South West Public Health Training Guide (The Green Book)

Amended January 2006

The Basic Training Structure  The Regional Tutorial Programme

Monitoring of Progress  Your service department On call duties

Secondments and attachments  Academic Public Health training

Regional and national training events  The RITA Process

The MFPH examination  Accreditation  Faculty enrolment

Useful_websites/_references  Contractual_Matters

Download as a Word document

1.          Introduction

Welcome to Public Health training in the South West.  We hope that this updated guide, from current trainees within the region, will give you useful information on the training programme structure and what you might expect from your future career.  It provides an “insider’s view”, to be read alongside all the official guidance from the Regional Training Committee and the Faculty of Public Health.

Public Health is constantly changing. During the last change (Shifting the Balance of Power) public health moved into Primary Care Trusts, Health Authorities were dissolved and Strategic Health Authorities were set up. The current reorganisation proposes amalgamation of PCTs to form larger organisations again with an increased emphasis on GP commissioning. This will have an further impacts on Public Health delivery.

Another important change in recent years has been the formal recognition that Public Health needs to draw on a wide range of skills, and that trainees should come from a variety of backgrounds. Since formal training schemes in Public Health were originally designed for those with a primary medical qualification who had chosen to specialise in this field, this recognition has led to many changes in the structures of training programmes, assessment and examination procedures. In the South West, Public Health trainees with a non-medical background were appointed for the first time in 1999. The training programme is well integrated, although exceptionally there may be specific details that apply to only to those from a medical background or to those from a wider public health background.  The consequences of the Agenda for Change policy of reviewing NHS salary scales for trainees is yet to be agreed.

Whatever your background, most people starting in Public Health experience “culture shock” to some extent.  If you are used to the challenges of clinical or frontline work and the rewards of dealing with individual patients, pupils or clients, the (relative) peace and calm of an office may seem strange and leave you feeling that you have done little to earn your salary each month.  However, that will rapidly change and your outlook and approach to problems will evolve.  Public Health training will equip you with a new set of skills and hopefully you will be left wondering how you managed without them!

Contact with other trainees is very important, because you are relatively isolated and to let us share learning experiences. There are regular meetings for trainees in the South West as part of the regional tutorial programme. 

Finally, please let us have some feedback on whether this guide has been helpful - producing it must be a continuous process as the specialty does not stand still!

2        The Basic Training Structure

2.1          Introduction

Full time training in public health takes 5 years, although for some individuals with specific prior experience this may be reduced. Training has both academic and service components.  All trainees have an identified service trainer (within their training base) and an academic tutor (until recently only from the Department of Social Medicine at Bristol University but now also from the University of the West of England {UWE} and the Peninsula Medical School). An outline of the overall structure can be seen at the end of this section.

Trainees may be based in service departments within Primary Care Trusts  (PCTs), Strategic Health Authorities (SHAs) or the Regional Public Health Group. Academic trainees may be based at the Department of Social Medicine at Bristol University, UWE or at the Peninsula Medical School.. Training consists of at least two placements, each at a different base. Generally a trainee will rotate between training locations grouped within a SHA area, and these are allocated at the time of recruitment. Trainees are required to undertake a minimum 3-month formal attachment in communicable disease with a local health protection unit, and may undertake secondments of 3 to 12 months in other locations, depending on their training needs and interests.

The CCST (Certificate of Completed Specialist Training) is awarded to medical trainees once they have completed the required period of training (usually 4 years in a service department in addition to the year allocated to the academic course) and have passed the MFPH examination. Consultants in Public Health Medicine must hold the CCST (or can be appointed if they are within 3 months of gaining it). 

Specialist Trainees will be entered on the Voluntary Register, once they have completed the required period of training (again, usually 4 years in a service department in addition to the year allocated to the academic course) and have passed the MFPH examination. At present, posts for Public Health Specialists do not require inclusion in the Voluntary Register, as this is still a relatively new development. It is currently noted as a desirable attribute in person specifications and will likely become essential at some future date.

The Membership exams for the Faculty of Public Health have recently changed. The old part 1 exam is now the PartA exam and although there have been some changes to the syllabus it remains a written knowledge based exam. It is expected that trainees will take their part A at the end of the first year of training. The old part 2 exam has been changed to the Part B or OSPHE exam (Objective Structured Public Health Exam). This is an assessment in which you have to demonstrate public health skills and competencies ina range of settings. It is expected that trainees will sit the OSPHE six to nine months after passing the part A ie in the second year of training.

