Regulation of Training
Public Health Training is regulated by two main bodies the General Medical Council (GMC) and the UK Public Health Register (UKPHR). The Faculty of Public Health (FPH) works with these organisations to set standards and maintain quality within the training programme.
The GMC sets the educational standards for all UK doctors through undergraduate and postgraduate education and training. It also awards the Certificate of Completion of Training (CCT).
The UKPHR is an independent, dedicated regulator for public health professionals in the United Kingdom, providing professional regulation to public health specialists and public health practitioners from a variety of backgrounds, all of whom have a common core of knowledge, and skills.
Regulations and procedures applicable to all Specialty Registrars (StRs) taking up appointments in specialty training which commenced on or after 1 August 2007 are set out in the Reference Guide is for Postgraduate Specialty Training in the UK - Gold Guide. The 8th edition published on 29 January 2020 replaces all previous editions with immediate effect.
Each region and Training Department has a written training policy which prescribes the structure of an acceptable training programme and/or location.
The Academy of Medical Royal Colleges (AoMRC) has recently produced guidance on flexibility in postgraduate training. Public Health has always been a specialty where the majority of people have already started or completed training in another specialty or discipline. We welcome the Academy’s guidance and set out below some details of flexibilities that currently exist, and areas where we are working on to develop greater flexibility.
The routes to registration are set out in detail but are in essence: prospective training routes (CCT) and retrospective portfolio routes to the GMC or UKPHR registers using (broadly) the same curriculum.
To join the GMC or UKPHR training route (leading to a CCT) you have to meet the ST1 Person Specification.
It is possible to combine the training route with equivalence route (see below) and enter at ST3 or ST4 although we have not had people using these routes. For ST3 entry: "A trainee must have passed the FPH Diplomate examination within the last seven years at the time of appointment (the date at which the post commences) and have demonstrated essential phase 1 learning outcomes". For ST4 entry: "A trainee must have passed the FPH Diplomate and Final Membership examinations within the last seven years at the time of appointment (the date at which the post commences) and have demonstrated 50% of learning outcomes."
The GMC retrospective portfolio is the Certificate of Eligibility for Specialist Registration (CESR). You apply to the GMC and they ask FPH to assess your application against the whole curriculum.
UKPHR retrospective portfolio route is called Specialist Registration by Portfolio Assessment (SRbPA). You apply to UKPHR and they assess your application through a two stage process.
While many people have accredited in public health and another specialty sequentially, there are no formal Dual CCT Training Programmes (i.e. done together with a shortened overall length). We recognise that there is some demand for joint Public Health and General Practice training but currently, the Medical Act does not permit dual training where one of the specialties is General Practice. We are lobbying to change this.
The Academy of Medical Royal Colleges (AoMRC) has developed the Accreditation of Transferable Competences Framework (ATCF) but this does not encompass the Public Health curriculum. The Public Health curriculum has many unique features so most people transferring complete the full programme of training. However, where there is demonstrable prior learning, it will be taken into account.
There are currently no credentials in public health but the Faculty of Public Health has opened up its examinations, the Diplomate Examination (DFPH) and the Final Membership Examination (MFPH) as UK recognised qualifications in public health to those not aiming to be fully registered. We are also working with others to look at what support is needed to those working in population and public health roles across the system.
Training is based partly on an apprenticeship model of learning and teaching - with delegation of routine work, and partly on an academic model, including the study of particular problems under supervision.
Since the learning of skills is by experience, supervisors play a key role, and the ultimate success of the programme rests on their ability to delegate appropriate work and give suitable guidance.
The role of the Faculty of Public Health (FPH) is to set minimum standards for public health doctors to be placed and maintained on the GMC register as supervisors. The role of HEE/LETBs is to ensure the delivery of these standards.
Non-medical public health educational supervisors are required to meet equivalent standards to doctors.
Types of Supervisors
The GMC has issued guidance and set up a register for educational and clinical supervisors in July 2016.
The roles of educational and clinical supervisors have been set out by the GMC and require demonstration of explicit competence in 5 and 7 criteria respectively.
FPH recognises four supervision roles:
named clinical supervisor
We expect minimum standards to be met and maintained in each of these four categories. The definitions for educational, named clinical, activity supervisors and academic supervisor are set out in
- Appendix 1- FPH Public Health Trainer definitions document. Criteria and Standards for Educational Supervisors.
We expect that general requirements set out in FPH guidance “Criteria and Standards for Educational Supervisors” are followed. The minimum standards to achieve and maintain competence in each of the 7 areas are set out in draft form, adapted from the PHE guidance
- -“DRAFT STANDARDS Supporting Information for Educational and Named Clinical Supervisor roles”- Appendix 2.
Those wishing to be maintained on the register as a supervisor will need to demonstrate for appraisal purposes that they meet the full requirement of the relevant training criteria (5 or 7 criteria depending on category). The local process will be determined by HEE and LETBs. It is expected that Educational and Named Clinical Supervisors will produce plans in their PDPs to maintain competence and strive to achieve excellence in accord with FPH guidance on standards. Any actions to maintain minimum standards or to achieve excellence should be suitably documented.
Roles and responsibilities of LETBs/deaneries
The responsibility of LETBs/deaneries is to ensure that supervisors are properly trained and inform the GMC of all their medical educational and clinical supervisors. We will expect all LETBs/deaneries to hold information on all four categories of supervisors for both medics and those from background other than medical.