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Doctors at Work Podcast.

Episode #43

What’s a career in public health like? With Joe Home

Mat Daniel


In this episode, Joe tells me what a career in public health is like. Public health is about working at global and population level, and with much more long term outcomes than many doctors may be used to. It’s also about dealing with the root causes of disease, rather than the end symptoms. Training is varied, you get to mix with lots of different people, and in different contexts.

Joe Home is a London-based Public Health Registrar with a medical background currently. Prior to starting training he undertook Fellowships in NHS management, health policy and leadership. He completed his medical studies at Peninsula Medical School and completed a masters degree in medical law and ethics at the University of Manchester School of Law and an MBA at Alliance Manchester Business School.

He is currently undertaking a Masters in public health at London School of Hygiene and Tropical Medicine and holds an honorary research position at The University of Salford School of Health and Society. You can find him on LinkedIn.

Further information on the public health training programme can be found here.

Podcast Transcript

[00:00:00] Mat: Welcome to Doctors at Work. My name’s Mat Daniel and this podcast is about doctors’ careers. Today we’re talking about public health. In this episode, Joe Holm tells me what a career in public health is like. Public health is about working at global and population level and with much more long-term outcomes than many doctors may be used to. It’s also about dealing with the root causes of disease rather than the end symptoms. And training is very varied. You get to mix with lots of different people and in many different contexts. I hope the podcast is useful.

Welcome, Joe. Tell me a little bit about yourself.

[00:00:47] Joe: Hi Mat, so thank you for having me. I am so my name is Joe. I’m a medical doctor by training and currently a public health registrar on the UK Public Health Training Scheme. In terms of the training scheme itself, I’m based in London, started off in East London, working in local authorities there, and then I’ve moved into the London School of Tropical Medicine, which is where I’m based now. What attracted you to public health? I think public health is an interesting specialty for a myriad of reasons, really. And I guess in some ways, there’s probably a truth that actually medics don’t necessarily know what they get themselves into a lot of the time of public health.

Certainly, in my medical school, it wasn’t something I was exposed to particularly. And but one thing that I did find in my journey into public health was I was, I was working in A& E, I was seeing patients and certainly I was seeing the same patients come in every day. And I think that was really challenging because they would come in and they would come in because they were perhaps experiencing homelessness or victims of sexual violence, and I could patch them up, I could give them antibiotics, but certainly I wasn’t really doing anything to change the circumstances that drove me to the A& E.

And then subsequently they’d come in the next week with a similar problem. And I think that really led me to rethink what I, what health meant to me, what healthcare meant to me, and how, how best to serve the population. And though a few of us have different experiences of what I found was there’s a certain element to clinical work that I loved definitely, but there was also elements to non-clinical working, longitudinal kind of working and project-based working and taking more of a bird’s eye view and, speaking to colleagues and speaking to some of my mentors.

It seemed that public health perhaps could offer that and certainly, I did want to stay in medical training. And I think there’s probably, we could talk about that all day about professional identity and, do I, how to see yourself as a medical professional. But certainly, I was really keen to, to stay in the public sector and stay in in some way in serving the population.

And it seemed like the balance of all of those things. public health seemed like quite, quite a good fit. I was also very fortunate, I think, to have some really good mentors in this space. So, one of my mentors in one of my other jobs, she has done amazing things with her career.

She certainly has crafted her career in a way that I think other medical specialties are only just starting to do in terms of building that portfolio and broad skills. really been self-directed. And I think inspiring people like that along the way, really cemented the idea that public health was a great place to be.

[00:03:36] Mat: And is that a fairly typical route into public health, do you think, or do other people do it for different reasons?

[00:03:44] Joe: It’s a really good question. In terms of I guess there’s also a question of who does public health and what kind of people are in public health. Public health is, as far as I know, the only training specialty where non doctors can apply, and certainly we really benefit from the diversity in the cohort.

I’ve got lots of people in my cohort who are not from medical backgrounds. They haven’t practiced clinically. They perhaps have worked in government or research or NGOs humanitarian aid. And this brings a real wealth of experience to the cohort of public health trainees and then later consultants.

