Epidemiology Track Handbook

Welcome to the Joint Doctoral Program (JDP) in Public Health Epidemiology, a collaborative effort of two academic institutions, San Diego State University (SDSU) and the University of California, San Diego (UCSD) that originated in 1990. While there are several joint doctoral programs in place between SDSU and UCSD, there are three with a Public Health focus: epidemiology, health behavior and global health. The purpose of this handbook is to guide you through the next few years and supplement the information contained in the SDSU Graduate Bulletin under General Requirements for Doctoral Degrees.

The JDP is jointly administered by the School of Public Health (SPH) at SDSU and the Division of Epidemiology, Department of Family Medicine and Public Health (FMPH) in the School of Medicine, via Graduate Division at UCSD. As a student in this program, you will complete course work and conduct research at both institutions. Faculty from each campus will serve on your advisory and dissertation committees, providing you with extensive exposure to experts with varied interests and proficiencies. The program is co-directed by faculty and staff from both institutions (See Appendix B for list of JDP faculty). The JDP co-directors and coordinators for the Epidemiology track are as follows.

While in this program you should document your affiliation on all professional citations including memberships, presentations, publications and other professional affiliations as follows:

San Diego State University/University of California, San Diego | Joint Doctoral Program in Public Health (Epidemiology)

The course of study should take into consideration: (1) required courses; (2) required teaching experience; (3) courses that would assist in passing the preliminary examinations in epidemiology and biostatistics (see section below) as well as oral and written qualifying examinations and the formal defense of a dissertation; and (4) courses that provide expertise in public health research principles.

If you do not have a Master’s degree in Epidemiology or equivalent preparation, additional courses must be taken before embarking on doctoral study. If you have a previous Master’s degree in Epidemiology (or equivalent coursework), the first year in the JDP will be at SDSU completing core coursework, electives, and the doctoral seminar. After the first year, your SDSU residency requirement will be completed. Depending on your background and experience, and with the approval of the Advisory Committee, you may fulfill one of the teaching requirements during this first year. During the second year, you will complete core coursework at both campuses; continue electives on both campus, and begin or continue teaching requirements. After the second year, your UCSD residency requirement should be completed. Beginning in the third year, you will be in residence at the campus that provides the faculty expertise and optimum environment for completing your dissertation. Although you may be taking courses on only one campus in a particular semester/quarter, you must enroll at each campus every semester/quarter. See Registration Information and appendix D for details.

The Advisory Committee (comprised of the two Co-Directors) works with all JPD students to develop a suitable course of study and monitor program progress to ensure that Advancement to Candidacy proceeds in a timely manner.

Once you choose a Dissertation Committee, the Dissertation Committee will assume the role of the Advisory Committee. You will meet with the Advisory Committee at the beginning of your first semester/quarter and every year during the spring semester, when an evaluation is completed.

** VERY IMPORTANT **

Our Public Health (Epidemiology) Program is known as PB79 in the UCSD registrar’s system.

Students should always enroll and register/pay fees at SDSU. However if a student is receiving funding from UCSD in the form of employment, stipend or award; the student will need to register for 1 unit of FPM297, Independent Study, using the S/U (pass/fail) option. A fee waiver will then be processed by the graduate coordinator at UCSD to cover tuition/fees on that campus. To maintain health insurance, students must register at SDSU for at least six units every semester. These units could be classes or PH-897. Students with a UCSD administered grant or fellowship will have to register on that campus full time, and pay fees at UCSD via their grant. Please check with your graduate coordinator and grant administrator about specific requirements, as this is a case-by-case scenario.

Please note that your health insurance is directly tied with paying fees, so your coverage will be on whichever campus you pay fees to.

Keep in mind that UCSD is on the quarter system and SDSU is on the semester system, so the starting and ending dates of each quarter/semester will vary. Check the academic calendars for each institution:

SDSU Academic Calendar and UCSD 2023-24 Academic Calendar

The goal of this program is to prepare graduates for careers in public health research, practice and teaching. Upon graduation, students with a Ph.D. in Public Health will be able to:

• Describe the distribution and determinants of health and disease in populations, and the factors that influence these distributions.
• Describe major national and international health concerns, their established risk factors and other contributing factors for these problems.
• Identify the ethical issues involved with studies of human populations.
• Develop a systematic approach for planning, collecting, processing and analyzing information in research and practice settings.
• Apply appropriate analytic and statistical methods to data generated from a wide variety of public health research.
• Design and implement independent research addressing a public health problem.
• Develop and write fundable research proposals and critique those of other investigators.
• Translate public health research findings into recommendations for specific interventions, health policies, or further investigative research.
• Communicate scientific findings clearly and concisely, both orally and in writing to other health professionals, as well as to the media and broader community.

