Printed from Public Healthy (URL:
http://www.publichealthy.com/trainingoverview.aspx
)
Public health training in the UK
Public Health training has recently undergone a number of changes. These were not only changes specific to Public Health, but also to
training in all medical specialities. These latter changes are part of the
Modernising Medical Careers (MMC) programme and applied to posts commencing
from August 2007.
Traditionally a medical background was required to enter Public Health
Specialist Training to be a Public Health consultant, but in the last few
years the training has opened up to non-medical graduates. The main
consultant roles are as Consultant in Communicable Disease Control (CCDC),
Director of Public Health (DPH) or as a general Consultant in Public Health.
A smaller number of individuals become Consultants in Academic Public
Health.
Non-medics currently in training are termed Specialist Trainees (SpT),
and medics Specialist Registrars (SpR), although (slightly confusingly)
'trainee' can refer to either. Jobs starting after August 2007 are
Specialist Training (ST, or StR) posts.
The Specialist Training (ST) programme takes five years and is overseen
by the Faculty of Public Health (FPH). Medics are eligible to apply after
completing their Foundation years (F1 & F2), and non-medics should have 3
years' post-degree experience in a health-related field, although some
applicants may have more experience than this.
Training is organised in local areas by academic Deaneries (contact details for Deaneries). For more
information on how the training programme is structured see below.
For information on applying for Public Health jobs please see the
FAQ
page.
In some Deanery areas there are opportunities for Foundation Year 2 (F2)
posts in Public Health, which can be a good 'taster' before committing to a
full ST rotation.
It is anticipated that under the MMC programme some Deaneries will offer
FTSTA (fixed-term specialty training appointment) posts, which will be
time-limited posts equivalent to ST1 or ST2 training (and equivalent, prior
to MMC, to Locum Appointment for Training - LAT - posts). Individuals taking
up an FTSTA post would need to apply for a full ST programme at the end of
their post(s), although any subsequent programme would be shortened by the
length of the FTSTA post.
The Training scheme usually lasts 5 years during which Trainees rotate
around attachments which vary in length between 3 months to 2 years. These
are normally in the Deanery region, but if an individual has a particular
interest may sometimes be further afield at national centres or even abroad
(e.g. with the WHO). There are currently minimum lengths of time which must
be spent in a Primary Care Trust (PCT) setting and working in Health
Protection. For examples of work carried out in attachments see
Topics,
and to get an idea of the breadth of subjects relevant to Public Health look
at old news stories here.
During training, individuals take a Masters in Public Health (MPH) or
equivalent MSc. Depending on the Deanery area this is either taken as a year
full-time, or studied part-time. The degree may be sat locally or elsewhere,
such as the London School of Hygiene and Tropical Medicine or
Liverpool.
Examples of some other MPH courses are listed on the
noticeboard. Masters
are usually funded as part of ST training, and are sat early in the training
scheme as part of preparation for the MFPH exams.
Upon successfully completing the Training scheme the individual is
awarded a CCT (Certificate of Completion of Training, previously CCST) which
entitles them to apply for Consultant posts.
Day-to-day work will vary depending on what attachment you are on. Click
here to read a bit more about what it's like to be a PH trainee.
Pay for current medical Public Health trainees (i.e. SpRs) is the same as
for an equivalent hospital training job (for up-to-date figures see the
BMJ
Careers site). PH posts are either unbanded or receive a small supplement
(e.g. 1C) if the post-holder takes part in a local health protection on-call
rota (see Day in the life...). New entrants to the training programme will
not be able to participate in on-calls until they have obtained their MFPH
part A, so banding will usually only start later on in the scheme.
A regular salary usually continues throughout any integrated MSc/MPH
course.
Current Public Health non-medics (i.e. SpTs) are paid at a similar (often
slightly lower) rate than SpRs, although this may still change depending on
the final implementation of
Agenda for Change.
New MMC posts have equivalent salaries.
During the Training scheme individuals are expected to pass Part A
(formally Part I) & Part B of the Membership of Faculty of Public Health
(MFPH) exams. Part B is a new exam called the OSPHE (Objective Structured
Public Health Exam) which will be similar in idea to OSCEs (Objective
Structured Clinical Exam) in clinical medicine. Part A is normally sat
during or after completing the MSc/MPH.
For more information on exams see the MFPH page.
Current Specialist Registrars and Specialist Trainees are assessed
annually under a system called Record of In Training Assessment (RITA),
which has been common to all medical specialties in the UK at Specialist
Registrar level. A number of new assessments are being considered as part of
MMC (see MMC Assessment page).
Until 31 May 2006 an option was open for individuals who had not
undergone formal training to be recognised as a
'Generalist Public Health
Specialist', based on retrospective assessment of a portfolio of work.
Completion of this 'portfolio route' made participants eligible for the
UK
Voluntary Register of Public Health Specialists.
A new portfolio route superseded this on 1 June 2006 also for individuals
who have not undergone formal training, but who wish to appear on the
Voluntary Register as
'Defined Specialists', working in one particular field
of public health. Individuals who wish to become general Public Health
specialists at consultant level are now all expected to go through a formal
training scheme, as described above.
As well as reorganisation of PH training there has also recently been
another round of NHS changes, including the merger of PCTs in many regions.
The structural changes in part reflect a shift in the function of local NHS
organisations from care providers (i.e. staff provide direct patient care)
to commissioners (i.e. the organisation can 'outsource' or buy in private
care from elsewhere if they wish).
Although these actions are unlikely to affect training dramatically they
may alter the location of some placements.
For more information on applying for jobs, interviews, etc. see the
FAQ
page, where I've answered some common questions. I've also tried to list
most of the complicated acronyms on the Glossary page. The following
websites may also be helpful:
Faculty of Public Health
FPH main site |
Training
in Public Health |
Training portfolio
Noticeboard (internal link) - free
listings of public health courses, seminars, masters programmes and more
Public Health in the Oxford Deanery
Oxford Deanery |
MSc in Global Health
Science
Public Health in other deaneries
List of deaneries (COPMeD)
Eastern Deanery Public Health Training
Department of Health - changes to NHS structure and medical training
Modernising Medical Careers |
Medical Training Application Service |
'Commissioning a patient-led NHS' pages including updates
Alma Mata Global Health Network
- information on careers in international health, including
international PH
Careers in Environmental Health - how to be an EHO
Chartered Institute of Environmental
Health careers website
NHS Networks - sharing information and good practice
NHS Networks |
Public Health |
Discussion forums
PCEL - Primary Care Electronic Library
PCEL, St George's, University of London
Got more questions or need some careers advice? Contact
me here to see if I
can help.