But I think people’s reasons for doing public health as well are really varied in that public health. isn’t a homogenous kind of job. Within public health itself there is sub, several subspecialties, and the different jobs are very different to one another. They’re all non-clinical, so unless I were to do work outside of my training role, so like locum work or something, then certainly I wouldn’t be seeing patients, and I haven’t seen patients for quite a long time.

Again, there’s a question around professional identity there and I could talk about that a bit more, but public health does bring people who want to be change makers. I think it brings people who want to take that broader view of health and health care. But it also offers lots of different things.

So, some public health consultants will end up being very good at data analytics and people who really love academia and research really. Public health is an amazing specialty to build that kind of career. Equally, if you’re really interested in policy levers, working at the centre of power, working in a way that small changes could influence or incrementally improve the life of, whole populations, public health is also a great place to find that kind of work.

There’s quite a few public health trainees I know who were really taken by global health and people who come in from perhaps an infectious diseases perspective, they’ve wanted to, or some people have trained infectious diseases, and they really want to build on that. And similar to what I described, they found that, working in some environments they could treat the diseases, but they weren’t treating the cause of disease, which was often social deprivation.

It was often macroeconomic factors. And public health allows you to build that global career. There’s, we’re really fortunate in that lots of the big global health organizations, the World Health Organization, the United Nations Medicine Sans Frontières, all of these places are quite a natural fit for public health registrars and consultants to really deliver value to whole populations.

I think that there is also something to be said about public health and that it’s a very different way of working to a clinical specialty. We do have on calls and those on calls are typically non-resident taken from home in terms of outbreak control and really trying to protect the health of the population that you’re serving.

But largely there’s lots of remote working public health. It’s. somewhat of a flexible specialty in lots of the rotations you do. You’re outside of the hospital environment, which for some people is a positive, some people is a negative. And I think that all of those things build into quite a unique proposition as compared to almost any other specialty.

There’s also, I’ve spoken about it very well there, but there is some negatives to that as well, of course, and going from a very thriving, very vibrant hospital environment, where, you’re constantly interacting with patients, you’re constantly interacting with colleagues, and it’s very social in that regard public health is quite different to that a lot of the time, there’s a lot of asynchronous working, there’s lots of working independently it’s, it, lots of desk based working, I would say probably the majority of the work is desk or computer based And, that suits some people, it doesn’t suit others, but fortunately, because of the breadth of public health as a specialty, I think that you can find your value in what, find a role that, that gives you the value that you need.

And sorry, that was a desperately long-winded answers the question.

[00:07:50] Mat: You mentioned identity and as doctors, okay, so you train and you do your hospital meds in your general practice, maybe some laboratory related stuff. And then in public health, you leave all of that behind and you go and work in an office and you’re training alongside people that are not medically qualified.

How do you navigate that?

[00:08:16] Joe: It’s a really good question, and I think it’s a question that public health as a specialty sometimes has grappled with, and certainly as an individual, that moving away from that traditional perspective and image of a doctor wearing a stethoscope and scrubs has been an interesting sort of journey, and there’s certain moments that make you reflect I’m sure lots of public, medically trained public health doctors or public health registrars have had similar conversations, the ones I’ve had from grandparents or family members. And they say, but are you still a doctor?

Do you still count as a doctor, but you don’t see patients. And I think that, isn’t it’s a very interesting Personal identity and professional identity thing to come to terms with because for, contractually, I’m a doctor. I’m registered to the GMC. I’m on health education, England training program, training to be on the specialist register in the same way that a general practitioner is, or a general surgeon is.

But it, it really is very different in that I don’t provide clinical care. And to, to a degree, it’s been so long now since I’ve seen patients face to face and I’ve provided that, clinical assessment, clinical plan. And clinical decision making that I almost don’t really feel like a doctor anymore.

And I, I think that is quite a common thing. And sometimes medical doctors who do it find themselves in somewhat of a dilemma and people approach that in very different ways. I’ve got colleagues who still work part time clinically. I’ve got colleagues who do lots of locum work to keep up their clinical skills.

