Canadian Field Epidemiology Program

About Us

• What is Field Epidemiology?
• What is the Canadian Field Epidemiology Program (CFEP)?
• What do Field Epis do?
• CFEP Office Staff
• Field Epidemiologists
• Opportunities after Graduation

What is Field Epidemiology?

Field epidemiology is the application of epidemiologic methods to unexpected health problems when a rapid on-site investigation is necessary for timely intervention (M. Gregg, Field Epidemiology, 2002). Field Epidemiologists are disease detectives; they are invited on-site to study diseases in order to better understand and control them. This "shoe-leather" epidemiology involves helping the investigation team define, find and interview cases, coordinate the collection and analysis of specimens, apply statistical methods to assess factors responsible for illness and recommend control measures.

What is the Canadian Field Epidemiology Program (CFEP)?

Public Health Agency of Canada's CFEP was previously known as the Field Epidemiology Training Program (FETP). It was established in 1975 at the request of Canadian provinces and territories to provide specialized training for health professionals in the practice of applied epidemiology. The CFEP was modeled after the Epidemic Intelligence Service of the Centers for Disease Control and Prevention. The CFEP was the first Field Epidemiology Training Program of which there are now close to 30 in so many countries. The CFEP has over 100 graduates now working throughout Canada and the world, contributing to increase public health capacity nationally and globally.

Field Epidemiologists acquire experience and contribute to scientific knowledge and public health service by exploring a variety of public health issues. During their training, Field Epidemiologists:

• Conduct epidemiological investigations and field studies to understand and control outbreaks, chronic disease clusters, health impacts of disasters and environmental health issues
• Conduct epidemiological and statistical analyses of large and complex datasets
• Design, implement and evaluate disease surveillance systems
• Provide public health information to the media and the public
• Present their work at scientific conferences and publish their work in peer-reviewed journals
• Train other health professionals directly and indirectly

Field Epidemiologists are Public Health Agency of Canada employees and are placed at the Public Health Agency of Canada, other federal departments as well as provincial and local health departments and public health agencies (Placements). They are deployed to assist in field investigations within the jurisdiction of their placement or on behalf of the CFEP, in Canada and internationally. The CFEP participates in international activities through the Training Programs in Epidemiology and Public Health Interventions Network (TEPHINET), the World Health Organization (WHO) and other organizations. Since the program's inception, Canadian Field Epidemiologists have investigated close to 250 outbreaks and other public health issues and provided epidemiological assistance to every jurisdiction in Canada and close to a dozen countries internationally (EPI-AIDs).

The CFEP aims to develop skills and competencies that are not easily taught in academic or workplace settings. Field Epidemiologists must complete eight Professional Experience Guidelines (PEGs) in order to graduate from the two-year program. Upon graduation, Field Epidemiologists earn a certificate and the recognition, nationally and internationally, that they have undergone Field Epidemiology training.

The CFEP offers specialized training courses for its Field Epidemiologists every year. The annual Epidemiology in Action Course is also offered to external participants. The objective of this course is to review epidemiological methods as they pertain to outbreak investigations, surveillance and field studies. The fall and spring courses are designed for the Field Epidemiologists. They focus on improving communication skills and on the surveillance evaluation projects. Additional training is acquired through attending conferences and workshops.

What do Field Epis do?

Duration
Field Epi training lasts two years.

Work Placements
CFEP Field Epis are placed in federal, provincial, territorial and local health departments or public health agencies for the duration of their two years of training.

Incoming Field Epis rank their top five placements and placements rank their top five Field Epis. The CFEP office matches each Field Epi with a placement. Most Field Epis are matched to one of their top three choices. If a placement match is outside the Field Epi's city of residence, the CFEP office will reimburse a portion of the relocation costs.

Field Work
Field Epis are deployed to the field upon request to support investigations to control diseases of local, provincial, territorial, national or international concern. This may include communicable disease outbreaks, clusters of chronic diseases, surveillance activities and teaching and training. Deployment is at the discretion of the placement supervisors within their jurisdiction or the CFEP staff for EPI-AIDS.

Field Epis may assist in:

• Developing case definition(s)
• Identifying the causal agent(s)
• Determining the extent of the outbreak or public health issue
• Developing and applying case finding methodology
• Organizing and interpreting data collected/providing a descriptive epidemiologic summary
• Determining whether the cases are related/epi-linked
• Identifying the source of the agent
• Determining the optimal control measure(s)
• Providing recommendations for disease control interventions
• Setting up a case-control/cohort/cross-sectional study
• Co-authoring publications arising from the investigation

Fieldwork can last from two to three weeks. Follow-up work (e.g., further analysis of data, writing the report) usually takes another four to six weeks once the Field Epi returns from the field.

Work Expectations

• In their placements, Field Epis are required to work full-time (five days/week, during normal working hours).
• Field Epis must be willing and available to travel to the field on short notice (24 to 48 hours) for several weeks at a time. While on a field investigation, it is usual for Field Epis to work additional hours, including evenings and weekends.
• Field Epis must have excellent teamwork, communication and conflict resolution skills. Field Epidemiologists never work alone while in the field; they always form part of an outbreak investigation team. Field Epis are invited to participate in investigations; they must be able to work collaboratively with their co-investigators in high-stress situations.
• Although some Field Epis have tried to work on other projects while in the program (course work, thesis writing, clinical work), most have found it very difficult to satisfy their work demands.

CFEP Office Staff

Dr. Lee Lior, Program Director
Dr. Linda Panaro, Program Director
Dr. Robert Pless, Program Director
Dr. Rob Stirling, Program Director
Samantha Wilson-Clark, National Training Coordinator
Ellen Nadarajah da Silva, Program Manager
Gisèle Jolicoeur, Acting Program Manager
Andrea DeFazio, Administrative Assistant

Field Epidemiologists

Cohort 34 (2008-2010)
Jennifer Cutler
Nova Scotia Department of Health Protection and Promotion (Halifax)

Catherine Elliott
National Collaborating Centre for Environmental Health (Vancouver)

Guanghong Han
BC Centre for Disease Control (Vancouver)

Ruwan Ratnayake
Direction de la santé publique de Montréal (Montreal)

Cohort 33 (2007-2009)
Maritia Gully
Vancouver Coastal Health Authority (Vancouver)

Monika Lindegger
New Brunswick Department of Health (Fredericton)

Jennifer May-Hadford
Foodborne, Waterborne and Zoonotic Infections Division, PHAC (Guelph)

Rachel McCormick
Foodborne, Waterborne and Zoonotic Infections Division, PHAC (Guelph)

Robyn Mitchell
Montreal Public Health (Montreal)

Sue Pollock
National Collaborating Centre for Environmental Health (Vancouver)

Joanne Tataryn
Saskatoon Health Region (Saskatoon)

Marsha Taylor
BC Centre for Disease Control (Vancouver)

François-William Tremblay
Ministère de la santé et des services sociaux du Québec (Quebec City)

Jordan Tustin
Human-Animal Interface and Public Health Intervention Unit, PHAC (St-Hyacinthe)

Opportunities after Graduation

Over 100 health professionals have been trained as Field Epidemiologists in Canada over more than 25 years. These CFEP alumni are now practicing as:

• Senior epidemiologists or medical officers in local, provincial, territorial or federal departments of health
• Private consultants
• International health consultants
• Researchers or professors in academic settings