A career in public health: how do I know it's for me?BMJ 2007; 334 doi: https://doi.org/10.1136/bmj.334.7589.s62 (Published 17 February 2007) Cite this as: BMJ 2007;334:s62
Gabriela Dixon describes her experience of an F2 public health placement
I was struck by the huge impact that these public health projects could have on the long term health prospects of entire communities
Like many of my colleagues, I didn't get much exposure to public health as a medical student, and so I did not consider public health as a career choice.
My interest in it was sparked by my elective in the high jungle of Peru, where I worked both at a medical clinic in a town and also on various community health, farming, housing, and sanitation projects in remote villages. I was struck by the huge impact that these public health projects could have on the long term health prospects of entire communities, compared with the small impact of treating individuals. Public health in the United Kingdom is far removed from this, but the basic principles of disease prevention and health promotion in the wider context still stand. After doing my house jobs I wondered whether public health was a career I wanted to pursue, but with little knowledge of what a public health specialist actually does day to day, this was a difficult question to answer.
Public health as an optional F2 placement
My foundation year 2 (F2) gave me the perfect opportunity to work in public health and gain a greater understanding of what public health is all about. One of the aims of the F2 year is to give a broader range of experience to young doctors, and many trusts are offering placements in specialties previously unavailable to newly qualified doctors, such as radiology, occupational health, palliative care, and public health. I did rotations in accident and emergency, general practice, and paediatrics, with public health being part of the general practice placement. My chosen option of public health was one of the highlights of my F2 year and a major factor in my application for the F2 post at Queen Elizabeth the Queen Mother Hospital, Margate.
What is public health?
Public health is defined as “the science and art of preventing disease, prolonging life and promoting health through organised efforts of society.” Its chief concerns are monitoring the health of a population, identifying its health needs, fostering policies that promote health, and evaluating health services.
What I learnt about public health
During my placement I gained a much greater understanding of the role of public health within the National Health Service. A career in public health is worlds away from clinical medicine: quiet offices and endless meetings replace the busy ward. One must be an excellent communicator, not only verbally but also in reports and projects. Although the excitement of dealing directly with patients is taken away, the job allows one to take a step back and look at the health needs of whole communities. It gives a long term view and a chance to make a real impact on the health of populations and the quality of their health services. This presents a big challenge, especially when many issues are so complex and intertwined with much larger social and cultural problems. I believe that it would be a rewarding job, essential to the successful working of the NHS.
A career in public health
Public health specialists do not have to be doctors, and there are training schemes specifically tailored for non-medics. Those wishing to enter public health as doctors must apply for one of the specialist training programmes nationwide, which normally last five years. On successful completion of training and gaining full membership of the Faculty of Public Health, a certificate of completion of specialist training (CCST) is awarded; the holder can then be employed as a public health consultant. Those eligible to apply for specialist training must have completed a preregistration year and have a minimum of two years' postregistration clinical experience. The Faculty of Public Health Medicine website (www.fphm.org.uk) gives further information. Many applicants are experienced doctors from general practice or hospital medicine who want a change of direction but have no practical experience of public health.
Benefits of my public health placement
My post gave me invaluable understanding of public health, at a stage early enough to be useful in my future career choices. I also gained an insight into the work of primary care trusts, which is rare as a junior doctor. I am certain that this will stand me in good stead in future, irrespective of which specialty I eventually choose.
With the recent publication of the first public health white paper, “Choosing Health: making healthier choices easier,” the government is putting public health issues high on the agenda for the first time. It would also seem that public awareness on many key topics is also increasing, with a little help from Jamie Oliver. At this crucial time it is important to open up opportunities in public health to junior doctors ensuring an informed and dedicated public health workforce in the future. The F2 year is an ideal starting point.