Public health is a unique specialty programme – It is the only one you can enter without a medical degree. The good quality of life, diversity of teamwork, and high-impact work mean that the application process is competitive. However, there is a lot you can do to improve your portfolio and the training is comparatively short, so there is no harm in taking your time.

What is Public Health?

Public Health was historically defined by the Chief Medical Officer, Donald Acheson, as ‘the science and art of preventing disease, prolonging life and promoting health through the organised efforts of society‘. There is a great video summarising public health from the Faculty of Public Health (FPH) here.

Why Public Health Training?

Public health is a multi-disciplinary specialty training programme, which integrates medical trainees with those from other backgrounds. You’ll work across organisations, local government, NHS organisations, and with the local and private sectors. There is a huge range of work, ranging from climate change to food poverty, to alcohol unit pricing. Small changes on a population level can lead to huge differences in outcomes, and this can be incredibly rewarding. Limited contact with patients and with on-call shifts means the quality of life is often really good for public health trainees and specialties.

Key characteristics needed

As per the Faculty of Public Health (FPH), the key characteristics desired in a Public Health practitioner are:

• Actively changes practice on the ground
• Influences policy at the national level
• Works collaboratively with all stakeholders
• Uses evidence and intelligence to convince
• Champions those who find it hard to be heard
• Has a passion to make the world a better place
• Wants to focus on population health to deliver the greatest benefit

Experience & Tasters

There is limited exposure to public health in medical school training. However, if you look for them, there are many opportunities to actively get experience. Not only will these help you know that public health is a fit for you, but they also work toward your portfolio.

• Medical school electives
• Student selected modules
• Summer internship with a public health department
• Speak to public health practitioners in your area about their experiences, or email them via LinkedIn/ Twitter
• Intercalations – many in public and global health BSc and MSc options nationally and internationally
• Foundation Public Health job
• Academic Public Health job via the Specialised Foundation programme (SFP)

Training Programme Structure

The training programme curriculum gives a comprehensive overview of the training content. It lasts 5 years and includes an MPH (Public Health Masters degree). Similar to other programmes, you rotate around jobs.

Image from: training programme curriculum

Dual Training

In the last year, the General Medical Council has approved a merger between the Faculty of Public Health, the Royal College of General Practitioners, and NHS England to develop dual training for Primary Care and Public Health. Until now, practitioners would have to do one training after the other, or interdigitate the two programmes. They’re hoping to launch in 2024 and it will last an estimated 7 years, so watch this space.

For other specialties, there is no plan to develop a formal dual training programme, but lots of practitioners are trained in two specialties but do the training sequentially.

Examinations

There are two main exams you do in public health training:

• Part A – Diplomate Examination: this is usually done in the first two years of training, and tests the core principles of public health. The format is four written papers which are taken across 48 hours.
• Part B – Final MFPH Examination: testing ability to apply public health knowledge, normally taken 6-9 months after passing the Diplomate exam. The format is six stations that test the main domains of public health.

The Application Process

For medical trainees, you can enter public health training straight after FY2, as per other specialty programmes. For non-medical trainees, you must have completed 2+ years of public health work to be eligible. You can check your eligibility here. The applications are a competitive process; there are around 60-90 places nationally with vacancies varying year by year. The competition ratio is around 11:1, making it one of the most competitive programmes.

How to apply?

National recruitment is every October, as with other specialty applications, with entry starting the following August. Applications are done electronically via Oriel as with other applications.

Interview and Examination Stages

Applications are ranked based on a staging process. First, you submit the online application and rank your location preferences. Those eligible with be long-listed and invited to attend assessment centres for timed verbal and numerical critical reasoning tests.

The Public Health Assessment Centre is 190 minutes in length and there are 3 component parts:

• A critical thinking paper (Watson Glaser)
• A numerical reasoning paper Rust Advanced Numerical Reasoning Appraisal (RANRA) 
• Situational Judgement Test (SJT) paper. 

Further structure of the Public Health Assessment Centre can be found here. Note: The Multi-Specialty Recruitment Assessment (MSRA)does not currently count toward public health applications.

If successful, applicants are then invited to attend a selection centre day where they have interviews and scenarios to pass. After this, final allocations are made.

How to build your portfolio

The competitive application process means building your application and showing interest is key. A benefit to public health training is that it is comparatively short, and you are not penalised for entering training a year or more later. This gives you lots of time to take years to work or travel after foundation training.

• Conferences: A great opportunity to network and present your research findings.
• Publications and public health research: Getting involved in research is a great way to network and learn more.
• Audit and QI: Projects within other specialities have relevance in public health, for example, projects in screening, immunisation updates, or health inequalities.
• “Getting Experience & Tasters”: All of the aspects of this section will strengthen your portfolio.
• Public health events: Lots available via the Royal Society for Public Health website and through university institutions.
• Picking relevant foundation programme jobs: We discuss these in a separate article in depth.
• F3/ onwards: Jobs in clinical fellowships, academic jobs, and abroad will widen your skillset and aid your application.
• Public health specification: Check out the specification and see where your CV has gaps – we recommend printing this out and filling it in.

Useful Resources

• Faculty of Public Health
• Public Health Assessment Centre Guidance

Written by Dr Lucy McCann (FY2 – Academic Public Health)