番茄社区

In this video, Jeremy Faust, MD, editor-in-chief of 番茄社区, talks with Megan Ranney, MD, MPH, about her new position as the dean of the Yale School of Public Health. Faust and Ranney also discuss the evolution of public health education and the importance of collaboration during the COVID-19 pandemic and beyond.

The following is a transcript of their remarks:

Faust: Hello, it's Jeremy Faust, medical editor-in-chief of 番茄社区. Thanks for joining us.

Dr. Megan Ranney will be joining us today. She's a practicing emergency physician, researcher, and an advocate for innovative approaches to so many things that we care about. She's done research on firearm safety. She also led Get Us PPE, a nonprofit that delivered millions of pieces of personal protective equipment during the pandemic.

Dr. Ranney is currently the deputy dean at the School of Public Health at Brown University, but she's about to become the dean of the Yale School of Public Health.

You're not just taking over a school of public health, you're rebooting the Yale School of Public Health, and it's going to be independent for the first time from its medical school. But in my view, it's also one of the first, if not the first, reboots of a school of public health in the post-COVID era. How do you think about that?

Ranney: It is such an exciting opportunity. And I want to be clear, the Yale School of Public Health is already extraordinary. What's happening at this moment is that I'm getting the opportunity to lead it at a moment of two transitions. One internal, one, as you say, external.

That internal one is: it is becoming autonomous for the first time in its history. It's one of the oldest schools of public health in the country, but it's always operated within the school of medicine. And now -- listen, you and I are both practicing physicians, but we also both know that public health is about so much more than the healthcare system. So this moment of separating out allows us the potential to really live into what public health means for most Americans and for the globe.

Which leads to the second part, which is that we are in this moment of transition around what public health is, how the public conceptualizes us, and I think we're also in a moment of transition of what public health can and should be.

So getting to join Yale at this double transition moment is super exciting and hopefully holds a lot of potential.

Faust: I think that's key. This moment of post-COVID -- we're still in it, but at least it's the post-beginning of COVID era -- really changed everything. The degree of the Masters of Public Health, Epidemiology, these matter more than ever. But I also sense that we can't train the next generation the same way this generation was trained because the world has changed in so many ways, not just in terms of biology and what's out there, but in terms of the tools we have.

How do you approach a new curriculum? What do you think will be different from when you got your degree in this field?

Ranney: I think there's a few different things. The first thing is that just like with med school, public health schools are accredited by a central body, so we obviously have to follow those guidelines of what's called SPH, for schools of public health. But my hope is that we'll move more to practice-based learning.

We're recognizing that public health is a discipline. It's not just reading through a textbook on epi [epidemiology] or a textbook on linear regression, right? It's about learning how do you use this discipline -- this way of inquiry, this series of data and communication and intervention development, behavior change, leadership skills -- how do you put them all together into a package that can be applied, not just in departments of health, not just in academic public health schools, but also in education or manufacturing or consulting or journalism or, of course, in the healthcare space.

My hope is that over the next 3 to 5 years we'll lead that transition in terms of what students expect to get out of their training and what they're prepared to do, the type of leadership experiences that they're prepared to take on.

I think of it in some ways as similar to what the Yale School of Law has done over the last 5 to 10 years, with really transforming the way that lawyers are taught. People that graduate from Yale Law School now graduate with a focus on leadership as part of their curriculum. It's expected that they're all going to go through the 1L year and learn the basics of case law, that's a given. But so much more of what Yale hopes to graduate lawyers as, is true leaders in society, and I would hope the same from our School of Public Health.

Faust: A school of public health can often have a very cosmopolitan feel in the sense that there are a lot of different kinds of people. But of course, as clinicians, we think about the physician who's in that room or who's in that school. Do you think that there's a different way that physicians looking to get that degree need to think about it as opposed to people who are not clinicians? Do you almost sense that it's like a melting pot? Do you think that the students need different things?

Ranney: In some ways. I think you and I have had discussions before about innovation, and I think that the very best public health, for lack of a better word, innovations or developments in the world have come from those melting pot moments.

I look at what you and I did with Get Us PPE early in the pandemic -- that came about because we had physicians, public health professionals, supply chain experts, coders, and graphic designers all together. So, yes, everyone's going to need something a little bit different.

But to me, part of the goal is that you're putting a lot of really smart, dedicated minds together who all have the same end objective of improving human health. And then you see what they come up with.

Faust: I think that the idea of a school of public health as a locus for these kinds of innovations, and again, your work on Give Us PPE I think was a great example of that. Just bringing the experts from different fields to one place and having that be the place where the reaction occurs and then you get a chain reaction. I think that's a strong argument.

I do want to talk about whether given the fact that, yes, it's a school of public health, it has to have certain accreditation and things it has to do, but you also want to be innovative. Let's talk about some of your major goals, or as you call them "verticals." What are your three or four big goals right now you think you can roll out in a new school or in a rebooted school?

Ranney: So this is the business language, right? In the matrixed organization, you've got your horizontals, your topical areas, and then there's these verticals or pillars. To me, at this point, with the caveat that I need to incorporate the views and the history of the folks already there, both at Yale and of course in the larger community, I see there being really three big verticals.

The first is around inclusion, which of course includes diversity and equity, but more so making sure that public health in general and the Yale School of Public Health in particular elevates and amplifies and invites in a trusted way a diversity of voices. Diversity of course in terms of race, ethnicity, gender, but also in terms of ability or disability, in terms of geography, socioeconomic status, and diversity of voices around disciplines and lived experience. That includes the community voice as well, which is so central. The voice of the public becomes central to public health.

The second big area is around innovation and entrepreneurialism. The history of public health is one of innovation, but we don't always scale or sustain innovation well, and we don't always successfully do that innovation in collaboration with for-profit policy, not-for-profit entities. My hope is that in working with the other schools within Yale, as well as with the larger community, we can create a culture and a roadmap to help fast-track that innovation in ways that help it take root across the globe in a way that's sustainable.

Then the third part is around communication, which you and I have some shared ethos around, but if we've learned anything over COVID, it's that we as public health professionals need to be really good communicators. But we also need to help the public to be good communicators. If we look at the rise of misinformation and disinformation, a lot of it is not because people mean to spread myths or mistruths or lies. Sometimes it's intentional, but a lot of times it's just because there's a paucity of trusted information.

So thinking about how do we both train the next generation to go out and be great communicators themselves, but also how do we serve as that locus of trusted information for folks across the globe who have their own communities that they want to share with? That to me is a big part of our work.

Faust: A lot of our viewers are in healthcare, they have a growth mindset, they're leadership-type people, so they think about where they're going with their careers. I certainly do.

What are you giving up to do this job? Is it your own research, which has been on gun safety and other issues? Is it clinical work? When you make a leap like this, what do you have to leave behind?

Ranney: I am going to have to leave behind some of my own research. Right now I have a significant portion of my time that is externally funded. A lot of that is going to have to decrease, and so it's going to be more about potentiating work with others.

I hope to keep that firearm injury prevention focus. It's something I care so deeply about, but it's going to shift. That's probably going to be the biggest thing. I'm not going to be writing a lot of PI grants in the future.

I think that my clinical practice is going to shift, hopefully not disappear, but shift, just because being the dean is a full-time-plus job. And then, TBD. I am someone who, up until now in my career, has always taken more things on and not given things up. Part of it is also about creating the teams, so that the goals can continue to move forwards, even if it's not me as the day-to-day leader.

Faust: Well, I think you have a full plate, and if anyone can do it, it's you. We're all watching and looking forward to seeing what you accomplish in this role. Congrats, and we'll check in sometime in the future.

Thanks for joining us today.

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