The Speciality of Public Health Medicine in South Africa: 1974–2021

Abstract

Summary The speciality, Public Health Medicine (PHM), was developed in response to political and health realities in pre-apartheid South Africa (SA), following the lead of the discipline in Britain, SA’s previous coloniser. This article describes a 47-year journey from its origins as Community Health through to current practice, based on reviews of archival material, databases of institutional stakeholders involved in trainee education and our own experiences. Embedded throughout PHM’s history are tensions between colonial forms of public health education and practice and resistance to these. As found in complementary SA research, and globally, this review shows that concerns about unclear roles, inadequate career paths and professional boundaries have preoccupied and are innate to the speciality. To be institutionalised more definitively in SA, PHM needs to demonstrate its value as a key resource for the functioning of SA’s health system and thus improve the health status of her population.