2.2       Pre MSc

Before attending the Masters course, most trainees will spend some time in a service location. This time has varied in the past, but more recently all trainees have started at the same time, and had roughly 3 months before going on their academic course. The service location is usually a PCT, although some trainees take this opportunity to get their 3-month communicable disease experience at a Health Protection Unit.

At the start of the post there is a regional induction programme. Trainees should also make sure that they have induction programmes within their service location, to meet key people within their host  organisation and other organizations with whom they will work closely (such as the local authority).

Each trainee has a nominated service trainer, who is responsible for overseeing a trainee’s training programme. An initial meeting(s) with your trainer should identify what skills you already have, and what your training needs are, and ensure that these are met by identifying suitable tasks and projects.  The amount of regular contact that a trainee and trainer will have depends on the stage of training, but at the start of training you should expect to meet with your trainer at least once a week and have an hour of protected time.  Academic trainers provide support for the academic component of training and support to prepare for the MFPH examination (part 1 and 2). You will have your first RITA (Record of In Training Assessment) prior to going off on the MSc course.

It is important that newly appointed trainees have support from more experienced trainees. Recent changes mean that trainees are often the sole trainee in a particular location. The buddying scheme means that all new trainees are (if they wish) paired with a more experienced trainee who can offer support and advice.  The scheme is additional to the trainer/tutor relationship, and is a complementary, less formal system of support.  Your ‘buddy’ will usually be post part I and may be based at a different training location. You will be asked whether you wish to join the buddying scheme on being appointed.  Buddies are paired up by the Chair of the Trainees Committee. Frequency of contact depends upon individual needs and is up to you.

2.3       The Masters Course

In your first few months you will be expected to get yourself on an MSc/MPH course. Although the training scheme pays for the course, it does not apply and secure admission on your behalf. The different courses are discussed in more detail in a later section.  Trainees are expected to take the course full-time, and are expected to take Part A at the end of the academic year, at the same time as taking your MPH/MSc exams. If planning to do this it is worth noting that:

·         No single Masters course prepares you fully for Part A

·         Most Masters courses are lighter in the first term than later on (although at the London School the first term is by far the heaviest) – so it may be sensible to do any extra work needed then (although you may not always know what you need at this stage).

It is also important to clarify what is expected of you during the academic holidays, and the date of your return to your placement. This has been an issue for trainees in the past, for example having to do on-call over the Christmas holiday or working part time in a Health Authority whilst writing up their dissertation.

2.4       Initial placement post MSc/MPH

On completing your MSc/MPH, you will most likely return to your pre-Masters placement. If you have not already done your 3-month communicable disease attachment you will need to arrange this. This initial service placement will usually take you up to 3 years from starting in post, but there is flexibility. 

If you have not already done so, you will be expected to take (and pass!) your Part AI, find useful projects and make substantial progress towards Part B during this time.  RITAs during this placement will focus on your exam progress.

2.5       Second Placement

            The second placement is usually at a second service location, and lasts 2 years.  You will be expected to complete and pass your part B during this time, and are expected to do so in the second year of training. After passing Part B, and/or in your final year you will be encouraged to consider secondments to other organisations.

For trainees with a specific agenda and training requirements (e.g. those who are clear that they want to specialise in communicable disease control), it is recognised that rotation to specialist units may be required. This more specialised training will usually take place during the second placement. It is best arranged following discussion with your trainer and the programme director and at your annual RITA reviews.

2.5       The Regional Tutorial Programme

There is a rolling programme of tutorials for all Public Health Trainees.  These are designed to be appropriate to all trainees and allow trainees from across the region to meet and share experience. Attendance varies, although in principle we are all expected to attend.  A register is taken and numbers attending are fed back to the Regional Training Committee.  The programme is drawn up in consultation with trainees, and trainees are now expected to lead on planning particular days, with Beth Carpenter finding venues and taking care of the administrative side. Trainee business meetings are also held on these tutorial days and provide a chance to discuss issues of concern, as well as to network. 

The Programme Director is Maggie Rae, and administration of the programme is co-ordinated by Beth Carpenter, based at Bristol North PCT (Tel: 0117 900 2679; Fax: 0117 900 2563) email:  beth.carpenter@bristolnorth-pct.nhs.uk, .

2.6            Monitoring of Progress

Your progress should be monitored informally through regular feedback and review with your service trainer and formally through the system of annual reviews (RITA assessments) and progress with the MFPH examination (chapter 6).

