How can intervention prevent burnout in medical students? Can mindfulness support patients in dealing with chronic disease? How can we predict obesity in young children?
Do you want to find the answers to these types of questions and are you interested in conducting research in the fields of epidemiology, public health, health psychology, or psychiatry with a strong focus on mental and physical health?
Clinical and Psychosocial Epidemiology (CPE) is a selective
two-year research master. The programme is unique in the sense that
students are encouraged to focus on their individual development as
a researcher. Therefore, classes are taught in small groups.
Students can choose additional courses that suit their personal
interests and moreover, research will be conducted side by side
with scientists who are leading experts in their field.
Mental and physical health and the reciprocal relationship between these two form the basis of the programme. There is a strong focus on prevention, diagnosis and treatment of physical and mental health conditions. The central idea is that psychological, biological and social aspects all play a role in any physical condition. Students conduct research in several populations, including children, adults and elderly, with or without a physical or mental condition.
As of September 2019, the CPE programme will offer a new a track called CPE Track Health Systems and Prevention. This track bridges the research focus of CPE with that of health systems, health policy and prevention. The programme is a collaboration between the University Medical Center Groningen and the Aletta Jacobs School of Public Health. HSP Track students follow the basic CPE programme, but with a focus on health systems and prevention. This focus is mainly incorporated in the Master Thesis project, which for HSP students also includes an internship at a non-academic (Health) organization, the elective courses and the research meetings.
'Conduct research side by side with leading experts'
As healthy ageing is high on the global agenda, interest sparks for the master programme Clinical & Psychosocial Epidemiology (CPE). Program director prof. dr. Adelita Ranchor: 'Our students aim to improve mental and physical health from a multidisciplinary perspective.'
CPE offers a multidisciplinary approach to research the cause and effect between mental and physical health and behavioural changes. Its strength lies, according to prof. dr. Adelita Ranchor, in the high involvement of top researchers. ‘The programme has been established in 2007 by a dedicated group of researchers. We teach small classes so everyone can actively join in, we know every student by name and offer everyone the opportunity to delve into our researches at the University Medical Centre Groningen (UMCG) in the field of their interest. Throughout the programme students are supported by a scientific supervisor.’
Master thesis project
Where the first year solidifies the students’ basis in psychology, medicine, epidemiology, research methods and statistics, the second year focuses on the master thesis project. Students can proceed within the UMCG departments of Public Health, Health Psychology, Epidemiology, or Psychiatry. ‘To give an example of a research project,’ the programme director says, ‘one of our students is examining how depression, anxiety and fatigue influence neurocognitive symptoms after organ transplantation.’ Students have the freedom to choose a research project that suits their personal interest. ‘They can use data from large cohort studies, such as Lifelines, or set up their own data collection. On top of that, every student is embedded within the research team of their supervisor with whom there is a close collaboration.’
Research or business or government?
Most CPE students use the master thesis as the basis for a PhD proposal, which in some cases is rewarded with a fully funded three year PhD programme. But not all students choose to do so: ‘We see international students return to their home countries to implement their new knowledge in the local public health system. Plus, there are good job perspectives in international business and government as well,’ prof. dr. Adelita Ranchor explains. ‘To help students orientate, career perspective workshops are organised to see the full scale of social impact and implications of the master programme.’
'Fascinating how the brain and mind work'
Dutch student Manon Schallig joined the research master Clinical and Psychosocial Epidemiology (CPE) after completing the bachelor Human Movement Sciences. 'The subjects I liked best – psychology and medicine – form the base of CPE.'
Also appealing to her: the fact that the programme is small-scale and top researchers share their knowledge on the reciprocal relationship between the psychological and physical health. ‘There are sixteen students of ten different nationalities in my year. The professors and researchers that teach us, encourage us to share ideas and to do background research on our own initiative. With success. Every student is motivated and involved.’
The master track CPE trains students to become top researchers. Each one of them will explore the fields of Public Health, Health Psychology, Epidemiology, and Psychiatry. Within these four fields, Manon will have the choice to apply to divergent research projects. ‘In January the Principal Investigators will submit a list with projects to apply for. My aim is to participate in the research programme of Interdisciplinary Centre Psychopathology and Emotion regulation or the department of Psychiatry, where Clinical Neuropsychology is a topic as well.’
‘It fascinates me how a small dissimilarity in someone’s brain, can cause an emotional and psychological “malfunction” of some kind,’ Manon explains. ‘Psychotic disorders like schizophrenia and bipolar disorders are quite common. For healthy people it’s hard to imagine what this mental disorder means, because it is intangible.’
Functions of the brain
The twenty-three-year-old student is also enrolled in a second master programme: Clinical Neuropsychology, which is focussed on the associations between the brain and neuropsychological functions like cognition, emotion and behaviour. ‘Dementia caused by Alzheimer’s disease is a terrible disease but unfortunately also common. My upcoming internship and thesis will focus on the relationship between Alzheimer’s dementia and disease insight.
