Hello,
I'm wondering if any of you might have any advice for
me in my difficult decision about where to pursue
graduate work in health promotion/education.

I have been accepted to the MPH program in the Health
Behaviour and Health Education department at the
University of North Carolina (UNC-Chapel Hill), and am
on the waiting list for the MHSc Health Promotion
program at the University of Toronto.  I am going away
on a backpacking trip this weekend for several months
and am trying to make up my mind before I go in case I
should be accepted to the Toronto program over the
summer.  I plan to pursue my career in Canada after
graduation.

Does anyone have any thoughts on either of the
schools? I realize that the approaches to health
promotion in Canada and the U.S. tend to be different
-- with the U.S. having a more individualistic
lifestyle and behaviour change approach and Canada
looking at health from the perspective of inequalities
within society and  social determinants of health
(Ottawa Charter, WHO definition of Health Promotion
etc).  However, I have been told that more and more,
an ecological approach to health promotion is being
incorporated in the American curriculums.

My interests at this point are in women's reproductive
and children's/adolescent's health.  I am interested
in learning more about incorporating lay health
advisor interventions into community health
programming, learning about methods for community
members to explain their health needs to
policy-makers, educational approaches for different
cultural groups and behaviour change strategies. At
this point, I hope to work for an international health
NGO for a few years after graduating. These are my
interests so far and I look forward to seeing how they
will evolve throughout my graduate degree and career.

Like the U of T program, the UNC program has a very
strong community-based approach. Both schools require
students to do a field placement practicum over
several months.  At U of T, you also do a field
inquiry practicum where students conduct an inquiry
into an issue in health promotion practice using an
agency as a resource and pilot for carrying out the
inquiry. At UNC, there is a 6 month long "community
diagnosis project" in the first year which is
conducted in student teams in local communities under
the guidance of field preceptors from local
collaborating agencies. At UNC, students must write a
big comprehensive examination at the end of the first
twelve months of the program to assess a basic level
of knowledge and competencies.  The courses at both
schools seem to be sort of similar and both programs
have limited electives.

I guess what I'm asking you for is your opinion on
whether a degree from UNC would be well-recognized in
Canada and whether it would be advantageous to have a
degree in health education from a non-Canadian school
just for the new training/ideas I might be exposed to
and bring back to Canada, whether you think the
research and work opportunities in the U.S. would be
much better than in Canada, whether Canadian
organizations would look down on an American degree
because of the completely different health care
systems. Also, I'm wondering if the differences in
definitions of health education/health behavior and
health promotion between the two countries is
perceived to be so different by Canadian health
promotion academics and practitioners that getting my
education in the U.S. will negatively affect my
career.  What about the community diagnosis and
individual project experience I will get in the U.S.
while I am studying there? Will that be well
recognized in Canada?

One of the main reasons I am hesitating about the
American schools is the costs.  It is probable that I
will get a job working on a research project with a
professor and possible that I will get tuition
remission, but this cannot be guaranteed before I
would arrive in the fall. If I am convinced that the
experience of studying and working in the U.S. would
be worth the expense, I will go for it.

Do you have thoughts?
Thanks for your help and sorry for my long-windedness!
Erika Steibelt

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