I certainly think there’s a value there, but I think. Having worked in a few different policy roles at local and national levels, there I’ve seen in myself a risk that policy can be quite far from the population and one can start to almost lose touch with the population that we’re trying to serve.

And I think clinical practice is very important in that because it gives you that finger on the pulse of, what do the real people in this country how do they live their lives? And how can we then, bring that lived experience, lived experience by proxy, to policy and decision making.

But certainly, it’s something, that idea of, Me wearing scrubs and a stethoscope and all the different elements of that in terms of personal and professional identity is certainly something I’ve not bottomed out myself and it’s something that I still think about quite often. But equally, I have colleagues who don’t think about that at all.

In terms of the second part of the question around… How do we navigate people, or how do we work with people who have not had a clinical background? So, in public health, we’re very fortunate that we have people from allied health professions who are public health registrars. So, physiotherapists, speech and language therapists and we’ve also got people who and…

I think that says a lot about the specialty in terms of the diversity in terms of the, our ability to approach solutions and problems or approach problems and develop solutions, I should say, because medicine is an interesting world. It’s we’re taught in a relatively linear way. I would say we approach problems from a patient in front of us perspective, which is really useful as a doctor.

And. But actually having that challenge by people who’ve come from very different backgrounds and very different experiences is absolutely crucial to developing good policy, to developing good health systems and develop, improving health for the population. I think that, in public health, we do have some great people on our program who wouldn’t be there if it was medics only.

And people from really diverse experiences. I’ve got colleagues who’ve worked in, worked in the World Bank, or they’ve worked in global NGOs, and they bring a perspective and experience that would be hard for, I think, a medic to bring. As a result, I learned so, so much from those individuals and, I’m hopefully, they learned something from us as well, but yeah, I, but it is a different dynamic, I think, because certainly a lot of those people haven’t really engaged and never had to engage with training programs in the same way that, medics do throughout their careers.

And I think non-medical careers can be somewhat less structured and more flexible, which has pros and cons. And then, in the same way that I say that some of the doctors grapple with not seeing patients anymore when they’re in the training program, I think some people who’ve worked in really interesting positions and in really interesting organizations doing great work also have to grapple with Oh, what is this medical training program?

What’s a TPD? How, what’s this portfolio all about? And so, I think we, we all have our own challenges, but certainly a lot of the value in the registrar training program, and then the consultant body comes from this diversity of experience.

[00:13:34] Mat: It’s interesting because if I think of my clinical roles here’s a very insular world where it’s full of people that are just like me and some of my nonclinical roles, it’s, the life’s actually much more interesting because it’s full of people that are nothing like me. So, and that’s good. And I think that there’s an interesting dichotomy, isn’t it?

That, okay. You want to change the world and we all want to change the world. And the reality is that if you’re focused on treating the one patient in front of you, you’re not changing the world. You’re changing that one person in front of you, but you’re probably not making a difference.

And if you are, as you’ve outlined, it sounds to me like public health, it’s very much about values. And, what’s your value in the world? If changing the global health scape, if that’s a strong value. then the reality is you’re not going to achieve that by treating one patient at a time, yeah?

So, you’ve got, the only way you’re going to achieve that is by saying, okay, if I’m going to change global healthscape, I need to change that on a population level, not on an individual level.

[00:14:36] Joe: I think it’s a really good point. I suppose I would agree and disagree because I think, each person that you’re treating and each person who as a clinician is, that, that interaction and that treatment of whatever sort of specialty or method that is, is incredibly valuable.

And certainly, a healthcare system cannot work if you don’t have clinicians providing healthcare. And I think it, it, the difference, perhaps, is that it depends what you find particularly fulfilling and valuable in a role. I’ve got lots of friends and colleagues. One of my very good friends is a paediatric registrar.

And the joy he gets from providing critical care to very unwell neonates is incredible. And there is multiple neonates that if people like him didn’t work, then they wouldn’t be here. And I think that the. That is just an amazing thing to be able to do and say and some of the challenge of public health is that I will probably never be in a petition where I will be able to hand on heart say there was a critically unwell child, there was a critically unwell elderly person, I really helped that person have a good death, I really supported that family through a grieving process, or I had a really satisfied interaction with someone at a very vulnerable part of their life.