To PhD or not to PhD
At the end of the master thesis project, Manon will have written a PhD-proposal, which could give her access to a PhD-position at any top institute. ‘I don’t know yet if that’s my future, there are plenty of CPE alumni that choose another path,’ she says. ‘Moreover, it’s somewhat of a misconception that you are only admitted for CPE when you are a straight A-student aiming to do a PhD. The commitment and motivation you show in the admittance interview and during the master track can outweigh your grades.’
'Winning the prizes was great, but sharing science is the most important'
In his master's thesis, Matheus Silva Gurgel do Amaral
focusses on health literacy: the skill of handling health
information by individuals, so they can make conscious decisions
regarding their own health. 'It is very important to keep improving
access to health information and think about the most effective
ways to deliver it so people use this knowledge for their
well-being,' Matheus explains. 'Obviously, patient-provider
communication plays a big role in this. But new media like digital
applications can also contribute.'
Science is sharing
His presentations titled The role of health literacy and the potential mediating function of depression in chronic kidney disease outcomes and Improving communication with patients using a digital tool got considerable attention from the international visitors at the conference. 'It is important to share science,' the student says. 'Topics that we research in Groningen can be of great importance to other countries and vice-versa. Talking about it leads to new perspectives and maybe even opportunities for further research by like-minded researchers.'
Before coming to Groningen, Matheus worked as a resident doctor in a hospital in Brazil. His understanding of the communication that takes place between a doctor and a patient is the perfect background for his current research. 'I paid a lot of attention to not talk to patients, but with them. It frustrates me when doctors remain distant from the people coming in for medical care. Health literacy is very patient oriented, and that fits me.'
Working as a researcher, however, was completely new to Matheus. In the first year of CPE, strong attention is given to statistics and research methods. A good preparation for what follows in year two of the programme. 'Most of my days are spent analysing large data cohorts at the University Medical Centre. Statistics, data, writing my thesis. It couldn't be more different from the work I used to do,' he says, smiling. 'But I love to learn and it is fundamental for a PhD track.'
Matheus did his research on the study opportunities abroad before coming to Groningen. 'Dutch universities are known for being well organized and highly qualified. I did most of my preparations on line on this website called Nuffic Neso, which also deals with cultural differences. From punctuality and buying your first bicycle to the Dutch rain alert Buienradar – yes, every detail has been covered.' There was only one thing he didn't expect to find. 'Work, social life and me time are well balanced in the Netherlands. In Brazil, I worked around 80 hours a week. When I tell that to my Dutch friends and co workers, they look at me like I'm crazy. I love how the Dutch claim their free time and allow others to do so as well.'
'I work on what matters to me'
At the time of this interview, 24-year old Rena Bakker is busy packing her suitcase for Ethiopia. As part of her thesis in the master's programme Clinical and Psychosocial Epidemiology (CPE), she is going to collect data among midwifery students in order to evaluate their stance on disrespectful maternity care in the field. 'The fear of it being mistreated plays a huge role in the maternity mortality in Ethiopia.'
Western Europe has one of the best medical health care systems in the world when it comes to safe and respectful treatment by medical staff. Pregnant women commonly seek maternity care, with almost no exceptions. ‘In Ethiopia however,’ Rena Bakker explains, ‘only twenty to thirty percent of mothers-to-be visit a medical professional. Most women go into labour unsupervised, which causes huge risks for mother and child.’
Is a slap on the thigh encouraging when a woman does not push enough? Is shouting and yelling acceptable if a woman does not collaborate? Is it okay for a nurse to give a 16-year-old a reprimand for having an abortion? And what if it’s the second time for the girl? ‘There are seven major categories of disrespect and abuse that childbearing women encounter during maternity care, thus is the conclusion of research by Bowser and Hill performed in 2010. These categories are processed as scenarios in my questionnaire. I hope to get 400 midwifery students to participate. In particular, I am interested in assessing differences between male and female respondents. The results can be relevant for improving their education.’
Rena Bakker isn’t new to Ethiopia. During her bachelor studies in Psychology in Groningen, she ends up working there. ‘This internship sparked my enthusiasm for working in the field of developmental aid.’ After finishing her bachelor’s degree, Rena Bakker completes another internship in the healthcare branch of international development cooperation. Back in Groningen she enters the CPE-master’s programme, where her mentor introduces Rena to Jelle Stekelenburg, professor Obstetrics & Gynaecology with years of experience working in third world countries. ‘CPE enabled me to get in touch with these people. But you still have to be motivated to do a lot on your own,’ she says. ‘Most of the preparations for my research and corresponding travel and data collection aspects are done by myself. In my opinion it is a good thing that students are able to do hands-on research if they are motivated enough.’
How does she look back on her time in Groningen? ‘With all their different educational backgrounds, everyone in the master’s programme has their own speciality. We are all very motivated and ambitious. That creates a good environment and an easy way to make friends. Also, Groningen is an enjoyable city to live in, I keep on coming back to it.’