Core Education – Doctors:
Occupational Medicine as a Trainee Consultant
By Professor Harj Kaul
Occupational Medicine-is the branch of medical practice that is concerned with the bi-directional relationship between work and health.
It is not regularly taught at a medical undergraduate level although you might have come across it in other modules such as GP, respiratory and dermatology. Some postgraduate doctors may have had some exposure in their foundation years.
On the other hand, some doctors/medical students may have had some experience as a patient/client/employee/student in accessing an opinion for continuation of their training/employment through occupational health practitioners e.g., nurses and doctors.
It is important that before embarking on this potential career pathway, background reading and making some speciality contact is undertaken. Initially, it may well be with a regional Training Programme Director (TPD), a representative of Health Education England (HEE) or Regional Speciality Adviser (RSA), a representative of the Faculty of Occupational Medicine (FOM). Medical practitioners thinking about the speciality commonly make preliminary contact by email or telephone call.
Medical Practitioners need to appreciate that this is an intensive training programme, over four years full-time. This equips individuals with broad skills so that after completion of the training, they have the necessary skills to be an independent accredited specialist practitioner registered with the GMC to work across the UK plc employment environment. There are number of chief medical officer posts at board level for national and international companies as well.
A regional TPD/RSA will be happy to be personally contacted to guide individuals. Support with taster sessions is provided, including sitting in clinics and taking part in supervised educational workplace visits. This allows individuals to ask questions and explore what normally constitutes “a Day in the life of an occupational health physician”. Active trainers will have postgraduate doctors in training (PGDiT) within their departments who can be shadowed. This can be very varied depending on the industry and geographical location that they work in.
Regional TPD’s can advise on the training requirements and expectations of the GMC approved training programme. They’ll be happy to share the annual expectations of progression through from ST3-ST6 mapped against the latest GMC curriculum.
The speciality has an above-average number of less than full-time postgraduate doctors, mainly in the NHS, but accommodated in industry training posts as well. There is also an above average culturally diverse and female intake into the speciality. Movement between the NHS and industrial training posts does occur to complete the full programme.
The current recruitment ratio varies between 5:1 to 8:1 applicant to an ST3 post, although in 2023 it was 11:1 On average, there are 10 to 12 trainees that finish the training programme per year.
Most training posts are in the NHS, approximately 30-35, with 10-14 in industry within England/Wales. Scotland has between 5-8 active training posts. There is ongoing significant interest in 2023 to deliver hybrid shared training e.g., split responsibility between the NHS and the private sector and such a post exists between the NHS and Ford UK in the East Midlands. This should improve the numbers going forward and the exposure to different training, employment environments simultaneously. Some of these posts are already being delivered between the NHS and the defence Deanery.
How do I enter the training programme – Requirements
All NHS posts are recruited through the National Recruitment Process, which is delivered by HEE twice per year. This will be advertised at https://specialtytraining.hee.nhs.uk/Recruitment/Recruitment-timelines and Oriel.
Non-NHS posts can be advertised in various platform e.g., Society Occupational Medicine (SOM) or LinkedIn. The Employer of the post will have their own recruitment process however all applicants must also attend the national HEE recruitment to be “benchmarked”. The purpose of benchmarking is to ensure that all trainees entering the specialty are above an appointable threshold.
Those who wish to have an NHS post will be offered an available training post in the order they are ranked in the national interview, until all posts are filled. Those who wish to enter a non-NHS training post only, need to be benchmarked but do not enter the ranking and will be appointed directly by the training provider. Those who successfully benchmark but are not successful in finding a training post can retain their benchmark status for 6 to 12 months depending on which post they apply for next. The National School of OH may contact them if a non-NHS training post becomes available to seek their permission to put them in touch with the training provider. Otherwise, these appointable OM PGDiT’s (Post Graduate Doctors in training) need to regular contact the National School of OH to see if posts become available.
Professor Harj Kaul has been the national training programme director at the National School of Occupational Health since 2016. He has been a trainer and TPD in the East Midlands since 2007 and currently supervises 3 CCT PGDiT in Occupational medicine. In the recent past he was a Part 2 MFOM examiner and is a current dissertation assessor.