A day in the life of a public health trainee

The working day

Day-to-day work varies considerably depending on what attachment you are doing at the time.  Most jobs, however, will be 9 to 5, Monday to Friday, and desk-based.

In a PCT environment you may be given certain portfolios of work to look after - e.g. Diabetes, Smoking or Cancer Public Health.  Your job would be to ensure the PCT is providing the best possible service to its population in these groups, as defined by the principles of good public health practice (see What is Public Health?).  Alternatively (or in addition), you may be asked to undertake some discrete pieces of work - e.g. a needs assessment (see an example here) or a health equity audit (example here).  This may require a fair amount of time out-and-about at informal or formal meetings (see below).  For an idea of how national policy can affect and guide public health programmes see the policy and legislation page.

Some services are more 'reactive' - i.e. the workload is determined by day-to-day events.  An example would be health protection work, which may be relatively quiet during the summer but much busier in winter with Nursing Home viral gastroenteritis outbreaks, and vaccination campaigns to help co-ordinate.  Work levels may vary widely on a week-to-week basis. For a tongue-in-cheek look at the health protection see Catherine Heffernan's website.

Academic public health may involve setting up or helping with a trial, reviewing or collecting epidemiological data, or undertaking some other type of research (e.g. literature review or meta-analysis).

Organise your own time

Usually you will be in control of your own time.  That is, so long as you can get your work done as requested by your supervisor/trainer/line manager then you decide how to run your day.  However, things like meetings (in all jobs) and telephone calls (mainly reactive services such as health protection) may interrupt your careful planning.  Coming from a medical background it can be quite strange working in an office environment to begin with - there is rarely an equivalent of the 'doctors' mess' to relax, but stress levels will generally be much lower.

Meetings and conferences

Depending on where you're based you'll either be invited to a lot of meetings you'd like to go to but don't have the time, or you'll have the time but be invited to meetings that sound less edifying.  If you're lucky you get the best of both worlds, with a pick of interesting meetings plus time to get on with the rest of your work.  A lot of Public Health is about influencing policy (rather than directly being able to dictate it), so meetings are an inevitable part of life. However, if they are planned well and used properly (e.g. timings and agenda stuck to) they can be a very productive way of getting things done and making professional contacts in your local area.  Conferences are usually a day or two of concentrated meetings or seminars focusing on a particular topic.  Examples of some current seminars are listed on the Noticeboard.

Work colleagues

Who you work with will depend a lot on where you are.  However, if you're based in a PCT you'll be working with other Public Health staff (the local DPH, Public Health Managers and possibly other Public Health Registrars in larger PCTs) as well as all people from other bits of the Trust that keep things going, like the Clinical and Nursing Directors, Finance and Commissioning Departments.  You may also be involved in Media and Communications. 

If you're in a Health Protection Unit you will generally work with the CCDC, along with Specialist Nurses and/or other Specialist Registrars.  You are also likely to have frequent contact with local Infectious Disease and Microbiology units, and Environmental Health teams (based at the local Council).

Given the scope of Public Health though, there's a high chance you will work with a wide range of other individuals at some point in your training, including clinicians from all different areas of care, emergency service representatives, local government, charities, SHA and Department of Health staff to name but a few.  There may be also be opportunities to get involved at a national or even international level. 

Patients....?

More likely to be the card game than the living variety.  Whilst there are some opportunities for patient contact, these are limited and the closest you will usually get will be the other end of the phone.  If you come from a medical or nursing background this may be a big change to your normal working practice.  However, it does make some sense given that the very nature of Public Health is taking one step back and looking at the whole, rather than the detail of an individual's care.  The exception to this is health protection work (including on-calls) when you may well need to give advice on a particular case (e.g. meningitis) to try to protect the general public's wellbeing.  Even then such advice would usually be by telephone and would be in conjuction with a clinician.

On-calls

Many regions don't involve Trainees in the on-call rota. In Oxford we are involved, and the Trainees act as 'first on call', so we deal with any problems ourselves if possible, or consult our DPH/CCDC colleagues on-call for further advice.  On-calls are done from home, on a roughly 1 in 8 basis; call frequency can vary, but one or two calls during an evening period is common.  Calls will often be about the local needlestick policy or contacts of meningitis cases seeking prophylaxis.  Other issues dealt with out of hours include water pollution/supply problems and major incidents (including chemical spills).

The Faculty of Public Health decided in March 2006 that people newly entering Public Health training can only start on an on-call rota after passing the Part A of the MFPH exam.

Teaching and the MPH

Your 'normal' work days are likely to be interspersed occasionally with training days, when the local deanery or the Trainees themselves have organised the odd day or half-day of teaching for the Trainees.  Additionally, in many locations Public Health Trainees will have an opportunity to help with teaching Public Health to local students (e.g. medical students).

Part of the Public Health training programme also involves doing a Masters in Public Health (or equivalent degree).  During this period you will be away from the normal work environment and back as a full- or part-time student at Uni.  This is generally an integral part of the training scheme, and you remain on a salary throughout (phew!).  At some point before finishing the training programme you will also need to dedicate some of your time to working for (and passing!) Parts A & B of the Faculty of Public Health exams (see MFPH page for more information).