"Public health medicine is a versatile and interesting career choice with ever changing opportunities - during your training and after. The training scheme in New Zealand opens the door to meeting motivating public health leaders and is constantly evolving to meet the challenges of modern training requirements."

Dr Lavinia Perumal, Public Health Registrar, Auckland District Health Board

Click on the questions below to view comments from clinicians.

Why did you choose this specialty, and what do you most like about it?

 

	The main reason for pursuing public health medicine is the belief that you are making a difference to improving health at a population level. You deal with a range of health care professionals and the job varies widely in its focus: there can be outbreaks of disease that require immediate attention, but there is also a substantial amount of long-term planning that concentrates on projects and unravelling complex issues. The career path is flexible and there are many different roles available, including working for primary care organisations, District Health Boards, academic institutions or the Ministry of Health, or undertaking consultancy work.

 

	It is essential to have good negotiation skills, to work well as an equal member of a multidisciplinary team, and to be able to take advice from other health care professionals. Flair for project management is an important attribute: you need to be able to prioritise, think strategically, and work to tight deadlines. It is necessary to have strong numeracy skills and be proficient at analysing and interpreting information. You need to be able to see the ‘big picture’ since you have to think of disease from a population perspective. Because the job involves conveying information to a wide and varied audience, public health physicians need to be able to communicate effectively both in writing and in speech.

 

	A typical daily schedule varies considerably according to the setting in which you practise. The role may include controlling population hazards such as environmental or infectious diseases, providing epidemiological analyses, writing policy documents, managing complex projects in community or hospital settings, undertaking health care research, teaching in public health medicine, or conducting public health programmes in developing countries.

 

	Funding constraints pose an ongoing concern. There is also a degree of uncertainty associated with frequent changes in health structures, agendas and priorities.

 

	Your clinical background will inform the decisions you make in public health medicine, so it is advisable to spend some time in clinical medicine first if you are considering this career path. It is a good idea to acquire a wide range of skills that may be useful in many areas of public health medicine. Some public health physicians continue to practise clinical medicine on a part time basis, but if you are looking to undertake public health medicine full time you must be sure that you are happy to discontinue clinical contact with patients.

 

	There is some disagreement over perceptions of the job market. One contributor commented that job opportunities are not particularly favourable as there are many people working in public health medicine already, although more jobs are available in rural areas. Another contributor believes that the workforce projections are optimistic, with many new opportunities emerging. Changes in health structures will inevitably have an effect on job opportunities, and to some extent employment prospects depend on your ability to build relationships with potential employers when you are working as a public health medicine registrar.

 

	It is possible to train in public health medicine part time, or to take leave from the training programme if necessary. After training you can elect to work overseas in public health medicine, but you would need to meet the requirements of the local medical registration authority.

 

	This specialty makes it fairly easy to fit your career around your lifestyle: in comparison with clinical medicine, the impact on family life is minimal.

 

	Because there is none of the immediacy of patient contact found in clinical medicine, the sense of achievement may be a delayed one: it often takes years or decades for new health strategies to come to fruition. It can be frustrating that funding constraints and uncertainties in the health system sometimes limit the extent of achievements.

 

	The Master of Public Health, undertaken during Basic Training, is a useful course that helps you to move from individual-focussed clinical medicine to conceptualising population health. The MPH is currently mandatory for achieving Basic Training. After you complete the Masters degree it is necessary to work some time in a public health unit and then to find your own job attachments (usually lasting between six months and a year). The training programme and informal networks do exist in New Zealand to provide assistance with this, and trainee training sessions are organised on a regular basis.