Training the Problem-Solvers: Students Prepare for Public Health’s Complex Challenges
In the flipped classroom, Columbia Mailman students take the driver’s seat.
Today’s topic is the ethics of egg donation and fertility clinics. Five students take turns presenting in front of the class—Xinyu Cai, Yizhe Li, Nancy Nguyen, Ashley Tay, and Jiayi Wang. They unpack a $30 billion industry with little to no international oversight, where women with the means to afford fertility treatments rely on poorer women whose eggs are harvested for minimal compensation. Donors face health risks ranging from swollen, painful ovaries to early menopause or reduced fertility, and sometimes, eggs and women are trafficked across borders.
Now the class weighs in on tough questions: Should egg donation be banned between countries? Is compensation a form of coercion? Can informed consent exist amid poverty? How do we balance reproductive freedom with protecting women’s health?
Reactions vary. One student argues that an outright ban could have unintended consequences—regulation might be better. Another student challenges the group: How can we call compensation coercive without centering the donors’ voices? Professor Miriam Laugesen, associate professor in Health Policy and Management, adds another layer: enforcement hurdles.
The Columbia Mailman flipped classroom has students independently study material beforehand, then use class time for active, collaborative problem-solving, transforming them from passive listeners into engaged leaders who tackle real-world public health challenges.
The egg harvesting lesson plan was entirely student-developed. Other sessions this semester have tackled equally charged topics: gun ownership and femicide; whether medical research exploits vulnerable populations; and the ethical tightrope of making weight-loss drugs like GLP-1 agonists accessible, balancing healthcare costs and public health priorities.
Public Health at Its Core
This spring, 379 MPH students are completing the second semester of the Columbia Mailman Core. In the fall, they master fundamentals—biostatistics, health equity, and social determinants of health—while honing leadership skills in small cohorts. The Integration of Science and Practice (ISP) course bridges the gap between academia and real-world public health work.
As the semester concludes, students gain more autonomy, presenting and leading discussions throughout four sessions. “We give them latitude to choose topics, develop content, and design presentations,” says Laugesen. The goal? Cultivate leadership and teamwork skills typically learned on the job.
“Today’s jobs demand collaboration. The Core isn’t only about social connectedness, which is good for health and good for organizations—it’s also about functioning as a team,” she says. “Students learn to own projects independently and present them compellingly.”
Collaboration in Action
Ashley Tay and her group spent several weeks refining their lesson. “We met weekly to synthesize research,” Tay recalls. “I focused on the lesson with Nancy, while others designed class activities.” They trimmed tangential issues like surrogacy from the lesson plan to stay focused.
The process was instructive. “I’d considered egg donation’s ethics but not its legal gaps,” says Tay, who plans to become a public health lawyer. “It’s women’s health—so oversight is sparse.”
Most importantly, the exercise mirrored real-world public health work. “It taught me to collaborate and moderate tough discussions,” she says. The respectful dialogue? Proof it worked.
