Higher specialist training programme
Regulations and procedures which apply to Higher Specialist Training
Most of the regulations and procedures which apply to Higher Specialist Training are found in A Guide to Specialist Registrar Training, informally known as the Orange Book, produced by the NHS Executive. It is available on the DH website or by fax on 01937 845 381. All specialties in the UK must adhere to the requirements set out in this volume and use the Forms A-G, which are given in it. Further clarification of specific requirements may be obtained from the postgraduate deans.
UK competent authorities
The Specialist Training Authority (STA) of the Medical Royal Colleges awards the Certificate of Completion of Specialist Training. It also awards other certificates required by the European Medical Directive on the recommendations of its constituent Colleges and Faculties.
The General Medical Council is responsible for maintaining registers of qualified doctors, including the Specialist Register, for disciplining those guilty of professional misconduct and for co-ordinating all stages of medical education.
The UK Voluntary Register for Public Health Specialists was established in May 2003 as an independent multidisciplinary register to provide public health protection by ensuring that only competent public health professionals are registered and that high standards of practice are maintained.
How long does training take?
Training usually lasts five years, full-time. Part-time training is proportionately longer. Shortly after they have been accepted on to a training scheme, trainees are likely to spend a year in a part or full-time academic course that will usually lead to a Masters or Diploma in Public Health, and give most of the basic training to take the Diploma and Part I Membership Examination of the Faculty of Public Health. Relevant experience prior to entering higher specialist training may enable the period to be reduced. Upon successful completion of training and the gaining of full membership in the Faculty, the Certificate of Completion of Specialist Training is awarded.
The organisation of training
In each region in England there are one or more Postgraduate Deans who, with their Regional Postgraduate Medical Education Committees, oversee training in all medical specialties in their locality. Similar arrangements apply in Scotland, Northern Ireland and Wales. The local specialist training committees for public health (medicine), like those for other specialties, are sub-committees of the local Postgraduate Medical Education Committee. Membership includes the Postgraduate Dean, the local Faculty Adviser, a representative of local university departments of public health medicine, trainers from NHS departments of public health and Specialist Registrars. The committees are the responsibility of the postgraduate medical dean, are independent of employing authorities and are usually chaired by the local Faculty Adviser. They co-ordinate training and continuing education in public health medicine at all levels within their locality as well as monitoring standards of training programmes and the progress of individual Specialist Registrars. Training Programme Directors are appointed in open competition by the deans and represent the deans. Faculty Advisers are appointed by the Faculty through an election process, work closely with Programme Directors and have a complimentary role in the implementation of the training programme.
Where public health fits into postgraduate medical education in the UK
The professional education of the doctor, which begins on entry to medical school, must continue throughout professional life. Within this education five phases can be recognised:
- undergraduate education culminating in a primary medical qualification (such as MBBS)
- pre-registration year (general clinical training - as defined by the General Medical Council
- general professional training - lasting at least two years after full registration with the GMC
- higher specialist training of five years, culminating in the CCST
- continuing education or professional development as a routine part of professional life
Careers advice
For careers advice please contact local Faculty Adviser/Specialist Adviser or the Training Programme Director. Training jobs are listed in the public health section of the British Medical Journal's classified supplement (for doctors) and, increasingly, in the Health Service Journal and The Guardian.
For additional information about multi-professional training programmes, the NHS Executive Regional Office [Public Health Directorate] will have up-to-date information about newly established programmes which in some, but not all, cases are integrated with medical training.