 

Table 1             Outline of Training in Public Health 

Year	Place	Comments
1	Service department 1/ Masters course	3 to 4 months in a service department before starting the academic course.  This allows trainees to understand the way Public Health functions and appreciate the approaches that practitioners use.  Trainees may undertake their 3-month attachment to a Health Protection Unit during this time. Start academic course (see section 4 for more detail). Encouraged to identify a project that can be developed as a dissertation for the Masters course.
2	Masters Course/ Service department 1	Complete Masters and return to service base.  Undertake Health Protection attachment if not already done. Take MFPH part A.  After passing the exam, work should focus on passing part B.
3	Service department 1	Gain wide experience of public health work. Secondments to specialist units may be appropriate.
4	Service department 2	Identify further training needs/ secondments/ preparation for consultant appointment
5	Service department 2	Secondments/ preparation for consultant appointment

 

3.       What to expect in your service department

3.1       On arrival

On arriving in a new service department you should expect:

·         A nominated trainer, who is accessible and available for regular meetings

·         A planned induction programme which familiarises you with the organisation, key personnel both within the organisation and other organisations

·         Adequate office space (desk, telephone, computer, shelves, filing cabinet etc)

·         A computer, with appropriate software, internet access and a plan to identify your IT training needs and ensure that these are appropriately met. (see also section 3.2 below)

·         Secretarial support

·         A work programme that is agreed between yourself and your trainer

·         To have access to a more senior trainee for advice

·         An induction programme to familiarise you with the role of the HPU before going on the on call rota

3.2       IT support

At present each trainee gets IT access and IT support through local arrangements. Trainees are provided with laptops, but there remain some issues about  IT support. This means that arrangements differ – trainees should speak to colleagues within their service department about how support is arranged. 

It can be difficult to know what to expect in terms of IT, especially if previously you have not used computers on a daily basis previously. As a bare minimum you should have access to (and know how to use) the following:

·         Word processor eg Word or Word Perfect

·         Spreadsheet eg Excel

·         Presentation eg Powerpoint

·         Email eg Outlook or Groupwise

·         Internet connection

·         Information databases held locally, such as local versions of Public Health Common Data Set, Census info, Hospital Episode Statistics etc. It can sometimes be difficult to find out about what is available and get connection to it – ask around.

·         Other software that is highly recommended is listed below, as well as more specialized software that may be useful for specific projects. For some of these you may find that your IT department already has a license, but you will not be given a connection unless you hassle them!

·         Highly recommended

·         Citation manager e.g. Reference Manager

·         Statistics package e.g. SPSS or STATA

·         Useful for specific projects:

·         Qualitative software package, useful for specific projects

·         Mapping software e.g. MapInfo

·         Microsoft Access (you are likely to have access to this as standard)

There are a number of email discussion groups linked to public health and specific areas of public health. The most important one for you to know about is the trainee email discussion group, and you will be invited to subscribe on starting in post.

3.3       On call duties

The Faculty expects all public health trainees to participate in the on-call rota. No trainee should join the rota until after they have been signed off as competent in the Health Protection RITA competencies. Trainees with a medical background may have become used to the practice of moving into a new area of clinical expertise and starting on-call with no formal training – this does not mean it is a good idea. Trainee Specialists in Public Health have experienced difficulties in agreeing competence to go on the on-call rota. An attempt is being made to clarify this issue so that everyone is agreed at what point someone is competent to go on-call. It is expected that all trainees will be expected to participate in the on call rota in the near future

Specialist Registrars will be on Band 1C so should not be on-call more often than 1 in 8. Specialist trainees will be paid a similar supplement to their salary.

If you are on call on a Bank Holiday, you are entitled to a day off in lieu, irrespective of whether you have been called in to work.

3.4  Regional Audit of Training

Training has been audited nationally using a tool developed by trainees in the South West.  This assesses your experience against explicit standards for induction and training.  This tool has proved useful in clarifying exactly what can be expected in terms of induction and general training support at a training location.  Where such standards are not already met, it provides a clear indication of areas for improvement; in some cases this has already led directly to improvements.  The aim is that administering the audit should be an ongoing process.  In this way weaknesses in training can be identified early and rectified.  If you are asked to complete an audit questionnaire please do so: it may improve your training location as well as provide evidence of standards region-wide.

3.5 RITA audit

The RITA process was audited for the first time in 2002 after concerns about the process. Training sessions were held on the RITA process for both trainers and trainees and has helped in clarifying the RITA process. This audit will be part of an ongoing process. Trainees are expected to take responsibility for the audit in turns.

3.6 Masters/Part A preparation audit

An audit of the different Masters courses was done on an ongoing basis to assess the strengths and weaknesses of the various courses. This has now been modified to focus on the preparation for the Part A including the Masters courses. Trainees are expected to take responsibility for this audit, also in turns.

