‘You are the first person I’ve met who wants to do that’ is the usual response I get when I tell people I want to specialise in Occupational Medicine. It doesn’t matter whether this is my friends & family, foundation year colleagues, or hospital consultants.
I first became interested in Occupational Medicine as a third-year medical student. It was a combination of discovering the sub-specialty of aviation medicine as a member of the Southampton University Air Squadron and attending Professor Coggon’s series of lectures.
As a final year medical student I was allocated four weeks to undertake an elective placement or career taster. I chose to do the entire block in the University Hospital Southampton Occupational Health Department. Not only was it a nice change from the busy wards and final year hysteria but it cemented my belief that this was the specialty for me.
I was in a unique position as the department had never taken on a final year medical student. I imagine this is similar up and down the country, even in other large teaching hospitals. This is due to the fact that occupational medicine typically attracts doctors later in their careers and is covered only briefly in most medical school curriculums.
The placement was advantageous in two main ways: The first was that I saw patients from a different perspective, as workers. Medical school training is highly focussed on the acute management of conditions, now I was able to see how people cope with long term management and the impact on everyday life. This was different from general practice as working age people (unless long term unemployed) tend not to have frequent contact with their GPs.
The second was that I was able to reflect on my own health. There have been a number of initiatives in recent years to promote ‘practitioner health’ and wellbeing amongst medical professionals. Seeing first-hand the mental health problems faced by medical professionals left me with a better understanding of resilience and why it is important.
Two years later I returned to the department (this time providing welcome relief from the A&E SHO Rota). All foundation trainees are allocated one week of study leave to further explore a specialty they are interested in and demonstrate commitment to that specialty when it comes to applications. For me it was important to revisit the specialty to ensure it was still what I wanted to do. Being around familiar faces was helpful as I could build on previous knowledge.
The week was well planned with a busy timetable of clinics and training opportunities. I attended registrar, consultant and nurse clinics. The cases had varying levels of complexity, and I saw a large number of orthopaedic and mental health problems as well as a smaller number of autoimmune and neurological cases. I was impressed with the team dynamic within the department. I know from my experience on the wards that just talking about having an multi-disciplinary team does not always result in good team working. What stood out to me was the unified sense of purpose and clear direction amongst all members of staff.
I was lucky enough to spend time discussing the training pathway, making the transition from other specialties, as well as the future of occupational health and the challenges it faces. The highlight of my week was finding out about the research of the MRC Lifecourse Epidemiology unit. They are doing some fantastic work which has helped inform national policies and improved safety at work. This work is also helping address health inequalities, something my generation of doctors and medical students are deeply passionate about as the gap in inequalities seems to be widening.
From these discussions, I think the next few years will be very positive for occupational health and I see it becoming an increasingly popular specialty. I think there will be a combination of push and pull factors; such as people becoming unhappy in their current specialties (with the working conditions and contract disputes). The pull factors will be more important though; which is that there are excellent training opportunities, time with patients, good job prospects, and it’s a specialty where you can really make a difference in improving service and shaping it’s future.
Many thanks to Dr Skidmore for organising my taster week, as well as Dr Smedley, Jean Piernicki, Dr Channa, Dr Walker-Bone, and the rest of the OH department who all gave up their time to accommodate me.
Dr Peter Tamony