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WORKING IN PUBLIC HEALTH IN THE UK.

Dr F. Makama Explains

So many of us are getting the more interested in Public Health in the UK and ever since I made it known that I am in this field some months ago, I have been getting a lot of enquiries from colleagues both here in the UK and back home. Yesterday’s post on this issue has prompted me to really squeeze out time to write EVERYTHING I know about the Public health, so gear up because this will be a long but interesting ride.

Public Health, here in the UK accepts three sets of professionals: 1. Medical Doctors. 2. Allied Health professionals (eg, Nurses, microbiologist, Pharmacists etc) But with a 2.1 CGPA. Take note of the emphasis on 2.1 3. All other degree holders (no matter the discipline), provided you have a post graduate degree in public health (MPH or a PhD). Bachelor’s Degree in Public health is unfortunately not accepted in the UK.

There are 2 routes to working as a Public Health officer in the UK and they are: 1. The Specialist training route by Doctors that are registered with the GMC. They go straight to ST1, through to ST6 after which they become consultants.

2. The Portfolio route by the other set of professionals (Allied Health professionals and other degree holders with a postgraduate degree in Public Health) and Doctors who are not interested in following the specialist route.

The good news is: both routes can lead you to the specialist position where you become a consultant in the public health sector. How is this possible?

The Doctor’s Route: 1. You must have GMC license to practice in the UK 2. You must have a little experience to know the ins and outs of practicing medicine in the UK 3. You should have background knowledge of public health scenarios, real life situations, applicability and how to make decisions. (This is where the issue is and this will be elaborated later). When coming from outside the UK, just use the PLAB route, come over and work for some time and then apply (usually in November). CVs will be screened and if yours is approved, you move to the next stage (which is usually in February). This next phase is writing a computer-based test which is mostly centred on some statistical analysis in solving some public health scenarios combined with aptitude test. Once you pass this, you then move to the final stage of the process: which is OSCEs. The OSCEs have about 10 stations and if I remember what my chief use to say correctly,

1. One station centers on your CV and what your working experiences entails. 2. Another station is on the publication(s) you have written, publish or about to publish. On this note, it is wise to say that publishing at least 1 publication is a criterion for entering into public health, here in the UK. 3. Another station centers on the conferences you have been to and what your contributions are 4. Then the other stations are on public health problems and how you can solve them. Once you go through this and you pass, you then enter into the training at ST1. In this training, MPH is compulsory but sponsored, which means, it is free. Your first year, or rather, your ST1 would be MPH. Immediately after your MPH, you are then eligible to sit for the first examination of the membership of the Faculty of Public Health (MFPH). The first examination is the Diplomate and if you pass, you will carry the title DFPH. Then you will be posted to do rotations in different public health organizations and associations affiliated with Public health corresponding bodies in the UK. When you are ready for the second part of the examination, you register and write it. When you pass, you then acquire the title Member of the Faculty of Public Health (MFPH); just as member, royal college of surgeons, for surgery (MRCS) or member, royal college of General practitioners (MRCGP) etc.

But you have to note the following: 1. You will need to write the first exams immediately after the MPH, because all the tricks to the examination would have been taught and some institutions like the Birmingham University go the extra mile to give courses that are targeted at passing the examination. 2. There is no given formula or clear syllabus for the second examination, but this book below has proven to have helped tremendously: https://www.amazon.co.uk/Dona.../dp/1909368954/ref=sr_1_3... 3. You need not do MPH to enter into this specialist training, it does not add any points to you, since it is part of the training. Nevertheless, if you pass and gain placement in ST1, you will not repeat your MPH, but is eligible to write the exam. 4. Writing the examination be it DFPH or MFPH, gives you no advantage to entering into the specialist training. No extra points for this, because a lot still use the portfolio route (which we will discuss next) and get these examinations done, so, if you do not make it into specialist training but you have the DFPH or MFPH already, you would be advised to use the portfolio route. Nevertheless, it is relieving if you enter into ST1 with your MFPH in the bag. 5. Permit me to say that Paul Rutter, a contributor to the book above is my direct boss and the Deputy Director of public Health of England, Sandwell local council, Birmingham… I am particularly vested in this because he was in Nigeria between 2012 and 2014 to encourage Nigerian students to come study MPH in Birmingham University. Through him a lot of Nigerians have become consultants in Public health, some of which are still very active in service, here in the UK. On the completion of your training, you will be conferred with the title: Fellow, Faculty of Public Health (FFPH).