4.          Secondments and attachments

Trainees are encouraged to undertake a variety of secondments and attachments to widen their public health experience.  These are usually of six months duration.

            Examples of past attachments include:

·         Academic Unit

·         Audit Commission

·         Communicable Diseases Surveillance Centre (CDSC), Colindale

·         Communicable Diseases Surveillance Centre (CDSC), Gloucester

·         National Statistics (formerly Office of National Statistics)

·         European Union

·         Government departments e.g. DoH/GOSW

·         Health Education Authority

·         Hospital Trusts

·         Local Authorities

·         Strategic Health Authority

·         Primary Care Trusts

·         Social Service departments

·         The King’s Fund

·         The NHS Centre for Reviews and Dissemination in York

·         Voluntary agencies

·         World Health Organisation

·         UNICEF

These are just suggestions, there are probably plenty of other useful secondments both in this country and abroad that you could arrange yourself.  New opportunities for secondments become available on a fairly regular basis and details will usually be circulated to trainees via the Faculty Advisor.  In general, unless you are post Part 2 or are using the secondment to undertake work specifically aimed at a Part 2 submission it is unlikely that a secondment will be approved.

Before undertaking an attachment you will need to be clear about what training opportunities the placement will give you, which RITA competencies and training needs it will help you address. It is always worth discussing with trainees who have done similar attachments in order to learn from their experiences. It is likely that the best success in securing and gaining skills from a secondment will come from matching your training requirements to the post. This can be done by determining those skills classified as requiring more attention in the annual review. The more RITA points you can achieve the better - and the more likely that the secondment will be viewed favourably.

Secondments to well established training positions or recognised posts are fairly easy to arrange (examples include HPA, GOSW). Others are less well recognised and will need to be formally approved by the Regional Training Committee.  It is best to discuss the possibility of an attachment with your trainer, the Faculty Advisor and the "trainer" to whom you will be seconded. Unless the attachment is in a regularly approved post, you will probably be asked to produce an outline of the attachment for approval at the Training Committee. This should give details of your supervisor, the projects you will be working on and how your training needs will be addressed.  You therefore need to plan your attachments a few months in advance.

In general, attachments are best done later in your training to help fulfil specific training needs.  However, communicable disease control attachments are often done earlier. Those trainees planning a career in Health Protection will undergo further atrttachments in other centres such as Colindale.

You will continue to receive your salary during the attachment. Arrangements will need to be made between the Training Committee and the organisation to which you are seconded around paying for expenses. In general however, your travel and subsistence costs (within this country!) will be met from the training budget and other costs will be met by the organisation for which you will be working.

5.          Academic Public Health Training

This section gives some background information on academic courses that trainees in the region have attended.  The training programme currently encourages all trainees to attend the LHSTM course, but it should be possible for individuals to attend other courses if these better suit their particular personal or training needs. There is a benefit from trainees in the same region attending the same course (both socially and to support each other through the course and part A exam). The training programme recommends courses geared for Part A although trainees should be aware that the syllabus for and requirements of Part A MFPH are quite different to those for a Masters in Public Health.

5.1       Cardiff MPH course

The MPH course at Cardiff is a reasonable all round introduction into the basics of public health. There are some excellent tutors at Cardiff who are extremely dedicated and very approachable. Most of the teaching is of a reasonable or high standard. The course attracts a fairly diverse range of students from all over the world and from many different medical and non-medical fields. As it is not top-heavy with doctors trainees can get good varied perspectives from different walks of life. There are on average around 12 – 14 full-time students and up to 20 part-time students in each year of intake.

As with any course there are some sections that are less well taught, but the course organisers are keen to get feedback and have made changes to some parts of the course based on this.

The course does not cover everything you need to know for Part A, but a separate set of tutorials (of variable quality) is provided to give more specific teaching towards this. Taking the Part A at the same time as the MPH exams is difficult, but may save having to go back to the books at a later date.

The course

Full-time trainees in public health are generally expected to attend full-time at Cardiff. The course starts in late September and is spread out over four terms. The first two terms involve two to three days a week in lectures at Cardiff and the remainder self-study time. The third term is mainly exams and this extends without interruption into the fourth term, which is self-study relating to your dissertation.

The course is organised in two parts; the core course; and options for specialty subjects. For full-time students both parts run in tandem. This means that some teaching in the specialty subjects can happen before the basics are covered in the core. 

The core course is generally one day a week (usually Wednesday), for all full time and first year part-time students. Part of the core was taught on a different day for full-timers in the first term, however it was possible in certain ‘special circumstances’ (e.g. travelling great distances) to have this moved to the end of Wednesday with the part-time students.