And those, very tangible and very, very real emotional interactions you have with people are what makes medicine and healthcare so amazing. And there is a trade-off there because in public health, it’s, you may be in situations where you do get those interactions, but I would say it’s infinitely rare.

Most of the time we will design a piece of work or, a health program or a health system or health promotion that in reality is going to benefit a population, hopefully in, the perfect prevention mechanism might benefit a population in 20 years’ time, in which case you might have done what could be seen as a lot of good, but you’re not as close to seeing that and you don’t feel it as strongly.

And I think, again, it’s that sort of doctor, non-doctor relationship or not clinic, clinical doctor to non-clinical relationship where, as a clinician, there’s very rapid feedback of what you do, I was in A& E assessing a patient and I’d know very quickly whether what I was doing was working or not working.

Whereas in public health, we could design and implement a program which. We might never be able to measure whether it worked or not. We just have to hope, because some of those health outcomes are very difficult to measure and they’re in a very long time. And, as a, if you’re in a very senior public health position, in a national position, for example, it may be that you have You develop a new program of work.

So, one that comes to mind is the discussion around smoking and the cigarette ban which I think is currently proposed by Rishi Sunak. And actually, that was heavily influenced by public health professionals and the evidence was built by public health professionals and academics. And those individuals will probably, the benefits from those interventions won’t be apparent for a long time which is so different from doing, I don’t know, a craniotomy and all of a sudden you see whether it worked or not.

And I think it’s almost difficult to compare ’cause they offer such different value in terms of the value you offer to the citizen or, but then the value that you derive from it yourself as well.

[00:18:36] Mat: So, what motivates you to do that? So, you’re giving up this instant feedback, this instant high that you get from making a difference.

You’re giving all of that up and instead you’re trading it for something where the incomes are. The outcomes are much more long term and perhaps less tangible. So, what motivates you?

[00:18:58] Joe: That’s a really good question. I guess there’s probably a, there’s probably an answer I’d like to give and maybe a more honest answer, who knows.

So, the answer I’d like to say is that actually, I, I want to have an impact on A broader population, I want to be able to improve the lives of people where I can in a proactive rather than reactive way. And I think certainly that’s the nature of public health, trying to be proactive, preventative.

Rather than the kind of current model of healthcare, which is very reactive which a lot of clinicians work within, or medics work within? Certainly. I think the slightly perhaps what another more honest answer is that actually I ne I was probably quite an average doctor, I think. And having worked in system improvement and.

Sort of leadership positions. I really enjoyed that. I really enjoyed the longitudinal nature of working. I really enjoyed, building relationships and collaborating with people across different sectors, different backgrounds, and really trying to build networks. To then allow other people to work at the top of their license to improve clinical care.

And I think probably what I saw throughout my career even before starting public health was, I think that’s probably where I could add most value to the population and to the system. Rather than being maybe an average, maybe a sub average, depends who you ask, SHO. I could deliver quite good value to an organization or a system or a government department by working in that way rather than working on the shop floor, I think.

[00:20:47] Mat: So, what kind of skills do you need?

[00:20:51] Joe: So, I guess in terms of skills, I would say that if this was a question from prospective applicants to public health, I would say. Going in with an open mind. I don’t think you need to have any particular skills before starting the program. I think the program is very good at building skills and just some background.

Sorry, the registrar training program is a five-year program. You apply through Oriel. The application is open at the same time as other programs every year and other specialty training programs SD one to five. If you’ve already got a master’s in public health, it’s four years, if you don’t have a master’s in public health, one of your years will be doing a master’s in public health full time.