In addition, graduates of the Epidemiology track will also be able to:

• Identify, measure, and discuss the major categories of bias and their potential impact on measures of association, assess the potential for their occurrence in specific situations, and propose methods to evaluate and/or reduce their influence on the measures of major interest.
• Identify situations where confounding and effect modification may be important, and apply designs and statistical methods to quantitatively assess confounding and effect modification.
• Understand and apply methods necessary to conduct outbreak investigations.
• Apply a range of sampling techniques and calculate appropriate sample sizes in accordance with study objectives.
• Understand and apply the principles of screening for diseases and risk factors, calculate and interpret sensitivity, specificity, and predictive values of negative and positive tests.
• Employ methods of direct and indirect standardization or adjustment for factors such as age or gender in a study population.
• Identify and apply appropriate advanced statistical methods including multivariable regression, factor analysis, logistic regression, survival analysis, and cluster analysis.
• Apply the principles of causation in designing studies and interpreting published literature.
• Use appropriate epidemiologic and statistical methods to calculate and interpret dose-response issues and trends in prevalence or incidence of disease outcomes or risk factors.

Prerequisites

The curriculum that leads to the doctoral degree is based on already having a Master’s degree in Epidemiology or having taken the equivalent coursework (as noted below).

Recommended SDSU Course Roadmap* - Year 1

Recommended UCSD Course Roadmap* - Year 2

*Students proposing deviations from the roadmap require formal approval from the program Co-Director

**See section on Other Required Material for programming requirements.

Core Course Requirements

With an existing Master’s degree in Epidemiology (or after completing the equivalent coursework) the requirements for the JDP are as follows:

39 total semester equivalent units: 28 in advanced epidemiology and 11 in biostatistics.

*(UCSD quarter units x 2/3 = SDSU semester units)

**See section on Other Required Material for programming requirements.

IMPORTANT NOTE REGARDING THE NUMBER OF UNITS

• Electives requirement: 15 semester equivalent units, may be taken at either campus.
• Residency requirement: 24 semester units at SDSU and 36 quarter units at UCSD.

Other Required Material

Electives

15 semester equivalent units in specialization area: The elective units are intended to be taken in coursework and field study to improve your expertise in your selected area of emphasis. These units can be taken from either institution. Typical areas of emphasis include infectious disease epidemiology, chronic disease epidemiology, cancer epidemiology, behavioral epidemiology, community base trials, physical activity/exercise and health, and nutrition and health. The Advisory Committee and your Dissertation Committee will advise you to take electives in your dissertation topic area. See Table below for course descriptions. This requirement can be completed before or after advancement to candidacy.

Independent Study Electives

Together with a program faculty member, you may design a course of independent study and/or research as an elective. In order to enroll in independent study units with a faculty member, please complete an ISP request form (available from the UCSD Graduate Coordinator), which includes a description of the course objectives and deliverables. You will need to complete the form and gather approval signatures from the faculty member as well as the track directors (electronic signatures are permitted). Submission of this form to the program coordinator (Hollie Ward) constitutes a contract between you and your faculty advisor to complete the described work.

Grades

The grade of a “B” or better is required in this program. Contact the graduate coordinator if you need to repeat a course. Both grades will be used to calculate the cumulative GPA.

Data Analysis Programming Proficiency

You must demonstrate proficiency in two of the statistical computer packages. Proficiency in statistical packages (SPSS, SAS, R, Python) is defined as course work in each package (a SAS course is offered at SDSU and SPSS is offered at SDSU and UCSD) or demonstrated familiarity with the software. For each package, you should be able to write a program that demonstrates computing skills in data management and analysis. Given a data problem and an accompanying (ASCII) data file, you should be adept at: creating systems files; transforming and creating new variables; carrying out basic data screening procedures and descriptive statistics; carrying out univariate and multivariate analyses appropriate to the problem; and demonstrating appropriate interpretation of the computer output. SPSS at SDSU meets for twelve 2-hour sessions in the Fall semester; SAS meets for twelve 2-hour sessions in the Spring Semester. This requirement must be completed prior to advancing to candidacy.

Teaching in Epidemiology (2 semesters/quarters)

Working with the Advisory / Dissertation Committee, you will determine appropriate courses to meet the teaching requirement. To obtain credit, please consult with the Co-Directors in advance for approval, and be sure to include this in your annual Spring evaluation. Helping faculty teaching courses in epidemiology or biostatistics at either institution will fulfill the teaching requirement. Please note that this requirement can be completed at either SDSU or UCSD, but should involve two different classes. The only other courses acceptable for the teaching requirement will be courses in your dissertation topic area and must be approved by your Advisory / Dissertation Committee. At least one of the two teaching semesters/quarters must be in epidemiology or biostatistics. The semesters when you are enrolled in teaching units (Field Supervision), you will be expected to assist with grading course materials, hold help sessions, and present at least one lecture to the class during the semester. This requirement can be completed before or after advancement to candidacy.