The core course covers Epidemiology, Demography, Research methods, Basic Computing, Basic statistics, Health Economics, and Management and Planning. Public health registrars have no choice in which specialty subjects to take. In the first term we covered Health Promotion and Health Informatics (Basic SPSS), followed by Communicable Disease Control, Health Informatics (Advanced SPSS), Applied Epidemiology, and Health Service Evaluation in the second term.

                                       

Our specialty subjects were taught on Monday during the first term and Monday and Tuesday during the second term. Organisation of the course is different each year, but they do try and keep days together if possible.

There are also dissertation workshops every Thursday morning that are of variable content and attendance. They are not compulsory and can be a pain to attend as this means yet another day in Cardiff, but going to at least one is really useful.

You are assessed by a variety of formative assessments (informal feedback) and summative assessments (marks count towards the final exam) as well as exams.  The exams are rather drawn out with long gaps in between.  If you also take Part 1 then you may have to do an examined presentation at Cardiff the day after your Part 1 exams.

Location

The course is all taught in the Public Health Department of the University of Wales College of Medicine, based at the Heath Hospital in Cardiff. This is a huge teaching hospital with plenty of facilities on site including a decent (well by hospital standards anyway) canteen, staff club, a post-office, Boots the Chemist, Blackwells Bookshop, a newsagent, a Sock Shop and a dodgy clothing/flower shop. The College is right next door to the PHLS and is directly off the main dual carriageway connecting Cardiff to the M4 Motorway (i.e., not in the city centre).

The Heath Hospital is about ¾ - 1 hours drive from central Bristol, or 1½ hours from Exeter.  You need £4.20 for the bridge, which you can claim back if you remember to get a receipt.  Most sessions don’t start until 10.00am, but occasionally some are earlier. ‘Student/staff rate’ parking is available at a rate of 75p a day, if you get a Delta Pass for the large multi-storey car park (£16 for 20 visits).  Otherwise, the daily parking rate is astronomically high unless you have a staff parking permit and find a staff parking space! If you are coming from the train station there are regular buses right outside the train station to the Heath hospital, which take around ½ hour.

Accommodation

There is student accommodation on-site that is extremely cheap and very convenient, however it is not that good. You can get living expenses (see expenses section) so if you want to stay overnight try somewhere else. The Travel Lodge next door to the David Lloyd Fitness Centre is two junctions down the road towards the M4, has a restaurant attached and is only a few pounds in a taxi from the hospital. Alternatively, there are many B&B’s and other hotels in the city centre. If you intend to stay up in Cardiff on a regular basis you may be able to negotiate a discount in one of the nicer hotels.

Attendance at training department during the course

Because there are only three to four days when you are attending lectures there has been some discussion around trainees returning to their service department for one day a week. The current situation is that during term time trainees/registrars are not expected to return to their service department and registrars are not expected to take part in the on-call rota. However, during the University holidays they are expected to return for 3 days a week and be on the on-call rota if needed / if academic work permits. The easiest way to avoid confusion about this is to maintain regular contact with your trainer via email during the academic year, and keep them informed of work commitments and when you aim to return to your base. Holidays are about a fortnight for Christmas and Easter. Your annual leave is also supposed to be taken during the holidays.

At the end of the third term, whilst writing up their dissertations registrars are expected to go back for 3 days a week until the end of September (the dissertation deadline). As there is no real distinction between the end of the third term and beginning of the fourth term this has been set as the 1^st of July.

Contact details

Christine Pritchard (Mrs)
MPH Co-ordinator
MPH Office, Room 11 UGF, Dept of Epidemiology, Statistics and Public Health
School of Medicine,

Cardiff University
Heath Park Campus,

Cardiff CF14 4XN
Or visit the website at http://www.cardiff.ac.uk/dentistry/medicine/epidemiology_statistics/

Or visit the website at http://www.uwcm.ac.uk/uwcm/divph/

Trainees who attended course in the past:
Sally Dowling, Paul Scott, Caryn Hall, Caroline Drugan (dental public health)

 

5.2       MSc Epidemiology at the London School of Hygiene & Tropical Medicine

Almost everybody who goes off to do a Masters as a trainee does one in Public Health rather than Epidemiology. It is unclear what the trainee committee would say if a trainee wanted to opt for an Epidemiology Masters as there is no local precedent. The Public Health Masters is certainly more appropriate for training purposes and for taking the Part A exams; however somebody for whom these issues were not relevant or who was considering a primarily academic career would certainly benefit from the Epidemiology Masters. Although it is difficult to give a precise figure, Epidemiology probably accounts for about one-third of the syllabus for Part A, which is what one would cover.

