Epidemiology Training: Developing the Next Generation of Research Doctors

Epidemiologists investigate who is affected by certain diseases and the factors contributing to those patterns. The field originated in response to past epidemics, when researchers began to examine disease trends. Today, the scope has expanded to include modern ‘epidemics’ such as cancer and cardiovascular disease, but any illness can be the subject of epidemiological study. Because individuals differ in genetics and behavior, epidemiological studies often involve large groups – hundreds to thousands of participants – and place a strong emphasis on methodology and statistics.

Training the Next Generation of Epidemiologists

At the LUMC (Leiden University Medical Center) in the Netherlands, the Department of Clinical Epidemiology offers a PhD training program. Astrid van Hylckama Vlieg, recently appointed as one of two trainers alongside Rolf Groenwold, explains: “This is an epidemiology-B program, a national PhD-level training. Students learn a broad foundation of conducting good research in various ways. The program comprises several components, including courses – both organized by ourselves and by Boerhaave Nascholing – and elective courses. Participants complete a doctoral dissertation and a minimum of four articles with an epidemiological focus.”

“Notice a limited number of places available, which is why we ask interested individuals to apply,” van Hylckama Vlieg continues. “Once admitted, they spend a year with our department, fully immersed in epidemiology, methodology, and attending research meetings. This shapes them into epidemiologists.”

Results as Truth

Géraldine Lafeber and Lodewijk Pet represent this new generation of epidemiologists. Lafeber explains: “I really see epidemiologists as doctors of research. Throughout my studies in Medicine and Biomedical Sciences, research was a recurring theme. What struck me was that when questioning the validity of results, people always turned to epidemiologists. That meant that if I were to read a publication later, I would have to defer critical assessment to them. I didn’t want that; I wanted to be able to do it myself. I found that incredibly fascinating!”

Pet adds: “I studied Medicine and realized that I always enjoyed the scientific aspects during my clinical rotations. With much of the research I encountered during my studies, I sometimes thought, ‘Something seems wrong if I were to work this out, it seems like it would cause problems.’ But I didn’t quite know what to do with that feeling. I felt that before offering commentary or judging whether something was good or not, I needed to know more about how research works. That led me to the epidemiology training program. Coincidentally, a PhD position became available to research quality and integrity in biomedical research. That was precisely why I wanted to pursue the training, so it all came together beautifully.”

Appreciating Nuance

Research is integral to the LUMC. What distinguishes the epidemiology training program from research in a bachelor’s or master’s degree? Lafeber explains: “In epidemiology, you don’t just learn *how* to do something in a certain way. You delve much deeper into *why* you’re doing it. In every course, you immediately apply the new knowledge you’ve gained in practice. And you write at least four papers with a methodological or epidemiological framework. You think about it much more thoroughly and can also discuss it effectively with your supervisor. There are countless ways to find an answer to a research question, and perhaps even ten different ways to answer it. You learn not only to apply research but also to explain it.”

Pet notes: “I also noticed during my medical training that scientific research was a relatively small component. You learned two important designs for scientific studies, and if you could remember those, that was considered excellent. In the epidemiology-B training, we go into much more depth. Fortunately, there’s also growing attention in bachelor’s and master’s programs to explaining why a study is well or poorly executed. Research is the foundation of treatment guidelines. At the same time, students will later have to make medical decisions themselves. It’s then helpful to look at the science to see what is known and to be able to assess its value.”

A Tangible Skill

With the knowledge gained from the training program, the PhD candidates often become the point of contact within their own departments. Lafeber says: “Thanks to the training, I can not only identify that something may not have gone entirely correctly in a study but also argue why it should be done differently, or why conclusions shouldn’t be accepted without question. I feel more confident because of the knowledge I’ve acquired. When I returned to my own department after the training, colleagues came to me with questions, and I was able to provide answers. That was incredibly rewarding! That’s a very tangible skill I’ve gained. We have a close-knit group of PhD candidates with whom People can still discuss things even after completing the program.”

Van Hylckama Vlieg adds: “And as supervisors, we continue to learn as well. For example, Lodewijk is now giving a lecture on artificial intelligence, and the head of the Epidemiology department is listening attentively.”

The evolving landscape of epidemiological research reflects a growing recognition of the need for rigorous training and a deeper understanding of research methodology. As new challenges to public health emerge, the role of the epidemiologist – as both investigator and critical evaluator of evidence – will only become more vital.