And it depends, the nature of that time depends on which dean you go to. And public health is very privileged in that way, actually, as a specialty, in that you get a full master’s paid for, you get your salary paid whilst you’re studying a master’s. And. To some degree, you are supernumerary for the whole of training now that there’s some, some people might slightly disagree with that, but actually compared to medical specialties or clinical specialties, we really get to design our own programs, which means that actually, do you need any specific skills?

in order to get onto the program. I wouldn’t say so. I think if there’s any medical doctors listening to this, I think that actually the skills you have already, the skills of communication, the skills of working under pressure and the skills of making decisions in sometimes tense situations.

absolutely all you need to get to be able to get into the program and then throughout the program you’ll have opportunity to build all the skills you want to. In terms of the skills on the program there’s I guess it’s useful to talk about what, where public health is in the UK at the moment.

There’s a huge focus on planetary health. So that’s how does environmental health, how does that affect the population? How does rising global temperatures affect the population? How will it affect the population in the future? There’s a big emphasis on health inequity of which, you know, looking at figures, the UK is huge, which doesn’t really make sense when we have free at point of access health care.

Everyone in theory has access to the exact same level of health care and health information. So why do we have such health inequity? So that’s one of the things that I think is, we do a lot of and because of that, we do lots of collaborative work and we do co development with local communities.

And there’s also, opportunity for it to be a very academic specialty as well. So, if you’re very academically inclined, you can build it in, you can build your training program into one that’s quite academic with quantitative and qualitative methodologies, but I wouldn’t really worry about not having the skills to get in.

I know colleagues who’ve come straight from FY2 as doctors without necessarily. swathes of experience in non-clinical kinds of working or academia and have really taken to the program. I guess it goes maybe back to your question about values and I think that public health suits someone who perhaps has the values to improve the health of the population, people who really value diversity, people who really value, improving and focusing on some of the most underserved communities and doing what you can to support communities and individuals.

So, I’d certainly say, rather, you don’t need to be a data analyst to apply to the program. You don’t need to have done lots of academic research. But if you can bring that mindset and those values of, I want to improve, which I think, most doctors, I probably don’t know any doctors who don’t want to improve things.

That’s the nature of the business, isn’t it? So, I think just having that, that positive mindset. And really focusing on where can, where and how can I make things better is the key to public health really.

[00:25:00] Mat: I hope you’re enjoying the show. If you are, please click subscribe so you will be notified when new episodes come out. This podcast is part of my mission to help doctors create successful and meaningful careers. You can be part of that mission too by forwarding this show to any one person who you think might benefit from listening. Thank you. Now on with the show.

How do you get in?

[00:25:26] Joe: Great question. So, the public health training program you apply through Oriel similar to other training programs.

It’s slightly different if you’re non-medical or if you’re medical. If you’re a medical applicant, then you will have you just have to prove that you’ve done your foundation competencies or at least your… Confidence, the level of foundation competencies over the last three and a half years. And then you’ll progress to be eligible to the exam.

The exam’s set in January. There’s a mixture of elements to the exam. So, there’s a situational judgment test, a Let me sorry, I do have it written somewhere. Oh, what’s a Glaser critical thinking test and a numerical reasoning test? I know some people do use question banks That I think the theory behind these tests a bit like the UK cat is that the you can’t apply you can’t prepare for them I think a lot of people who are successful do prepare for them And if you meet the minimum pass grades for the test, you’ll then go to the interview stage and the interview is usually held I think in February then your combined score of your test and your interview leads to a ranking and then you rank the jobs in the UK.

If you’re non-medical, you have another hurdle to go through at the start to make you eligible to take the initial test. And that’s to prove that you have. at least 46, sorry, 48 months of full-time work post-graduation in a public health sort of area. That’s, it’s somewhat vague what that means. It could be policy.

It could be research. It could be got a colleague who was working in operations but in healthcare organization. So, it’s quite open to interpretation. So, you need 48 months of full-time work in a health orientated career. of which 24 months have to be at AFC band six or higher.

And then if you meet that eligibility criteria, then you’ll be, then you get through to take the test. And then if you get through that, the interview. I think typically there, I think this year there’s 125 jobs in the UK in this application. That went up quite significantly from last year. I think usually there’s about 90 jobs or slightly less.

