TEPHINET

Contact Information:

Please select one * New Member Continuing Member

1. Program Director's name: *

2. Address of Program:

Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country

3. Email: *

4. Phone Number: (primary contact)

5. Other Program Contact:

6. Title:

7. Email:

8. Phone Number: (other contact)

9. If the program maintains a website, please indicate the web address:

General Program Information:

10. What is the program's official name (in the home language)?

11. What is the program's name (translated in English)? *

12. If there is an acronym for the programs name, please enter it here:

13. What year did the program begin? *

14. What year did the program become a member of TEPHINET?

15. What other country(s) are involved in the program? (Please separate by commas)

16. What type of institution hosts the program?
University Public Health Institute MOH Other

Other Institution( please specify)

17. Does the institution grant a degree upon completion of the program? * Yes No

If yes, what degree is conferred upon completion of the program?

18. Does completion of the program satisfy requirements, in whole or in part, for a medical specialty? Yes No

If yes, what is the name of that specialty?

19. On average, how many hours per week of individual attention do trainees receive from mentors?

20. How many full-time and part-time staff does the program have?
(ex. 3.5 for 2 full-time and 1.5 part-time) *

21. How many articles were published in peer-reviewed journals within the past three years?

22. How many investigations of acute health events were conducted by trainees in the past three years?

23. How many surveillance systems were either established or evaluated by trainees in the past three years?

24. Does your program use a monitoring and reporting tool? * Yes No

If yes, please provide details

25. What other national organizations (private or public sector) does your program collaborate with for surveillance and response? * Public Health Institute Livestock organization OIE (World Animal Health) FAO (Food & Agric.) Ministry of Agriculture (MOA) Ministry of Health (MOH) University, specify: Other organization(s), specify: NGO, specify:

University ( please specify)

Other organization(s) ( please specify)

NGO ( please specify)

Trainee's Information:

26. What criteria are used to select candidates for the training program? (Please select all that apply) Education Current position within the national public health system Qualifications Epidemiological skills Experience Other (please specify)

Other ( please specify)

27. Approximately how many persons, in total, have trained in the program since it began? *

28. Approximately how many persons have graduated from the program? *

29. How many persons are currently enrolled in the program? *

30. How many people in each track? Epi track Veterinary Laboratory Other (please specify)

Epi track

Veterinary

Laboratory

Other tracks

Other tracks (please specify)

31. What are the disciplinary backgrounds of the trainees (in all cohorts) this year? (Please select all that apply) Approximately how many trainees are within each of the selected disciplines? * Doctors / Physicians Pharmacists Epidemiologists Laboratory specialists Veterinarian Other (please specify)

Doctors / Physicians

Pharmacists

Epidemiologists

Laboratory specialists

Veterinarian

Other (please specify)

32. How many oral or poster presentations were given by trainees in the past three years? *

33. What software/freeware do the trainees use for surveillance, analysis, or outbreak investigations? Arc GIS SAS Other statistical , please specify: Epi Info SPSS Other freeware, please specify: MS Access STATA Other GIS program, please specify:

34. Other statistical:

35. Other freeware:

36. Other GIS program:

Training Curriculum Information:

37. What training components are currently included in the program? ( Please check all that apply) Biostatistics Policy Informatics Analytic Epid Communications Laboratory Survey /sampling Descriptive Epid Zoonotic diseases Surveillance Management Non-infectious Disease Control Other: Please specify

Other: Please specify:

38. What percent (%) of the training curricula is field work?

39. (%) Course work?

40. What are the specific goals of your training program?

41. Does your program include a laboratory training component? Yes No

42. If yes, how is the lab component integrated? One degree (FETP) for all disciplines of trainees entering the program with specific workshops or modules on laboratory issues?
One degree, with two different specializations (epidemiology and laboratory specialists)?
Two separate degrees for epidemiologists and lab specialists respectively?

43. Other possibilities?

44. If no, (please check all that apply): Skills already exist Not enough time Have access to labs already Epi/lab collaborate already Not enough resources Not a priority

Other Reasons?

45. Is there interest in including a veterinary training component in the program? Yes No

46. If yes, how would you like to include this component? One degree (FETP) for all disciplines of trainees entering the program with specific workshops or modules on veterinary field training?
One degree, with two different specializations (epidemiology and veterinary epi)?
Two separate degrees for epidemiologists and veterinarians respectively?

47. Other ideas?

48. How can TEPHINET better support the program?

49. How can TEPHINET be a resource for WHO's IHR requirements?

50. Other questions/ comments: