Domhnall MacAuley:Working Epidemi-holiday

Domhnall MacauleyEpidemi-holiday is what the students used to call their attachment. A bit unkind, although with hindsight I may have missed an occasional lecture or tutorial as a student myself……times have changed, and epidemiology was centre stage, at the launch of the Centre of Excellence for Public Health in Northern Ireland (June 18th), part of the £20m investment by the UKCRC.
And, what a launch, with speeches by the Deputy First Minister, the Minister for Health, the Chief Medical Officer, and the University Vice Chancellor. An impressive line up (“All the big guns”, just doesn’t sound right in Belfast) for what is often perceived as a Cinderella speciality. And the audience was certainly engaged when the Deputy First Minister, Martin McGuinness, began to talk about leadership and described his recent experience of talks in Helsinki with various parties in the Iraq conflict.

Nick Mays (London School of Hygiene and Tropical Medicine) said that his role was to lower expectations- a not inappropriate message to balance the enthusiasm of the day. But what struck me as particularly interesting and innovative about the academic programme was that it was all outward looking. No local experts pushing their own agenda, but an entire programme presented by national and international partners. Is this a new Northern Ireland, where opposing politicians share a platform and the explicit message is to look outwards? A pity that this vision of the future is at a time of global economic downturn.
In a specialty where risk factors are the day to day currency, it was no surprise that obesity cast a long shadow. But, Elizabeth Barrett-Connor (University of California, San Diego) had another angle on the solution. Never mind the medical evidence, appeal to vanity as the major factor in adherence and maintenance. Similarly, Mandy Ryan (University of Aberdeen), used her research on discrete choice experiments to show people put a price on staying thin. As medics we need to get out more. Other disciplines have a lot to offer in helping us understand behaviour. Indeed, doctors may have precious little to contribute to changing health related behaviour.
Changing attitudes to epidemiology is also difficult. Most doctors just want to get out there and do something, rather than reflect and research potential causation. At this stage I should declare an interest. My own Pauline conversion occurred through my involvement with this particular department where I studied public health and undertook my MD and hence a research career that evolved into editing. True leadership is encouraging, facilitating and enabling others- always a key feature of this particular department. It was great to meet so many old friends. I wish them every success.

Domhnall Macauley is Primary Care Editor, BMJ