Intended for healthcare professionals

Career Focus

How to pass MFPH

BMJ 2004; 329 doi: (Published 03 July 2004) Cite this as: BMJ 2004;329:s5
  1. Peter Cross, freelance journalist
  1. London


In the last article in our series to help you succeed in postgraduate exams, Sabina Dosani and Peter Cross give the lowdown on the membership exam of the Faculty of Public Health

MFPH consists of the diploma and part 1 and part 2. Passing the diploma and part 1 examination leads to diplomate membership, and passing part 2 leads to full membership of the Faculty of Public Health. The diploma and part 1 tests knowledge and understanding of the scientific basis of public health. Part 1 and the diploma are made up of the following written components.

Paper I (four hours) (the so called knowledge paper). There are 10 compulsory short-answer questions on core sciences of public health. Most questions will be prefaced by “write short notes on.” Paper I is in two sections:

Section A (two and a half hours): Six questions covering:

  • Research methods, qualitative research, epidemiology, statistical methods, and other research methods

  • Disease prevention and health promotion

  • Health information.

Section B (one and a half hours): Four questions covering:

  • Medical sociology, social policy, and health economics

  • Organisation and management of health care.

Paper II (four hours) (the so called skills paper). This paper tests public health skills. It comes in two sections:

Section A (two and a half hours): Critical appraisal and commentary based on an article from a journal and application to a specific public health problem. The second half of the question may be phrased in general terms and allow candidates to give examples from different contexts.

Section B (one and a half hours): Candidates have to synthesise a range of material and produce a summary, policy, or other document aimed at a particular target individual or group. Data manipulation and interpretation may form part of this.

Part 2 is designed to test application of knowledge, skills and attitudes to public health. Part 2 has three components:

Written submission

Candidates produce between two and four reports demonstrating four competencies, chosen by members of the facility as being four key competencies for practice. They are critical literary review, health needs assessment, information for planning health services, and evaluation of the effectiveness of health care and health services. Taken together, the word count for the whole submission (covering all four competencies) must not exceed 20 000.

Oral examination

Candidates are invited to summarise their written submission and are then further questioned on specific aspects of their submission. The second part of the oral exam is spent discussing issues in public health.

Who writes the questions?

The questions are set by examiners. There is an annual exam setting meeting every September to choose papers for the following year. In the past couple of years the faculty has started to develop a question bank and now draws some questions from the bank. A bank of general oral questions is available on line.

How much does it cost?

Part 1 £450

Part 2 £506

What is the pass rate?

Sixty per cent at each sitting.

The examiners' views

“People lack clarity,” says Professor Brian McLoskey, chief examiner for part 2 membership of the Facility of Public Health, “We advise them to ensure that their reports are directed towards the competency. A good piece doesn't necessarily demonstrate the competency that you are trying to get. Being clear about it in writing it and in drawing up of conclusions and action plans is essential.”

“Make sure that you stay focused on the competency you are trying to deliver,” he suggests, “put it away and come back and read it again. You get so wrapped up in writing it you get mixed up in the beginning and the end. Get somebody else to read it through who can give you advice whether it makes sense or not. Do conclusions flow naturally from the results? If you put it away and come back to it later you see where the typos are and the logic fails.”

Make sure that you stay focused on the competency

“Each person in training in public health will have a service and academic supervisor allocated,” explains Brian, “They will give guidance both in choice of the projects and writing up. We also produce guidance made from feedback to candidates going back five years: good and bad points, and there is the opportunity to sit down and talk to one of the examiners about any project work. Most deaneries also run general questions based on any range of topics related to public health and mock vivas.”

Reports can be submitted on three occasions every year. “The report goes out to two examiners who mark it independently,” explains Brian, “then they are told who the other marker is and exchange notes and agree a common mark. You are invited to London for an examination on it. The two examiners plus one observer will ask you questions: clarification or things they disagree with. The grades you can get on your submissions are a provisional pass, provisional fail and depending on your oral pass or fail. You could pass two reports and bank them and fail the other two. So you'd only have to retake the competencies you'd failed.”

Brian also explains there are changes in the pipeline: “In about three years we will have moved to an electronic computer based simulation based model.”

“We can spot when one examiner is being unduly influenced by another,” says Stephen Georg, chief examiner for part 1. “Each examiner marks all papers in their section and sends their unconferred marks to the faculty, then they talk between themselves and agree a mark for each candidate.”

Stephen says that although, “not everyone has to be a statistical genius, candidates need an element of numeracy.” He continues, “We much rather have people who say, `I don't know what this statistical test is, I'll have to go and look it up' than people who make wild guesses.” He also outlines the most common reasons for failure: “One is extensive variability: good at one bit of the exam and rotten at another. Some people are never going to be numerate and you can speculate whether you can ever train them, I'm not sure one can. One can improve people who've got a basic level but there are some people who will never see numbers. It's a very professional exam; it's about competency in the things we are asking people to do. We won't usually ask people to calculate confidence intervals in an exam but we will ask them to calculate the relative risks.”

The candidate's view

“You fail part 1 if you don't answer all the questions,” says Ash Paul, specialist registrar working for the national public health service for Wales. Ash revised by, “getting hold of past questions and writing out answers within an allocated time span.”

Ash explains how the competencies for part 2 can be written, “One of my reports had three competencies and another had one. But the danger in having a three in one is that if you fail one of the competencies the whole project fails. You have to submit all three competencies again.”

He suggests, “Go to the website and you'll see examiners have come up with a series of questions in each competency that they expect the examinee to have answered in their project.”


View Abstract