Where IMGs have an issue with this route is the fact that it is difficult to find past questions or clues to the computer-based test and as well as the public health scenarios and real life situations, usually asked during the process of getting a placement. I have also made enquiries on how I can get in touch with these materials and I notice some nonchalance from my superiors and no response at all from the Nigerian seniors (funny right?). The only hope that I have is, Dr. Paul Rutter, himself has assured me of some materials if I meet some certain demands (this is between me and him). Though it will take a while for me to meet those demands, I hope to do so, so that I can lay my hands on some of them. If at all, there is anyone here into Public Health specialist training, then you can do us good by helping us with these materials.

The Portfolio Route This route simply, is working in public health without undergoing the Doctor’s specialist training. This route is also in two categories: 1. Those who want to become specialists in public health and in extension, potential consultants in public health 2. Those who are not interested in becoming specialists in public health. If you are not interested in becoming a specialist in public health, then just go ahead and work in any of the public health organizations or sister associations and build up your career (MPH and PhD, if you choose to).

But, if you want to become a specialist using the portfolio route, then you will need to: 1. Work for 60 months non-stop in any public health organization(s) by the closing date of your application to becoming a specialist, of which 24 months must be in an area relevant to population health practice. These 24 months should be at Band 6 or above of Agenda for change or equivalent (i.e, your salary should be > 36,000 pounds/year) and a minimum of 3 months at Band 6 level or equivalent in the three and a half years preceding the intended start date. 2. TO BOOST YOUR CHANCES: Have your MPH done and sit for the DFPH and FFPH examinations. I only hear that some people, due to their solid portfolios became approved specialists without these exams, I AM YET TO SEE ONE! 3. Register with the Uk pubic health register: UKPHR, this is the body that will give recommendation and in some times, responsible for your approval to becoming a specialist. 4. Then, if you are into research or Academics like me, publication of journals is very necessary.

BUT……There is one issue with this route. The number 1 criteria for this route to happen is: You MUST have permission to work. And since the public health service is not saturated, no one or organization will give jobs or CoS to prospective employee outside the UK to come and work in public health, hence, the need to work out this issue. So, here is my recommendation to any IMG (especially from Nigeria) coming over to do public health in the UK: 1. Use the PLAB route and get work in the UK 2. Come and work for some time, this will be part of your CV 3. The Portfolio route is your best chance and with your GMC registration and a little work experience, you may find jobs available. 4. Here is a list of 160 sister organizations that are approved by the public health corresponding authorities. The excellent news is: they mostly operate on areas relevant to population health practice and can give you a job once you reside in the UK and have permit to work: https://yougov.co.uk/.../popu.../charities-organisations/all 5. Dedicate a weekend, go through each and every organization and tick the ones suitable for you, then send them an e-mail about the potential of working with them. In most cases, they tell you to subscribe to their website so that you get instant notifications on jobs. As 9ja wey we be, I will recommend you subscribe to the website of every organization that interests you AND STILL send them an e-mail. Once, there is a job opening, you will know. If you do so to 30 out of the 160, you may get a job within 60 days. 6. Another way is to download the App adzuna (it is a recruitment and job seeking app). Download it and in the search section put in “Public health” or “Public health officer” as keywords. Do so every morning and evening and hopefully, within 60 days, you can find one that will suit you. Another App that seems good is the indeed App. But from my experience from London to Derby and now to Birmingham, senior colleagues emphasize more on adzuna when it comes to public health. So, I will likewise recommend that for you 7. Another way is to bookmark this page link below and click on the links under “Public Health” to see the latest jobs. The only problem I have with this is, they are always only looking for consultants. Nevertheless, it is another way and there is no harm considering it: https://ble.lshtm.ac.uk/mod/page/view.php?id=105280 8. If you do not get a job immediately, you can go for your part time masters online whilst you keep searching. If you want to apply to Public Health of England, you do so to the local council of where you reside or anywhere (but it is preferable if you apply to the local council where you reside- they always consider that). 9. As soon as you start work, apply for part time MPH in any of the institutions around. The following institutions run a 100% Online programme in MPH: a. Kings College London b. University of Liverpool c. University of Edinburgh d. University of Manchester e. University of Glasgow 10. At the completion of your Masters, go for the DFPH: https://www.fph.org.uk/.../the-diplomate-dfph-and-final.../ 11. Once you pass, get the Book: Donaldson’s Essential Public Health by Llam J. Donnaldson and Paul Rutter (the link has been shared already). Go through it, interact with other colleagues and register for preparatory courses for the MFPH (Birmingham University offers such coarses). 12. Go for your MFPH and get it over with. 13. Be a part of the United Kingdom Public Health Association (UKPHR): not compulsory but good, as you will be exposed to more professionals that can assist and give you recommendation. Also, you can register earlier, you do not have to wait until you have acquired your MFPH. https://www.doctorsforthenhs.org.uk/.../the-united.../ 14. Continue working until you have completed your 60 months, then apply to the United Kingdom Public Health Register (UKPHR) and apply to be a specialist: https://ukphr.org/ 15. This is a tip. As a medical doctor in public health, it is still good you get registered with the GMC even if you do not have to. Levels dey, trust me when I tell wunna say levels dey (and I mean this in every sense of the word). The more qualifications you have as a medical doctor, the more the levels. One of my seniors I once worked with has MRCOG and the guy was almost a god in our centre. Having a PhD is also a holy grail. So, imagine say you be MRCS and get PhD! Huuulala!

