Will you blossom in public health medicine?

Cambridge consultant and academic David Pencheon discusses the prospects for the budding public health physician.

Public health medicine is the medical specialty devoted to improving health in populations rather than treating illnesses in individuals. The specialty has always had a profound impact on the health of the population in the UK, particularly at the turn of the last century. It continues to have an important effect both within health care and on the other (often more important) determinants of health, such as housing, employment, and the environment.

What do we do?

In Britain most public health physicians work for health authorities, health boards or their equivalent, in the communicable diseases centres, or in the armed forces. An increasing number work, either part or full time, in trusts or in primary care, and some work outside the health service-where, after all, most health is won or lost-in local government, a relationship which dates back into the 19th century.

Public health physicians tend to be subdivided into those who are consultants in communicable disease control (CCDC) or their equivalents full time and the majority who are involved in wider health care strategy, and who only get involved in communicable disease control work when on call. Although it is easy to recognise, for example, surgeons, by looking at what they do in a day, the range of professional activities with which public health physicians are associated is much broader. Some provide the medical input into the strategic decision making of health authorities. Others spend much of their time identifying those areas of health care that can be improved, either in making the health service more effective, more efficient and more equitable, or more widely in the field of health promotion. Understandably the …