The course itself is very reputable and is well recognised internationally. The tutors are on the whole good, and the teaching methods very modern. Most lectures are followed by group work and practicals to reinforce learning practically. The tutors are often involved in exciting projects world wide, which they bring to their teaching. To give an example of the class composition, there were 40 students in my class (1998-99) of whom 10 were part time (over two years), only one-third were medical, came from 19 different countries, had 15 males, and had an average age of around 30 (range 21 to 40). A higher than usual average age was a big asset as most people came from very rich experienced backgrounds, which added to the discussions in the class, and social life outside it. The above class composition would be fairly representative. The course covers three terms and a dissertation. Unlike the Public Health masters, topics such as health promotion and policy planning etc are not covered; the time instead is devoted to more rigorous grounding in Epidemiology (communicable/ non-communicable), Statistics (the software taught being Stata, which is also preferred at the local academic unit) and organising research studies (writing for grants etc).

Outside academic life, the school is a fun place to be in, full of interesting people. Because students often tend to be from abroad, they are keener to make friends and some long lasting friendships are formed. The situation of the school also helps (Keppel Street, close to Oxford Street) with access to all the attractions of central London. The London University buildings are also close by. Accommodation is available in the form of various University Halls, which are generally friendly and reasonably priced, but may not necessarily meet everybody’s standards of luxurious living. The issue of on call is not relevant to the London Masters as it is too far to come back and one is generally expected to return after the completion of studies.

For more details, a brochure can be obtained from the school Registry (phone: 0207 299 4646 or email: registry@lshtm.ac.uk or website: http://www.lshtm.ac.uk

5.3       MSc Public Health at the London School of Hygiene & Tropical Medicine

A Department of Public Health was created at the London School of Hygiene and Tropical Medicine in 1929, the year of the School’s opening. The Department has run an MSc course since the 1960’s. This is now run through the Department of Public Health and Policy. The general aim of the course is to provide an academic foundation for the understanding and practice of Public Health as a basis for service or academic posts in the UK, or other industrialised countries with similar problems. 

The year falls into four sections, divided by Christmas (end of Term 1), Easter (end of Term 2) and written examinations (end of term 3 in mid-June). From the written examination until the oral examination in September there is no formal teaching; this time is spent in preparing and writing the Summer Health Policy Report / Dissertation / Literature review.  The report is based on an in-depth consideration of a topic selected by the student in conjunction with their trainer / academic supervisor.

The course may be followed full time for one year or part time over two years. In 2003/4 there were 63 people on the Public Health masters, and about 750 on all masters courses combined.  About 2/3 of students on the Public Health masters are full-time and about 1/3 are medically qualified.  Half are British nationals and of the remainder 2/3 are from Western Europe, North America, Japan and Australia, and 1/3 are from Africa, Asia, Latin America and Eastern Europe. The wide range of experience and background of the students is one of the great strengths of the course.  As most modules are shared with other MSc courses this gives an opportunity to meet and work with people from an even wider range of countries and backgrounds (there are more than 100 nationalities represented in the student body).

The course uses a good balance of lectures, seminars, group work and private study.  Group work can be a significant part of some study units.  Students are allotted a tutor to oversee their progress and give guidance.  An advantage of the modular structure of the course is that there is a good choice of topics, especially in the 2nd and 3rd terms.  In term one, a number of compulsory courses are taken.  These include: Basic statistics; Introduction to health economics; Principles of social research; Issues in public health, and Epidemiology.  There are two choices for epidemiology (basic and extended) and the school recommends that those planning to sit Part A exams opt for the extended, rather than the basic option.  The extended epidemiology course is very well taught and we were all glad to have taken that option.  Other non-compulsory options include: health promotion; health policy, process and power; health services and the biology of health and disease (for non-medics).

You may tailor your choice of modules in terms two and three to suit your: previous experience (e.g. taking advanced epidemiology or statistics); interests  (e.g. public health ethics); need to cover as much relevant information for the Part I exams as possible.

The course is not designed to cover part A prescriptively and this means that those wishing to take the part A exam at the end of the MSc year have to spend time outside of the course practising questions and filling in gaps. This may be achieved by forming working groups in lunch times and evenings as well as support and teaching from faculty members at the school.

Unlike some other Master's courses, teaching occurs Monday through Friday.  Depending on which modules you select you may have one day in the week that is solely for private study, although this varies at different times of the course. 

