Specialty Registrars (StRs) are placed for their first 24/30 months in a Local Authority to gain a firm foundation in public health. During this time registrars sit the Parts A and B MFPH. StRs are supported to gain the knowledge foundation appropriate for sitting the Part a MFPH. This may be through a masters course or some other method of delivery of the exam syllabus.. A three month health protection attachment is also arranged during the second year of training.
StRs are expected to attempt the Part A in the January of their second year and the Part B around half way through training.
StRs mainly learn through regular service work which is designed to meet educational need. Time is also allocated for private study. There are some generic skills which are best provided to cohorts of registrars and linked to particular phases of training. These include examination preparation, teacher training, communication skills and safe on call revision. Senior registrars make use of specialist courses according to their educational need and career intent. Emphasis in the latter stages of training is placed on leadership and management.
It is a requirement of the curriculum that registrars gain experience in at least two training locations (excluding the mandatory health protection placement). Placements are arranged according to educational need and training capacity. Registrars are encouraged to plan their placements early in discussion with their trainer, training location co-ordinator and the programme director. The final decision on placements rests with the programme director.
Health Protection unit attachment
There is no requirement that the mandatory three month attachment to a health protection unit is started before inclusion on the on call rota but it may be advised that on call starts during a period of attachment to the health protection unit to provide immediate debriefing and support for out of hours calls.
StRs are expected to be available for out of hours duties no more than 1:9 and in line with requirements under the European Working Time Directive. StRs working less than full time should be available pro rata. An additional supplement is payable for out of hours duties. The supplements are governed by relevant terms and conditions of service. Banding is only payable once the StR has been certified as competent to start on call and has been included in the on call rota. Competence to begin out of hours duties is assessed by both a full pass at Part A MFPH and a pass at formal in programme assessment. Each move of training base is regarded as a new placement for the purposes of defining whether banding is payable. Terms and Conditions of service apply.
StRs are expected to make themselves available out of hours when on call in line with requirements in Good Public Health Practice. StRs are normally expected to live within a reasonable distance from base (this would be considered no more than one hours travel time). If an StR chooses to live further than this they will not be entitled to claim for accommodation costs during periods of duty. StRs in specialist placements (ie not in a PCT) must discuss with the programme director the possibilities for remaining on call. StRs on call must be available for a full handover and debrief the following morning. The PCT will wish to consider the governance of this arrangement. The educational supervisor in the specialist placement will wish to consider whether the StR will remain fully available to discharge all educational objectives.
StRs are covered by NHS Hospital and Community Health Services indemnity against claims of medical negligence. StRs are strongly advised to secure personal indemnity through a medical defence union or other appropriate insurance package.
During the course of training, depending on individual interests and career aspirations, a registrar may identify the need for a specialist training opportunity not available within the East of England. These "Out of programme" (OOP) placements are available for senior registrars who are progressing satisfactorily with their training.
Time out of training is occasionally allowed by individual negotiation depending on personal circumstances and educational need. There are HEE policies for application and return to training.