.66 billion “to establish, expand, and sustain a public health workforce” in state, territorial, and local health departments — a massive boon for underfunded agencies. But people in public health hope the government will maintain such funding; too often public health gets rewarded after a crisis period, but then neglected afterward. If the pandemic highlighted how stretched departments already were, authorities are stressing they have plenty of work outside a coronavirus outbreak, from addiction to childhood vaccines to climate change.

“There are still going to be a lot of sick people even after Covid is over,” said Michael Fraser, the CEO of the Association of State and Territorial Health Officials. “There’s going to be a need for these people. It’s a matter of how you sustain these positions.”

It’s not yet clear whether the booming interest in public health programs is echoed at nursing schools, which, like medical schools, had already been seeing increases in the number of applicants and enrollees in recent years. Enrollments in select nursing programs grew 5.6% in 2020 — more so than in most recent years, but about the same as they did in 2010 and 2018, according to the American Association of Colleges of Nursing.

Deborah Trautman, the CEO of the organization, noted that nurses have always been trusted. But the pandemic, she said, raised their stature even more, in ways that she thinks will attract people.

“What people saw was what contributions these nurses were making,” Trautman said. “They were treating patients, but they were also keeping their communities safe.”

At Hondros College of Nursing in Ohio, its network of campuses has seen double-digit percentage gains in enrollees since the pandemic began. Tawnya Lawson, the senior vice president of academics, said some people who had lost other types of work because of the pandemic were looking to nursing as a stable career, in addition to an honorable one.

“Folks just want to help other people, and nursing is one of those professions,” Lawson said.

For infectious disease physicians like Emory’s Armstrong, the pandemic served as yet another reminder of the importance of their field — and how the shortage of specialists poses risks to the country.

Armstrong and her colleagues have been warning for years about infectious disease fellowship slots going unfilled, and during the most recent fellowship match in December, 365 of the 416 positions were filled. That’s an increase both in the number of positions offered and taken from recent years, but Armstrong lamented that fewer than 90% of the spots were grabbed. In most other fellowships under the internal medicine umbrella — with some exceptions like geriatric medicine and nephrology — the rates are higher, often in the 98% range.

People typically start to veer toward an infectious disease specialty while in medical school, said Armstrong, who is also a spokesperson for the Infectious Diseases Society of America, so any influence of the pandemic in luring more people can’t be seen yet. But she said she hoped in years to come more people could be drawn to the field or to the work of public health more broadly.

“I do think at the end of the day this has been important to highlight the crucial role of public health,” she said.

Source: STAT