Addressing workforce gaps in public health medicine subspecialties in Turkiye: A call to action

Preventive health functions are essential to system resilience, yet remain chronically underprioritized across many European and neighbouring countries. The value of preventive public health professionals becomes visible during acute crises—pandemics, environmental emergencies, occupational health incidents—when surveillance, rapid response, system-wide coordination hinge on specialists trained in epidemiology, occupational medicine, and environmental medicine. However, the difficulty of quantifying the routine impact contributes to persistent political and financial neglect of this workforce. In Turkiye, as in other middle-income countries, these subspecialists are severely underrepresented. Despite formal recognition of public health subspecialties, the Ministry of Health has not fully integrate these roles into workforce planning or service delivery. In 2024, only 3 of 1035 subspecialty training positions were allocated to public health— underscoring institutional deprioritization. Without defined staffing models or programmatic roles, even well-trained specialists remain underutilized. On the demand side, preventive medicine is an unattractive career path for physicians. Extended training durations, additional compulsory service, uncertain career trajectories deter recruitment and retention. Addressing these gaps requires more than technical reform: financial, academic incentives must be complemented by defined career pathways, leadership opportunities, integration into national health strategies. These gaps are not merely administrative—they reflect a deeper failure to position public health as a strategic pillar of system resilience and national health security. Turkiye’s experience reflects a broader regional challenge: preventive public health subspecialties remain undervalued and poorly integrated across many middle-income countries. Without structural reforms, countries may face the next crisis with insufficient capacity to detect, respond to, and prevent public health threats.