If you do not already live in London the scheme offers to pay for your accommodation in London for the duration of the course or for the cost of travelling to the School from your home.  Some students have commuted daily from as far afield as Bristol, although they would not recommend this as an ideal option!  For further information on issues outside of academic life see section 5.2 above.

Further details can be obtained from the Registry (phone: 0207 299 4646 or email: registry@lshtm.ac.uk or website: http://www.lshtm.ac.uk)

Trainees attended:  Isabel Oliver, Paul Pilkington, K Kumaran, Mark Salter, Valmiki Nagaraj, Harvey Gamble, Debbie Simmonds, Tanya Cross, Janet Maxwell, Fiona Taylor, Alice Walsh, Mary-Ann McKibben, Sabina Akhtar, Kerry Bailey, Ike Anya, Ruth Kipping, Kirsty Alexander, Sam Crowe, Matt Smith, Sara Gibbs.

5.4       Other Courses

            Trainees attended Birmingham: Ruth Howlett-Shipley

            Communicable Disease Module attended at UWE: Issy Bray

            Health Economics module at UWE: Julie Frier

6.          Regional and national training events

Regional tutorial programme

See section 2.5

Annual South West Public Health Conference

One day conference, usually held in May,  for all public health practitioners across the region.  Good opportunity to gain experience of giving a conference presentation.  Organised by the Regional Public health Group at GOSW.

Considered mandatory for trainees.

Annual South West Public Health Residential School

A two day programme of presentations and workshops for all public health practitioners across the region. Good opportunity to network with colleagues around region.  Organised by the Regional Public health Group at GOSW.

Considered mandatory for trainees.

University of Bristol Department of Social Medicine Short Course Programme.

This annual programme offers training in epidemiology and health services research for researchers and practitioners. Courses vary from 1 to 5 days, usually spread over a period.  These courses are free of charge for public health trainees.

Details available from Jessica Dunton, at the department of Social Medicine. Tel 0117 928 7221 or E-mail j.dunton@bristol.ac.uk

Department of Social Medicine seminars

Held on Thursday afternoons during term time, 4-5pm at Canynge Hall, Whiteladies Road, Bristol BS8 2PR. Open to all. Good speakers from across UK and abroad, interesting variety of topics. Programme available on: http://www.epi.bris.ac.uk/seminar/socmedseminar.htm

Key National conferences

All trainees are expected to attend these national conferences (at least once) during their training:

UK Public Health Association not just Public Health, but much wider membership and content (usually March, 3 days)

Faculty of Public Health Scientific Conference (June, 4 days)

Society for Social Medicine – the more academic of the three (September, 3 days)

A wide range of other, single topic, national conferences relevant to the specialty are put on each year.  You will need to check within your own department about how these are publicised (circulation lists/ ”read me” folders).  

7.          Assessments and Accreditation

7.1       The RITA Process

Everyone in the training programme is required to participate in the system of annual reviews (known as RITA assessments – Record of In-Training Assessment), in which progress in the specialty is monitored. Before each review you will need to complete the training record book (available form the faculty website), send an up dated CV and complete a record of study leave taken and attendance at Regional Training Days.

The training record book asks you and your trainer to state whether you are competent in subsections of 10 key areas. It may be helpful to have an initial review where you look at what experience you already have and how it can be evidenced. Trainers differ in the extent of evidence they require before signing someone off as competent.  Training the trainer sessions on the RITA process (open to trainees too) should help to address some of these inconsistencies, and help to explain the process if it is new to you.

The annual review process is co-ordinated by the Faculty Adviser, the Deanery and the Programme Director and run along the same lines as for other medical specialties.  The panel at each assessment consists of the Faculty Advisor, the Programme Director, an academic trainer, an external assessor (usually from the Wales region), a representative of the PG dean and a CCDC.  At the end of each review you will be given a certificate C (making good progress and you can pass to the next year of training) or certificate D (further supervised training is required). A form D is issued usually if one has not made the expected progress for that stage of training in terms of examination progress. 

7.2       The MFPH examination

This consists of two parts, both of which are now open to all trainees.  The part A examination covers a broad syllabus, which is set out on the Faculty website.  While an MSc or MPH undoubtedly prepares you for part of the examination, you also need to be able to apply theoretical learning to a service situation.  Trainees who have had little service experience before taking the examination can find this difficult.  You are allowed four attempts at passing the exam- some candidates have preferred to take the Irish part 1, as there are some differences in the structure and type of questions asked.  At present the Irish exam is not open to those without a medical degree, although this may change

For the part B or OSPHE examination you need to be able to demonstrate competencies in the following for the three areas of public health (health promotion, health services, health protection)

1. Communication skills in public health settings

2. Assimilate and communicate information from a public health perspective

3. Demonstrate reasoning, judgement and analytical skills

4. Handle uncertainty, challenge and conflict

7.4            Accreditation

Medical practitioners cannot become accredited in Public Health unless they have the MFPH.  Accreditation for Public Health Specialists will be via the voluntary register held by the Royal Institute of Public Health and Hygiene.

