In this series of posts, I answer questions from medical students and doctors interested in getting into Occupational Medicine. If you have any questions you’d like me to answer, please feel free to put them in the comments below.
Q: What is the main difference between a DOccMed occupational physician and a consultant OHP – are there significant differences in career opportunities?
A: There are three levels of occupational medicine professional qualifications for doctors in the UK:
DOccMed is the basic professional qualification and can be done by any fully-registered doctor. It indicates basic training in occupational medicine and is designed for doctors who are working part time in occupational medicine or who have an interest in the specialty.
AFOM is a higher-level qualification, in which candidates complete the MFOM exam but not the rest of the MFOM curriculum. It is generally taken by people who have more in-depth occupational medicine experience and indicates a higher level of knowledge. Someone with AFOM may be able to attract a higher salary than someone with DOccMed and may be in a better position to act in a more senior role.
MFOM is the highest-level qualification, associated with the full training and competence needed to become a consultant in occupational medicine. MFOM in the UK is effectively the same as being an accredited specialist or “board certified” (the US term). This is different from many other specialties – someone can have FRCP (Fellowship of the Royal College of Physicians) or FRCS (Surgeons) without being an accredited specialist.
Only those with MFOM and on the GMC's specialist register can take up consultant-level jobs in the NHS. Other more junior roles are an option in the NHS with DOccMed or AFOM qualifications. This may include staff grade or associate specialist jobs.
Outside the NHS, MFOM significantly increases access to senior-level roles in industry, which are very much more restricted to those with DOccMed and AFOM. Those with MFOM have a higher level of clinical expertise and more in-depth training in the clinical, scientific, research and ethico-legal frameworks relevant to occupational health practice. In cases of a company being involved in a legal dispute (for example at an employment tribunal), the evidence of an accredited specialist may be preferred to that of someone with other qualifications. No employer wants to be in court and find the opposing barrister challenging the expertise or training of their company doctor, or bringing in a better-qualified expert witness to counter their in-house doctor’s testimony.
Engaging the services of an accredited specialist with MFOM is attractive for employers who wish to assure the quality, robustness and legal defensibility of their occupational health and wellbeing provision.
Although being an accredited specialist does not automatically confer the right to work abroad, the higher-level qualification may make international work much more realistic as an option.
All this being said, becoming a consultant is not for everyone, and not a prerequisite to having a fulfilling career in occupational medicine. If your intention is to have a portfolio career doing, say, some teaching, some OH work and some work in another clinical specialty, becoming a consultant may be overkill. Even for someone who wants to work full-time in occupational medicine, DOccMed and AFOM offer good employment opportunities. As you gain experience, salaries can increase while retaining a good work-life balance. Although the very most senior positions may be much less accessible without being an accredited specialist, this suits some people’s life and career aims very well.
Some doctors undertake occupational medicine work without any OH qualifications at all. Unless supervised by a suitably-qualified doctor this is not recommended, as the understanding of health and work gained through the DOccMed training and assessment process demonstrates a basic level of competence which any doctor working in occupational health ought to have.
* FFOM or Fellowship of the Faculty of Occupational Medicine is awarded for exceptional services to the specialty/Faculty rather than being an academic qualification, so the level of clinical training and attainment is no different when compared with MFOM.
Many thanks to Mohammed Blaaza, medical student at UCL, for the question.