Research and Dissertation (6 units/semester)

The Ph.D. dissertation should consist of original epidemiologic research that adds significantly to the existing state of knowledge. The project should include original data collection, although your Dissertation Committee may waive this requirement provided that you have had significant experience with original data collection through another project. After advancing and completing required coursework, students will register at SDSU for 6 units of Research (PH-897) each semester they are working on their dissertation. When the student plans to defend his/her dissertation, they will then register for 6 units of Dissertation (PH-899) if they fail to complete in the Spring semester they will need to register for three (3) units of PH-899 for the summer. Summer registration is not budgeted. The student will be responsible for payment.

Epidemiology Research Exchange Conference

UCSD and SDSU partner with the San Diego County Health Department and the Naval Health Research Center each year to host a conference which highlights local epidemiological research. The day-long conference is usually held the first Friday in May. Students are expected to attend this conference every year. Presenting research is also highly recommended. Students taking FPM 259 at UCSD (in 2nd year of program) will be required to present their research at this conference.

Overview of the Epidemiology Preliminary Exam

This examination (offered every summer) will test your ability to understand basic principles of epidemiology as well as require you to integrate and apply these concepts. The exam will include, but is not limited to, the material covered in the Epidemiology Core Classes of PH601 (or equivalent), 623, 820A, and 820B and may include the following topic areas:

• Study Design (case-control, cross-sectional, prospective studies, outbreak investigation, community intervention trials, ecologic studies);
• Screening (sensitivity, specificity, PPV, NPV);
• Sampling (simple random, systematic random, stratified random, cluster sampling);
• Causation;
• Measures of Frequency (incidence, prevalence, rates/ratios/densities/ – crude, specific, adjusted);
• Effect and Association (ratio and difference measures);
• Analysis of Vital Statistics;
• Precision;
• Validity;
• Bias;
• Confounding;
•  Matching.

In addition, you should be familiar with the use and interpretation of:

• Sample Size; Power
• Stratified analysis (M-H methods)
• Regression
• Analysis of Follow-up Data
• Interaction (effect modification)
• Test for Homogeneity
• Dose-response/test for Trend.

Preparation should also include review of:

• Principles of Infectious Diseases Epidemiology (outbreak investigations, infectious concepts, control of infectious diseases) and Chronic disease epidemiology (risk factors and disease outcomes or major chronic diseases).

Studying for the epidemiology Preliminary Examination should include review of material covered in the Epidemiology core classes (listed above) and studying from any of a number of epidemiology textbooks. Texts which may be particularly relevant for the exam include:

• Modern Epidemiology, (Rothman)
• Methods in Observational Epidemiology (Kelsey)
• Foundations of Epidemiology (Lillienfeld)
• Case-Control Studies (Schlesselman)
• Epidemiology (Gordis)
• Field Epidemiology (Gregg)
• Statistical Methods for Rates and Proportions (Fleiss)
• Statistical Methods in Cancer Research Vol. 1: The Analysis of CaseControl Studies (Breslow & Day)
• Statistical Methods in Cancer Research Vol 11: The Design and Analysis of Cohort Studies (Breslow & Day).

Overview of the Biostatistics Preliminary Exam

This examination (offered every January) will test your ability to understand biostatistical concepts and applications of biostatistics to the analysis of epidemiologic data. Topics will include, but are not limited to, those topics covered in 602, 627 and 628 (SDSU) and may include the following: probability and probability distributions, relationship between populations and samples, sampling distributions, point estimation, construction of confidence intervals, hypothesis testing for the one-sample and two-sample problems, analysis of categorical data, simple and multiple linear regression, simple and partial correlation, one- and two-factor analysis of variance, analysis of randomized blocks, statistical issues related to confounding and interaction, use of dummy variables, analysis of covariance, concepts of stepwise variable selection, logistic regression, analysis of
covariance, concepts of stepwise variable selection, logistic regression, maximum likelihood estimation, point and interval estimation of the adjusted odds ratio in logistic regression, likelihood ratio test, basic concepts of survival analysis, censored samples, functions of survival time, product-limit and life-table estimates, log-rank and Wilcoxon tests, Cox proportional hazards model, point and interval estimation of adjusted relative risk, basic concept of time-dependent covariates, regression diagnostics for multiple and logistic regressions, principal components analysis, cluster analysis, ordinal and polychotomous logistic regressions, Poisson regression, and analysis of longitudinal data using mixed effects models.

