The Complete Guide to Becoming A Public Health Medicine and Epidemiology Doctor

Published on: 5 Oct 2021

Public Health Medicine and Epidemiology Doctor

 

The Role Of A Specialist In Public Health Medicine & Epidemiology

Public health involves measures put in place by governments and institutions in order to prevent disease, improve the health of a population and promote life expectancy. There are four domains to public health:

  1. Health protection: from environmental and biological factors. 

  2. Health improvement: by mediating risk factors such as smoking/drinking and improving living conditions and hygiene. 

  3. Healthcare public health: ensuring accessibility and efficiency to healthcare services. 

  4. Academic public health: includes compiling evidence across the domains of public health. 

Public health consultants require skills in all four domains but can choose to specialise in one. Consultants in dental public health lead and implement policies relating to dental services, nutrition and food.

They must be fully registered with the GDC, be on the GDC Dental Public Health Specialist List and have a Master’s in Dental Public Health. 

Consultant epidemiologists are involved in leading infectious disease and environmental hazards monitoring. They must analyse and assess research and evidence from a variety of sources to make recommendations and guidelines. They investigate disease outbreaks, different interventions and the cost effectiveness of each. 

There are differences between the work of a public health consultant and an epidemiology consultant, but both involve leading and working within teams to roll out new policies. Public health consultants focus on creating interventional policies aimed at specific demographics to promote wellbeing and increase life expectancy.

They must evaluate existing programmes and ensure that health services are cost-effective, safe and accessible. Inequalities in healthcare are tackled by public health consultants. Working with different organisations, managing staff, budgeting, training juniors and leading research projects make up the daily life of public health consultants. 

Consultant epidemiologists focus more on policies to survey, control and prevent contagious diseases. They are involved in planning the response to local outbreaks and evaluation of existing disease epidemiology. Advice to the public health sector and other organisations and research, training and auditing are part of the working life of consultant epidemiologists (1). 

According to Health Education England in 2017, approximately 70% of local authority public health consultants and just under 60% of Public Health Directors were female (2). 

Flexibility, leadership, communication, working under pressure, research, political awareness and respect towards other cultures are important skills and qualities in the public health sector. Employment opportunities are rising in public and global health for individuals who can analyse data and format it to develop guidelines and policies. 

 

A Typical Week

It is difficult to give an example of a typical week in a public health career due to the variation of posts and jobs. It is rare for someone to stay in the same job for their entire public health career as they will accept posts more tailored to their interests and developments. Academia and multi-disciplinary team working is to be expected in most posts. 

Often trainees are required to be a part of their local health protection on-call rota team.

 

The Route To Public Health Medicine & Epidemiology

Unlike other specialities, the training programme for public health takes medical and non-medical graduates. Non-medical consultants will be registered with the UK Public Health Register while medical consultants will be registered with the GMC.

Medical graduates who have not met the requirements for GMC registration will be registered on the UK Public Health Register. Training for public health usually lasts 5 years. 


The entry requirements for ST1 in public health include a MBBS (Bachelor of Medicine and Bachelor of Surgery) degree or a first degree (1st or 2:1) or a Masters/PhD. For trainees applying with a medical degree, full registration and licence to practice from the GMC is required as well as the completion of a UK foundation programme or two year equivalent overseas. 

Trainees without a medical degree or those applying through the non-medical route, a minimum of 48 months of work experience is required. 24 of those months must be in an area related to public health practice (3). 

The above criteria can change annually, information can be found on 

Health Education England- Speciality Training 

There are two examinations to earn membership of the Faculty of Public Health (FPH). These are the Faculty of Public Health Diplomate Examination (DFPH), previously known as Part A of the exam.

The second is the Final Membership Examination (MFPH)/Objective Structured Public Health Examination (OSPHE), previously known as Part B of the exam. DFPH is used to examine the understanding of the scientific basis of public health, passing will lead to entry into Diplomate Membership. MFPH/OSPHE examines trainees’ ability to integrate the theory of public health into its practice. 