Not quite clear whether or not they will keep the same number of jobs. The, these things always do seem to change, but. I would say that anyone who’s interested in applying, and I applied two years in a row. First time I took the exam and got the minimum grade to get through it to go to interview, but my ranking wasn’t high enough to get an interview.

So, I didn’t get to the interview stage. Second year I applied, I Did quite well in the exam and then got through to the interview stage and got a job. It’s very it’s quite often that people have applied several times. And I think if you’re thinking of applying, there’s nothing to be lost.

It doesn’t cost anything to apply. And. Certainly as a medic, the actual application process is very straightforward in the first instance, you just put your personal details into Oriel, there’s no white space questions, you don’t have to submit any portfolio or anything like that. So, it’s one of the quickest applications you could do as a medic, actually, I think.

[00:28:37] Mat: What does the interview involve?

[00:28:41] Joe: Oh, it’s a little while since the interview. But as far as I can remember, there is a few different elements to it. There’s a few different stations. One of them is a competency-based station. So that’s talking about what you do in certain situations similar situation of judgment, the first part of the interview, as far as I can remember, and I could be completely wrong here, it may have changed.

But you’re given some element of public health information and you then got to present it back to the panel. And there’s also something, at least in the year that I applied, they sent you a piece of public health information 25 And you had to prepare a very short presentation just an oral presentation, no slides just to talk through that public health problem and then present a policy solution.

And the interview certainly, I think, is quite challenging for people who’ve not worked in non-clinical context before. And there’s some good content online about what it might look like. And I would really recommend really trying to do as much preparation as possible if that’s what you want if you get through to the interview stage.

[00:29:50] Mat: And as a trainee, what’s your typical week like?

[00:29:57] Joe: It’s very difficult to say what a typical week may look like, because the training jobs can be so different. I’ve worked in local governments, so local authorities in East London. I’ve worked at the UK Health Security Agency as a trainee. Which is… Very different. So, in local government, you might work with local stakeholders, building relationships with the voluntary sector, the charity sector, local leaders, looking at how to promote health, how to, what the needs of that population are and how you can improve it.

the UK Health Security Agency. It’s very much that is, slightly more clinical in that it’s quite a reactive role. You’re looking at how to improve or reduce the amount of health challenges in the population you’re serving. So that includes infection control, it includes if there’s any radiation leaks, chemical exposures and how to mitigate that.

So that includes lots of communicating and coordinating with local schools, GP practices, hospitals, nursing homes. It’s a very sort of your coordinator response to often outbreaks and it’s often infectious disease. So that includes lots of phone calls, lots of meetings. When it goes to other places, so I’m currently at the London School of Hygiene and Tropical Medicine doing my master’s in public health, which is part of the program.

And there I’m a full-time student effectively. I’m actually a part time student, but most people are full time students. Doing a master’s program which is again a very privileged position. Once you get through that side of the program, so the program split into two phases. So, there’s phase one where you do health protection at the UK Health Security Agency local government work, which I described, and your master’s if you haven’t done it already.

And then you have two exams, the part A and the part B exam. And then you go into the next phase of training. And within the next phase of training, you effectively design your own training program. And you are enabled allowed to decide what kind of consultant you may want to be. So, for example, for those people who I mentioned earlier, who have a real interest in global public health, you might want to work in organizations like the foreign office the foreign…

the FTDO, which I can’t quite recall what it stands for now the Foreign Commonwealth and Development Office. Some people work at Médecins Sans Frontières you could work in different global functions of the UK Health Security Agency. However, if I decided that I want to be. An academic public health consultant, I could then choose to do academic rotations.

So, in London, we’re very fortunate in that I could choose to go to the London school of hygiene, UCL, Imperial, all as part of my training. And you can really tailor your program. Some of it is identifying where your learning needs are and what you. where your gaps are and how to fill those gaps in organizations.

And some of it is discussing with the training program directors what kind of consultant you want to be, what kind of public health specialist you see yourself as in the future. It may be that you want to work. deep in the bowels of government making policy and supporting policy decisions, in which case you might choose to go to the Department of Health.