Studying for the Biostatistics Preliminary Examination should include review of lecture material covered in the SDSU biostatistics core courses (listed above). In addition to the books listed under Epidemiology, many of which discuss biostatistical methods, the following books will also be useful in studying for the exam: Fundamentals of Biostatistics (Rosner), Applied Regression Analysis and Multivariable Methods (Kleinbaum, Kupper, Muller, Nizam), Computer-Aided Multivariate Analysis (Afifi and Clark), Logistic Regression: A Self-Learning Text (Kleinbaum), Survival Analysis: A Self-Learning Test (Kleinbaum), Statistical Analysis of Epidemiologic Data (Selvin).

Process

Depending on your background and experience, you should plan to take the Preliminary Exams after either your first or second year of study. The Advisory Committee can provide input as to your readiness for these exams. The Epidemiology Preliminary Exam is administered every July and the Biostatistics Preliminary Exam is administered every January. To take the exam, you must first notify the SDSU Director of your intentions by June 1st for the Epidemiology exam and by December 1st for the Biostatistics exam. The SDSU Director will determine the exact dates for each year’s exam after consultation with the students who have provided written notification of intention to sit for the examination.

Development

The exams are developed from questions submitted by Epidemiology and Biostatistics faculty from both campuses. The Preliminary Exam Committee is made up of the Co-Directors plus at least 1 other faculty from each institution. Two members of the Preliminary Exam Committee will independently grade each exam without knowledge of the student’s identity. Both readers will agree on the assignment of a numerical grade for each exam. If two readers disagree about the competency of a student, a third member of the Preliminary Exam Committee will evaluate the exam.

Scoring

Scoring of the exams will be on a 100-point scale. Students with a grade of 80% or higher will receive a Pass. Students with a grade of 75% or lower will receive Fail. The Pass/Fail status of students with a grade of 75% to 79% will be determined on an individual basis. For these students, the Preliminary Exam Committee will review the student’s record and the items missed on the exam and determine whether the student will: 1) be given a Pass conditional on taking additional coursework in weak areas; 2) be asked to answer additional questions in weak areas to determine Pass/Fail status; 3) be given a Fail and be instructed to retake the entire exam the next time it is offered.

Appeals

If you feel that your exam was graded unfairly, you may appeal in writing to the SDSU Program Director. In these cases, the JDP Steering Committee will decide the appeal. All communication between the student and Steering Committee will take place through the Program Director until the appeal has been decided. The Steering Committee will render its decision within 10 working days after the appeal is received, or as soon thereafter as a quorum of the Steering Committee is available. The decision of the Steering Committee is final with respect to the substantive issues. You have two attempts to pass each of the preliminary exams. If you do not pass on the second attempt you will be asked to leave the program. Readmission to the program requires a petition to the JDP Steering Committee through the Program Director.

When working on any research project while in the JDP, all students must ensure human subject concerns have been addressed by having the project approved by the Institutional Review Board (IRB) of both SDSU and UCSD. All research projects are subject to IRB approval, even analysis of data that have already been collected. Research projects that involve primary data collection must have IRB approval prior to any data collection.

Human subjects’ forms and instructions are available at each institution. For additional information, location and maps to the offices, or to obtain online forms for SDSU see

Human Research Protection Program and for UCSD see http://irb.ucsd.edu.

Pre-Candidacy

Each year you will receive a comprehensive progress review. The review for pre- candidacy students is to be conducted by the Advisory Committee and signed by the Co- Directors, and the student. The evaluation is used to track the student’s progress through the program. In preparation of your evaluation meeting, please complete the Doctoral Student Progress Form  and bring along the form.  Additionally you will need to review and sign the online UCSD Spring evaluation.  Please follow this link to the online Annual Spring Evaluation Tool to complete that requirement  The Spring Evaluation is due to the UCSD Graduate Coordinator by June 1.

In the event that a student has established their committee, but has not yet advanced to the In-Candidacy status; the student’s chair will be responsible for the generation of the evaluation. Online signatures in this scenario will include the student, committee chair, the directors from UCSD and SDSU, and the Program Chair from UCSD.

In-Candidacy

Each student in PhD candidacy is to receive an annual substantive progress review. At least three members of the student’s doctoral committee are to participate in the review. The review should cover the student’s progress to date, recommended modifications to the dissertation’s scope or methodology, and timetable for completion.

The doctoral committee chair shall write up the results of the review and discuss them with the student. All members of the doctoral committee participating in the review (at least 3 including the Chair), the student, the UCSD and SDSU directors and the Program Chair at UCSD are to sign the online progress report.

The Spring Evaluation is due to the UCSD Graduate Coordinator by June 1.

Please note: failure to complete the spring evaluation will create a hold on your UCSD account, which will prevent you from registering the following fall quarter.

The only exemptions for submitting Spring Evaluation are students who will advance to candidacy or graduate in spring quarter (when the evaluation is due). Students need to notify both Directors, via email, in either of these cases. Also, those students that are on an active Leave of Absence (LOA) are not required to submit a Spring Evaluation Letter.