PS: I will never discourage anyone from using the specialist training route, but please, if you do, ensure that you familiarize with the mocks and past questions of what is asked during the process of screening and do well so share with others (especially on this platform), these materials. As soon as I lay my hands on them, I will share. Common Questions asked:

How do I build my public health CV? ANSWER: I do not know if there is anything as a “Public Health CV” because I have stumbled upon 3 different kinds of CVs in the three centres I have worked so far. So, in answering someone who was persistently on my neck, I had to thoroughly research the internet to look for similar templates to share with him and here are the templates: 1. https://www.livecareer.co.uk/.../registered-dietitian... 2. https://www.livecareer.co.uk/.../public-health... 3. https://www.livecareer.co.uk/templates/cv/healthcare?utm_source=google&utm_medium=sem&utm_campaign=1148430132&utm_term=&network=g&device=c&adposition=&adgroupid=53334310739&placement=&gclid=Cj0KCQjw0emHBhC1ARIsAL1QGNf9LwYjUD5LXtUOs9gdsIUDOIIqBm4tzejnAqDpn5j82dvd-wOulOsaAjKXEALw_wcB

Would my experience in Nigeria count? ANSWER: Absolutely… All na packaging, package your CV well and be very illustrative and convincing. Make sure you also have proofs or at least a recommendation from the places you have worked, in case you are asked to validate your claims. 60% of my interview in my present centre was on my past working experience; they were so fascinated.

I am a GP in training and want to combine it with Public Health, is this possible? ANSWER: I cannot say if it is possible. But even if it is, I think it will be too stressful for you. As a GP in training, your experience is recognized (unlike surgeons for instance), but the issue is: you may not have working experience relevant to population health practice. So, maybe it is possible to do part time both in your GP training and in any of the 160 organizations shared above, combined. Whether this is possible or not, I do not know, but it is a possible way nonetheless. My recommendation is: As a GP in training, you can go for part time MPH (which is 2 years; 3 in a few Academic institutions). Get it done and after your training, see how you can venture into public health. Remember, after training, you have had working experience as a doctor and have acquired the MPH and FRCGP titles. You may end up being a hot cake.

Public health in the UK is only for the British Citizens, is this true? ANSWER: No, it is not true, but they have a lot and I mean a lot of advantage over you, who is an IMG and I think, in one way or the other, this applies to other specialties. So, if there are further questions, you can hit me up via my inbox. I also have some PDF files that explain all these in a more complex and professional form. But since I have broken down the info to you, these PDF would be easier to read, you can also send me your e-mail address to forward them to you. I hope this helps. Goodluck everyone.

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