What are consultants in public health?

Consultants in public health or public health medicine are essentially senior managers who provide strategic and systems leadership to improve health expectations and reduce health inequalities.

They are skilled across the three 'domains' of public health (health protection, health improvement, healthcare) but in practice they may specialise in one area, e.g. screening, health protection.

How do you become a Consultant?

The graph below illustrates the different routes you can take to becoming a consultant

Could you explain the routes a bit more please?

There are essentially two routes to becoming a consultant - a prospective route and a retrospective route.

Prospective (Training) Route

The main prospective route into being a public health consultant is to complete the five year postgraduate training programme in public health as outlined in Hot Desk . This is where you start as a junior doctor and work your way through your competencies. Unlike other medical specialties, public health training programme intakes non-medical graduates as well as medical. The difference is that non-medical consultants are registered with the UK Public Health Register whilst medical consultants are registered with General Medical Council. Medics need to demonstrate that they have met the Foundation requirements in order to be considered for GMC registration. If not, they'll be registered on the UK Public Health Register. Some medical public health registrars therefore apply for the CESR route (see below) whilst doing the training programme if they want to have GMC registration rather than UK Public Health Register registration.

There is also the CESR-CP route for medics. Applicants start at ST3 so they will need to have achieved Diplomate and Membership of the Faculty of Public Health. It is usually registrars of other medical specialty programmes who take this route as they already have some competencies done. See fph-combined-programme-guidance-oct-2023.pdf for more information.

Both non-medical and medical consultants perform the same jobs and have to keep their competencies up-to-date including annual professional appraisals as well as their managerial appraisals and continuing professional development (returns of which are submitted annually to the Faculty of Public Health). Consultants also need to be revalidated every 5 years and Public Health England runs a revalidation appraisal scheme for its employees.

Retrospective (portfolio) Route

For the retrospective route, you need to demonstrate that you meet all the competency requirements before applying for registration. Referred to as 'the portfolio route', this is restricted to people who have held senior public health posts for several years. They need to demonstrate through a portfolio of past work that they meet the required competencies to become public health specialists. Medics and non-medics can apply to do the Specialist Registration by Portfolio Assessment (SRbPA). This was opened in September 2018 and is a two stage application process. For more details, please see UK Public Health Register. They have a lot of guidance and helpful guidance posted here. They also run Q&A sessions and workshops. Contact register@ukphr.org for more details.

Medics also have the option of doing GMC portfolio route. This was previously called CESR (Certificate of Eligibility for Specialist Registration). This is an assessment against standards of UK CCT curriculum and the application is online via the GMC. Once you activate your account, you have to submit your application within 12 months. Typically it takes 6 months from submission to the GMC making a decision. To be eligible, you need to have had 6 months continuous training in public health or in a specialist medical qualification and have a specialist qualification in public health (e.g. Masters in Public Health, the Faculty of Public Heath exams). Submissions should demonstrate recent and periodical 360 degree or multiple source feedback, workplace based assessments, full information on activities undertaken and full audit cycle. Having the diplomate and membership parts of the FPH exams is not mandatory but is advisory as they demonstrate a number of competencies. If a medic on the public health training programme has not met the foundation requirements for GMC and wish to have GMC registration, s/he can apply for the CESR within the training programme. See GMC website for more details.

The Faculty of Public Health has information on both routes. Please see CESR & CESR (CP) - FPH - Faculty of Public Health for more information.

It is worth noting that the retrospective routes may have an element of prospective work as you may have gaps in your training which you will need to address with new pieces of work or placements.

What about dental public health?

The route into dental public health specialty training is a bit different. Dental.hee.nhs.uk provides a good overview on how to get into it. Dental public health is about preventing oral diseases, promoting oral health and reducing inequalities in oral health. Further information can be found at Dental Specialty training.

I have a degree in public health, should I apply for the specialty training programme?

You will need to gain some experience first working in public health as a manager, analyst, officer or other public health post. The specialty training programme is training senior managers and leaders who specialize in public health, so you will need to be able to demonstrate that capability.

Are there any recruitment or information events?

Public health introductory events will be posted on the NHS England Public Health Recruitment Hub webpage:

https://medical.hee.nhs.uk/medical-training-recruitment/medical-specialty-training/news/regional-recruitment-events-and-taster-days

UK Schools of Public Health

It is worth looking on the webpages of the Schools of Public Health in the UK. Many of them will do taster evenings, where you can find out what it is like to train and work in public health in the UK. Please have a look at the schools below for more information.
Public Health Training London Deanery
Public Health Training Severn
Public Health Training East of England
Public Health Training Yorkshire & Humber Deanery
Public Health Training West Midlands
Public Health Training East Midlands
Public Health Training North West
Public Health Training North East
Public Health Training Wessex
Public Health Training Thames Valley
Public Health Training Scotland
Public Health Training Wales
Public Health Training Northern Ireland

Useful Links

http://www.fph.org.uk/public_health_careers

https://www.healthcareers.nhs.uk/

Agile Work

How to become a Consultant in Public Health