Occupation medicine is a fantastic specialty and one with a huge variety of opportunities. In this article, we discuss this in-depth and give you an idea of what it involves.
Why do Occupational Medicine?
Occupational Medicine is a specialty that focuses on the impact of health on work, and the impact of work on health. A large part of the role involves proactive health promotion and primary prevention of illness. It is one of the few remaining generalist specialties, and it is impossible to know what will come through the door!
Occupational Health physicians normally work “office hours”, with no on-calls, ensuring a positive work-life balance.
As it is a small specialty, there is the opportunity to influence strategic policy at a national level, and the profile of Occupational Medicine, and Occupational Health generally, continues to rise. There is the opportunity to find work in niche areas of interest (for example, with organisations or activities which you enjoy).
One of the things I value most about working in Occupational Medicine is the chance to spend a long time with each patient, and to take a holistic view of the situation.
I also value the opportunity to practise preventative medicine, and to act early if there are issues that might impact someone’s health or work, and thereby reducing any problems which may arise later on.
Working as an Occupational Health doctor in the NHS is extremely rewarding, because it supports staff to continue to provide care to patients. It is vital that we look after our staff, and one way to do this is to ensure that there are enough Occupational Health staff to support them.
What is the day-to-day work like for an Occupational Medicine physician?
As an NHS doctor, I see members of staff, for pre-employment health checks, manager’s referrals (when there are health concerns) and Ill Health Retirement assessments. We also see patients from external organisations, such as councils, special schools, and factories. I can make recommendations and discuss these with patients, employers and managers about the options to support the individual. I also undertake health surveillance for potential workplace hazards.
Outside the NHS, the options for work as an Occupational Medicine physician are endless, and you can have the flexibility to work in any areas which interest you (for example, this could range from working as a medical advisor at the BBC, to working in the Houses of Parliament, to undertaking diving or aviation assessments).
How to build your portfolio
It is very helpful to look at the websites for the Faculty of Occupational Health and the Society of Occupational Health as a starting point. There are also opportunities to join them as affiliates. They both have regular events, as does the Royal Society of Medicine’s Occupational Health section. The Faculty is also likely to be able to put you in contact with Trainee Reps, whom you can talk to.
Each NHS trust is likely to have access to Occupational Health services, so try contacting your local department, to request a conversation with a physician, or to observe one of their clinics.
Workplace visits are an integral part of Occupational Health work, so if there are any interesting organisations try approaching them to explain that, for your own education, you would appreciate the opportunity to look at how they manage workplace hazards. The Health and Safety Executive website can give you tips on what to look for in each industry.
Depending on which speciality you currently work in, try to reflect on cases with an occupational element – this could be because the work is contributing to the patient’s condition, or because their health is affecting their work.
The Faculty of Occupational Health offers Diplomas in Occupational Medicine, Aviation Medicine and Disability Assessment Medicine, which you don’t need to be a trainee to take.
If you have the Diploma you can take further training through the Health and Safety Executive to become an appointed doctor, under various regulations (e.g. The Control of Lead at Work Regulations 1998, The Ionising Radiation Regulations 2017).
The University of Manchester also runs a Masters Degree in Occupational Medicine.
Occupational medicine training begins at ST3. In order to get onto the training scheme, a person must have MBBS or equivalent medical qualification. They must then have undertaken further training, for example, in Medicine, Paediatrics, GP, Surgery, Anaesthetics, Psychiatry, Radiology, Public Health. The Person specification can be here.
Training can take place within the NHS, in industry (either within a specific organisation or with a private Occupational Health Services provider), or within the Military. In addition, it is possible to become a qualified physician through the CESR pathway.
NHS training is via national recruitment, managed by the National School of Occupational Medicine. The School also produces a newsletter. Applications usually happen twice/year. There is an online self-scoring element, and, later, an online or face-to-face interview stage. Candidates are then ranked, and if successful, can be offered an NHS role. NHS jobs can be found at NHS Jobs.
Industry trainees also have to go through the same process, to ensure they are “appointable”. This is known as benchmarking. They can then apply for any Industry role. Roles can be found at BMJ Careers.
Military trainees also have to attend national interviews, but the armed forces manage their own recruitment process.
The competition ratio for Occupational Medicine in 2021 was 5:1.
Training takes 4 years FTE. Exams involve Part 1 MFOM (which is an MCQ written exam), and Part 2 MFOM (which is both written and clinical).
Occupational Medicine is an extremely varied and rewarding specialty, which provides the opportunity to practise preventative medicine, the time to take a holistic view of the situation, and the ability to have a very good work-life balance.
The training is detailed and requires a broad range of knowledge, but no two days are the same, and the opportunity to decide what areas of Occupational Medicine you want to practise are endless!
As well as the above website, various books can be of use. These include:
- The ABC of Occupational and Environmental Medicine
- The Oxford Handbook of Occupational Health
- Fitness for Work: The Medical Aspects
Written by Dr Jessica Whitehead (Consultant in Occupational Medicine)
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