|In-service training programme
About 90% of the two-year fellowship is taken up by in-service training
at the host institute. For the fellow to be fully integrated into the host
institute, a good working knowledge of the local language is required and
may be gained at the beginning of the fellowship by intensive language
Apart from general service duties, each fellow is expected to acquire
practical experience in three areas: (1) Design and/or evaluation of
surveillance systems, (2) investigation of infectious disease outbreaks,
and (3) execution of research projects in the area of public health.
Fellows should also develop communication skills (interaction with media,
scientific presentations, publications in bulletins and scientific
journals) and participate in teaching and training activities.
About 10% of the fellowship is taken up by formal training courses.
The EPIET fellowship starts with a three-week introductory course in
infectious disease epidemiology, held every autumn in Veyrier-du-Lac,
France. This course offers systematic lectures in applied epidemiology,
interactive case studies, practical exercises in small groups, and the
development of a study protocol based on a current public health problem
in a EU country.
During the remaining 23 months, four to five one-week courses (modules)
are held in any of the participating institutes in the areas of
communication, immunisation, surveillance, advanced statistics, and rapid
assessment methods in emergencies. Fellows are also encouraged to attend
appropriate courses organised in their host country.
Twice during the two-year training period fellows join alumni and
colleagues from host institutes in an annual EPIET scientific seminar,
where they present papers describing the results of their various services
and research activities.
Training support and supervision
Local supervision in the host institute is a major determinant of the
quality of the training and is provided by a designated trainer who may
spend 10% or more of his/her work time on supervising a fellow. Fellow and
trainer are responsible for ensuring that the EPIET training objectives
and any personal learning objectives related to the fellow’s career are
achieved. Additional support is provided by two to three training
programme coordinators, who are accessible for advice to all fellows.
During the fellowship an EPIET programme coordinator together with a
trainer and an EPIET fellow from different collaborating institutes will
carry out a training site appraisal. For one day they systematically
review the training environment and the training activities of the EPIET
fellow, then make recommendations on how to further enhance training. The
results of the visit are summarised in a formal appraisal report which is
made available to all collaborating institutes and reviewed in the course
of follow-up visits.
To date (February 2001), 62 fellows have entered the EPIET programme
(n=51) or the closely affiliated German FETP (n=11) (4). Currently, 43
fellows have completed their training; another 19 are still in training.
Figure 1 shows the number of fellows by their country of origin and their
country of training.
The average age for the 51 EPIET fellows on entry into the programme
was 35 years (range 26-46). Forty-one (80%) were medically qualified, 6
were veterinarians (12%) and one each a biologist, a pharmacist, a social
scientist and a research scientist. Thirty-three (65%) fellows held a
Masters' or higher degree in a public health-related field (MPH, MSc,
PhD); 27 (53%) had worked outside of their own country for variable
lengths of time before joining the programme.
Among the 36 EPIET fellows of the first four cohorts, 33 were
subsequently employed in an environment where they could apply and further
develop their knowledge and skills acquired. Twenty found employment in
national or regional institutes in their country of origin, four in a
centre with responsibility in European or supranational surveillance, and
five in their host site. Another four fellows extended their training to
obtain specialist accreditation.
The presence of an EPIET fellow has stimulated all institutes to
further develop links with other collaborating institutes within the EU
and to improve their capacity to respond to outbreaks within their
national boundaries (4). Trainers involved with EPIET have gained useful
experience of a wide range of training material and techniques, and the
activity fostered binds between senior infectious disease epidemiologists
from different EU countries. This has led increasingly to a unified
approach to communicable disease surveillance, intervention epidemiology,
and public health research.
Training activities and achievements
Since the first introductory course in November 1995, fellows have been
actively involved in evaluating or developing national surveillance
systems, e.g. for Legionnaires’ disease, tuberculosis, poliomyelitis,
trichinellosis, HIV infection among intravenous drug users, hepatitis B,
sexually transmitted diseases, verotoxin-producing Escherichia coli
(VTEC), waterborne outbreaks, and adverse events following immunisation.
Fellows were also involved in comparing surveillance data from
different European countries, e.g. on VTEC infection and Haemolytic
Uraemic Syndrome, Q fever, salmonellosis, campylobacteriosis, sporadic
listeriosis, and legionellosis.
At EU level, EPIET fellows and their colleagues contributed to European
networks, such as the European Working Group on Legionnaires’ Disease
(EWGLI) and the International Surveillance Network for Enteric Pathogens
Fellows investigated many outbreaks of infectious
disease at local and national level, but were also involved in most major
cross-border investigations within the EU. Between 1999 and 2000, a total
of 61 outbreaks of infectious disease were investigated at national level
with EPIET fellows in the role of lead or co-investigators (table 2).
Table 2. Examples of outbreak
investigations at national and EU level in 1999 and 2000, with EPIET
fellows as lead or co-investigators