Passing the MFPH leads to Membership of the Faculty of Public Health. CCT is awarded following MFPH (UK) membership and completion of approved training programmes and posts (4) 

Below is a training pathway for trainees with a medical background: 





There were 804 applications for 86 posts in the UK in 2019 for entry into Public Health Medicine ST1. This makes the competition ratio the highest compared to all other specialities at 9.35 (6). 

Due to the competition in entry to public health, interested trainees can attend conferences, apply for research project funding and be involved in quality improvement projects. Experience in teaching and management is valued.

Medical trainees can apply for public health rotations. At the student level, students can become members of public health societies in university and undertake electives or work experience in a public health related field. 

Less than full time training is available for interested trainees. 

 

Subspecialties

There are no distinct sub-specialities for public health medicine in the UK (7) although consultants can choose to focus on which public health domain they want to work in. Research and academia is an integral part of a career in public health. 

 

Earnings

NHS consultant salaries are the same for all specialties but vary between Scotland (highest), England, Northern Ireland, and Wales (lowest) and increase with service (up to 19 years). In 2020 the salary bands range from £77,779 to £109,849.  Salaries can be further enhanced with NHS excellence awards. 

As with any speciality, there is potential to enhance NHS earnings by private practice. JRSM reported in 2008 that the total income for public health medicine consultants was £80,659 with NHS earnings making up £66,427 and private practice earning £14,232 making the ratio 0.21. This is similar to general psychiatry (0.20) and haematology (0.20) but much lower than orthopedics (1.4), plastic surgery (1.9) and many other specialties (8).

For more information on salaries within the NHS, please feel free to review The Complete Guide to NHS Pay.

 

Resources

The Royal Society of Public Health (RSPH) publishes three peer reviewed journals. Public Health, Perspective in Public Health and Public Health in Practice. Public Health contains research papers and reviews. Perspectives in Public Health publishes opinion articles as well as peer-reviewed research. Public Health in Practice contains research behind the practicality of delivering public health and the theory behind the issues in the field (9)

 

Related Job Sources With BMJ Careers

 

More Complete Guides By BMJ Careers

 

References

  1. Public health consultants and specialists [Internet]. Health Careers. 2020 [cited 3 July 2020]. Available from: https://www.healthcareers.nhs.uk/explore-roles/public-health/roles-public-health/public-health-consultants-and-specialists 

  2. Rankin B, Speller T, Sasiak A. Public health specialist capacity - findings [Internet]. 2020 [cited 3 July 2020]. Available from: https://www.hee.nhs.uk/sites/default/files/documents/Public%20health%20specialist%20capacity%20-%20findings.pdf 

  3. Person Specification 2020- Public Health- ST1 [Internet]. 2020 [cited 1 July 2020]. Available from: https://specialtytraining.hee.nhs.uk/portals/1/Content/Person%20Specifications/Public%20Health/Public%20Health-%20ST1.pdf 

  4. The Diplomate (DFPH) and Final Membership Examination (MFPH) [Internet]. FPH. 2020 [cited 2 July 2020]. Available from: https://www.fph.org.uk/training-careers/the-diplomate-dfph-and-final-membership-examination-mfph/ 

  5. Public health medicine curriculum [Internet]. Gmc-uk.org. 2020 [cited 2 July 2020]. Available from: https://www.gmc-uk.org/education/standards-guidance-and-curricula/curricula/public-health-medicine-curriculum 

  6. Specialty Recruitment Competition Ratios 2019 [Internet]. 2020 [cited 3 July 2020]. Available from: https://specialtytraining.hee.nhs.uk/Portals/1/Competition%20Ratios%202019_1.pdf 

  7. Specialties, sub-specialties and progression through training the international perspective [Internet]. 2020 [cited 2 July 2020]. Available from: https://www.gmc-uk.org/-/media/documents/specialties-subspecialties-and-progression-through-training---the-international-perspective-45500662.pdf 

  8. Morris S, Elliott B, Ma A, McConnachie A, Rice N, Skåtun D et al. Analysis of consultants' NHS and private incomes in England in 2003/4. Journal of the Royal Society of Medicine. 2008;101(7):372-380. 

  9. Our Journals | Royal Society for Public Health UK [Internet]. Rsph.org.uk. 2020 [cited 3 July 2020]. Available from: https://www.rsph.org.uk/our-services/journals.html