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: For a medical student/junior doctor interested in Occupational Medicine, is there a particular training “route” you recommend after Foundation Training? Should I qualify as a GP in 3 years and then start OH training to retain career flexibility? Or is it better to do 2 years in core medicine or surgery (assuming no real preference)?
A: For the medical student or early-career junior doctor wanting to go into occupational medicine, I would certainly recommend entering training at ST3 and completing a GMC-approved training programme to be a consultant.
In terms of early specialty choice for someone who is set on OH, stick with the"approved specialty" for OH training entry that interests you most. If you're going to spend a few years in a role developing as a doctor you should enjoy it and find the work rewarding. There is certainly value in having specialty-specific expertise, and if you're interested and engaged in the subject matter it's more likely to give you experiences you can retain and take forward into your occupational medicine career.
The approved specialties are (at February 2022): Medicine, Paediatrics, General Practice, Core Surgery, Core Anaesthesia, Core Psychiatry, Radiology, and Public Health
If you're not certain about occupational medicine, then completing GP training is certainly an option. Doing this, you can be a qualified GP and either enter training as an ST3, or do a Diploma in Occupational Medicine and start doing some OH work on the side - if you find you like it you can extend your OH practice gradually.
The tricky bit with this is that it sometimes gets harder to go into ST3 when you're fully qualified, simply because entering another training programme can feel like a big task - you achieve one big goal and you immediately start with another. It certainly can be done - I know long-practising consultants in other specialties who have gone back to ST3 in OH. Bear in mind that your salary may drop when you go to ST3, which may be a challenge depending on your circumstances at the time.
It's a very personal choice as to whether you want to retain career flexibility. People often change medical careers and there often isn't a way to know how things will look 5 or 10 years after you qualify. When I left medical school I would never have conceived of being anything other than a surgeon - I went straight into it and enjoyed it, but looking back I'm glad to have done my time in surgery and also to have changed to occupational medicine.
Flexibility isn't always a good thing because as you get older/more experienced, options close off to you simply as a factor of time marching forward. For some people, combining GP work with OH work gives an ideal career. For others, focusing on one or the other enables them to advance their career in their area of focus to an extent that would not be possible if they hedged. Family commitments, where you want to live, personal preferences, interests, health, money, and a multitude of other factors come in to play so there does come a point where you just have to evaluate the information you have and make a choice.
The shorter length of training by going from CT2 in an approved specialty to ST3 in occupational medicine is a factor when compared with 3-year GP training. However, in a career, a year is very little time indeed - the extra clinical experience from longer training won't go to waste, but if you want to run straight through and get to ST3 as soon as possible that will also work. If the life of a GP is one you could see yourself being happy in if you never changed career - complete GP training. If it doesn't interest you that much, you may as well do a specialty that does make you feel engaged.
If you’re not sure about a career change at CT2 – you don’t have to make one straight away. Continuing in training in another specialty will only add valuable clinical experience, whatever specialty you’re in. I got over halfway through higher orthopaedic training before switching to occupational medicine. Some people have asked me if that time was wasted, but I feel that’s very much not the case. I was more familiar with managing complex situations on my own given my seniority, and had more in-depth clinical experience. I still use a lot of my orthopaedic knowledge and clinical/research experience today (though I don’t operate any more of course!), and I’m very glad to have had the chance to develop in that specialty before moving to occupational medicine.
The Faculty of Occupational Medicine (FOM) has some useful information for prospective trainees here:
Here’s the person specification for occupational medicine for 2022 (this link may break as it’s updated in time):
The BMA has a brief explainer on medical training pathways here:
Many thanks to Mohammed Blaaza, medical student at UCL, for the question.