8.          National and Regional Committees to know about

Training in the South West region does not occur in isolation- there are a number of national and regional committees that have an important bearing on how things are organised.  These include:

Faculty Committees

The Faculty has a number of committees including the Education and Training Committee, Faculty Advisor’s Committee, which produce guidance on the organisation of training, set standards and oversee the examination process.  There is a trainee members committee, which is a useful forum for trainees to share experience and feedback on issues of particular relevance to trainees.

Regional Training Committee

This is the regional committee chaired by the regional DPH, which oversees training, continuing professional development and manpower planning.  There are trainees’ representatives on this committee and it is important that everyone has the chance to make their views on training felt through these representatives.  We ensure that discussions are fed back to trainees at Trainee Business Meetings, which are part of the regional Training Programme.

There is also a subgroup of this committee consisting of the programme director, faculty adviser, chair of the trainees committee, the training administrator, an academic trainer and a service trainer. This subgroup deals with the details of the training issues and monitors the progress of individual trainees.

A proposal has been passed recently to expand the main training committee and the subgroup; the main committee will have much more of a strategic role overseeing public health training in the broad sense within the region while the subgroup will deal with issues relating to the specialist training scheme.

BMA subcommittees

There are both regional and national committees on which Public Health Medicine is represented.

The Association of Public Health Specialist Trainees

Public Health Specialists have established a national network with a committee consisting of representatives (from each region currently running a public health specialist training scheme). For more details ask Paul Pilkington (UWE)

9.                 Enrolling with the Faculty

After you are appointed you will receive a letter from the Faculty of Public Health congratulating on getting your post and asking for about £200!  This is faculty enrolment; it is not the same as becoming a member.  Payment can be made in 4 instalments, although this is not usually advertised as an option upfront.  The enrolment fee covers “administrative costs in overseeing your training”.  Once you have sent off your enrolment form and fee you will receive your Training Record Book (on disc) and a letter detailing your expected CCST date.  It is important that you enrol with the Faculty as it is the Faculty that will recommend you for inclusion on either the Specialist Register or the Voluntary Register at the completion of your training.

10.          Becoming a trainee member of the Faculty

There are two ways of becoming a member of the faculty while a trainee:

·         Specialist Registrar/Specialist Trainee membership: open to all trainees in approved training posts in public health

·         Diplomate membership: open to all those who have passed the Part I examination.

Details (eligibility, cost) for both types of membership can be found on the faculty website (go to About the Faculty, and then Membership)

Full Membership of the Faculty is restricted to those who qualify for Membership by examination (passing Parts 1 and 2) or by exemption (after scrutiny of your credentials by the Faculty) or are otherwise elected to Membership.

 

11.          Useful websites/ references

Faculty of Public Health	http://www.fphm.org.uk/
Department of Social Medicine (links)	http://www.epi.bris.ac.uk/links/links.htm
Department of Health	http://www.dh.gov.uk
South West Public Health Observatory	http://www.swpho.org.uk
South West Public Health Education	http://www.swph-education.org.uk

12.          Contractual Matters and Entitlements

Your problems and queries in this area are likely to be linked to your personal circumstances so that general advice is of limited value.  Bristol North PCT administers trainee’s contracts on behalf of the South Western Deanery and is your employer.  Whitley Council terms and conditions apply (TPHSs are currently employed on Senior Managers contracts but this may change as a result of the ‘Agenda for Change’ process which is scheduled to begin in December 2004).  Salaries are paid around the 21^st of each month and it is important to ensure that expense forms are submitted to Human Resources Officer (HRO) at Bristol North PCT by the 6^th of the month for payment that month.

If you have specific problems, it is best to discuss your individual needs with HRO, Human Resources Officer (tel 0117 9002520).  If he cannot help you, he will point you in the right direction.  Contracts should normally be sent out within the first month of employment but there has been considerable variation and delay. Maggie Rae, the programme director is the current Budget Holder for the training scheme.

The BMA will provide advice (to doctors who are members) from your local office or Bristol. Other trainees should seek advice from whichever union they have chosen to join.

Common Problem Areas	Notes		Help from:
Starting salaries			HRO
Long term sickness	Affecting employment		HRO
Maternity leave	Affecting employment		HRO
Disciplinary issues	Affecting employment