Thinking about a career in OH?
When fourth year medical student Vera Onongaya wanted to find out more about a career in occupational health, I connected her with Dr Pippa Leighton, occupational health physician and occupational medicine trainee. Here are the highlights from their chat.
PL: It’s good to talk to someone interested in Occupational Medicine (OM) so early in their career. Why OM?
VO: I always thought I would be a GP but then I did the BMA speciality explorer and it came out with OM which really surprised me! I haven’t heard much about it in medical school. So I contacted a few OH physicians on LinkedIn and have been looking up more information online. To me, it looks like a varied career option and I like the idea of the non-NHS work. From your perspective, what is OM about?
PL: Yes, OM doesn’t always get much airtime in medical school, which is a shame because it is such an interesting career option. OM is a very different way of delivering medicine compared to other specialities. The traditional description is that it deals with the interaction between work and health. I also like to think about it as the study of the function and capabilities of people in the real world, with or without disease. It could also be seen as a professional medical advisory service. There is a significant medicolegal element to practising OM. We use knowledge of the laws and regulations that employers operate under to appropriately advise them. OM stands in the middle ground between employee and employer. It takes practice to move away from the ‘treating clinician’ role and instead become the neutral medical advisor to all parties.
VO: That change from a treating role is interesting because some of the OM doctors I have met have done different specialities in the past. Is there a set pathway to an OM career?
PL: There are a few routes into OM. Everyone completes their Foundation Years and then you need a minimum of two years of further general training: either core medical or surgical training, or GP training. From there, it’s an Oriel application to specialist OM training, followed by interviews and ranking, as with all other training stages across specialties. The difference for OM is then the choice between NHS and industry-funded specialist training. Many, like myself, train entirely outside of the NHS. There is also the choice of CESR training, which can be more flexible but tends to be harder to organise. Doctors working within other specialties also have the option of completing the Diploma in Occupational Medicine if they are interested in taking on some work as occupational health physicians. There’s lots of information on the Faculty of Occupational Medicine website here, here and here. Where have you gone to find information on careers in OM?
VO: It’s been challenging to find information through my undergraduate training. I don’t think many of my colleagues are aware of OM as a career choice, there isn’t much outreach and information geared at people like me early in their career. I have spoken to a few specialists online through LinkedIn which has been helpful (everyone is so friendly!) and I am planning to shadow a clinic to see how it works in practice. Do you have any advice to medical students considering a career in OM?
PL: Yes! A great taster, if you can find it, would be to shadow a workplace visit by an OM practitioner. Not only doctors do these- you could shadow an OH nurse or OH hygienist. For me, these visits are always fascinating and a great insight into the day-to-day of OM. Otherwise, contact your Trust’s OM department who are usually very approachable and happy to host.
VO: OH seems very multidisciplinary as a speciality. What does the team structure look like?
PL: There are many practitioners working in the field. OH physicians and nurses form a large part. But depending where you work, there are also occupational physiotherapists; technicians undertaking monitoring such as spirometry and audiometry, hygienists who lead technical assessments of workplaces and psychologists. Working in OM also involves interfacing with managers, employers and human resources which is another really interesting aspect of the job.
VO: It seems like working in OM has different dimensions compared to other medical careers. How does OM allow for career progression?
PL: There is a lot of room for career progression and a variety of work opportunities. Firstly, as a consultant, an OH physician can work fully employed in an NHS Trust or large corporation, be self-employed as a freelancer, develop a business, or do a mixture of all of these. The Faculty and Society of occupational medicine are both really active, and there are opportunities for clinicians with interests beyond practicing OM, including research and policy roles. There are lots of opportunities to undertake in-practice research and bring work to publication which feeds back into evolving best practice. For example, OM has a lot to contribute in the current dialogue about the future of the health and social care workforce given the issues with challenging working conditions and work-related stress. Post-covid-19 working has meant more remote work for OH teams in some areas, but most OH physicians will still be working in a clinic/on site for some of their week.
VO: The way OM clinicians use their clinical expertise to interface with the world of work, which is such a big part of individuals lives and the broader socio-economic climate is really appealing. What do you think is the best and worst thing about OM?
PL: I would say a downside can the separation from other specialities. OM is separated from other hospital specialities often working on a different site. An OM doctor is usually in an advisory rather than treating role, so it is rare to prescribe or order investigations- this is something that we hand over to the treating team. It is a different way of practising. However there are many advantages of OM: work-life balance; flexibility; wide scope of work; ability to influence workplace policy and culture. That combination is hard to come by in other medical specialities.
this is great - I've sent an email