There’s options to work with people like the Chief Medical Officer or the Deputy Chief Medical Officers and gain lots of exposure experience to that national decision making. Lots of registrars work in, also work, choose to work in acute trusts. Given that public health perspective and helping develop their health services with a public health sort of mindset and framing.

I’m just trying, I’m sure there’s lots of other really interesting placement opportunities. So, the National Institute for Clinical Excellence

yeah, I think, yeah, there’s just, to NHS England. It’s really very unique in that way. And the other thing just to build on that, I would say is that. trainees who find unlike other clinical training programs, if I were to find that my learning objectives were not necessarily being met in whichever placement I was in, you can negotiate and discuss with your program directors to change.

And I think that’s also a very privileged position. I can’t imagine if you’re an orthopaedic surgeon and you weren’t getting enough hips that you were doing, you could just ask to move hospital. Whereas certainly here. If my training needs weren’t being met, I could choose to end a placement slightly earlier than I’d anticipated and choose to move somewhere else where my learning objectives were going to be achieved, which again is, very unique to public health.

And we’re very fortunate that we can build our portfolios in that way.

[00:34:30] Mat: I think that sounds great that it’s focused on the learner. For any other trainees that are listening, if I think with my experience of surgical training it is possible also to move and in fact, it’s quite often that the training program directors would move trainees to an area where the trainees’ objectives are being met. Other trainees can be reassured that their learning needs are also take into account.

If I take forward to consultant level, then I take it that also means that consultants work in all of those different areas. There’s not one path. You don’t become a consultant and there’s a choice of teaching hospital or district general hospital, so it’s all of those avenues that you’ve outlined, that is where public health consultants work?

[00:35:14] Joe: No, certainly. And there is, the majority of consultant posts exist within local authorities. And actually now, integrated care boards and integrated care systems have a big public health consultant cohort working within them. But I’ve worked with consultants who’ve worked in organizations like UCL Partners.

I’ve worked with consultants who’ve worked in think tanks like the Health Foundation or the King’s Fund. And then you do have those big. there’s sort of national policy roles as well work, working with the Department of Health and developing health systems and developing providing that analytical health focus and that core element of public health.

Or just general policy, actually, a lot of the time, places, even like TFL has had registrar placements there before. So, some of these national organizations or regional organizations, which, on an initial observation might not have that distinct link to health, taking that broader perspective of health and that.

You know what we I guess try for in public health and you can go do placements there and there is there’s consortium jobs there a lot of the time.

[00:36:30] Mat: Wonderful. And my final question, what would be your top tips for a doctor who’s considering a career in public health?

[00:36:39] Joe: I think. One thing I found quite challenging when I first applied and I wasn’t successful was that if you’re in the clinical world certainly in some parts of the country, it may be that you don’t have much exposure to public health or public health registrars or public health consultants.

I was quite fortunate in that I did a national fellowship with the Faculty of Medical Leadership and Management. where I got lots of exposure to public health registrars and consultants and having lots of discussions with them about what they did. And as I said, it’s a specialty that has very different kinds of roles very different kinds of ways of working.

It was really crucial to. have as many conversations as possible with public health registrars and consultants to get an idea of what their day is like, what they did. And no registrar probably has the same experience. So, I would try and reach out to as many as you can. And it’s a specialty that is a portfolio specialty in lots of ways, which means that lots of these people will be present on some forms of social media like Twitter or LinkedIn.

And I think for the most part, current registrars and consultants. know that there’s those barriers to knowledge and to applying, I would actually probably be quite happy to have a conversation, grab a coffee, have a team’s call. And certainly, whenever anyone reaches out to me and asks if they can have a chat about what it looks like to be in public health, I’m more than happy to.

And I think that, as it’s something that you don’t see in medical school as much. And you don’t really have your, it’s, I think it’s quite infrequent that people do these jobs in their foundation rotations. It’s a difficult place to gain experience or get an insight into the role. And it’s just really trying to find those people who are doing the role at the moment and reach out to them and have that conversation.

[00:38:35] Mat: Wonderful. Thank you very much, Joe.

[00:38:37] Joe: No problem at all. Thanks very much.

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