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Occupational medicine

Nature of the work

Occupational physicians visit workplaces and assess a range of work-related health issues. Helping people to stay at work or to return to work following accident or illness is a key part of their role. The work is varied, combining clinical medical practice with the need to influence and shape the behaviour of both individuals and organisations.

Preventing illness and injuries that can occur as a result of work are an important aspect of occupational medicine, as well as rehabilitation following illness or injury.

Occupational physicians may be employed by the NHS or by a large organisation, such as the Emergency Services, the Armed Forces or transport organisations including rail companies. These offer good opportunities for part-time, varied employment. Manufacturing companies often have their own in-house occupational health services offering further employment opportunities for occupational physicians, although this is a diminishing trend given the reduction in UK manufacturing.

Occupational physicians are also employed by independent occupational health providers who provide services for a number of employers.

Psychological factors are important in occupational medicine. For example in the armed forces, alcohol issues, depression and adjustment factors often predominate, along with (to a lesser degree) post traumatic stress disorder.

Examples of some of the more challenging issues facing occupational physicians include alcohol misuse in safety critical roles, weight control for individuals in transportation industries and managing healthcare staff returning to work following a period treating patients abroad from an Ebola risk area.

Occupational physicians also need to combine their clinical knowledge with a detailed understanding of employment and anti-discrimination legislation as well as environmental and health and safety law.

As the importance of employment to health and wellbeing become more widely understood, occupational medicine is moving up the political agenda and is likely to play a larger role in future government policy.

Teaching medical students and trainees will usually be part of the work if you are employed in a teaching hospital or academic centre.

Common procedures/interventions

Occupational physicians assess workplace health risks and work with others to formulate methods of controlling those risks. They also work directly with individual employees.

They typically deal with issues including:

• work-related stress
• diseases caused by asbestos
• noise-induced hearing loss
• work-related back pain
• problems caused by exposure to chemicals and vibration

Sub-specialties

Related sub specialties include:

• aviation medicine
• disability assessment medicine
• diving medicine
• occupational dermatology
• radiation medicine
• respiratory medicine
• sports and exercise medicine
• travel medicine

Want to learn more?

Find out more about:

• the working life of a doctor in occupational medicine
• the entry requirements and training and development

• Pay and conditions

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  This section provides useful information about the pay for junior doctors (doctors in training), specialty doctors, consultants and general practitioners.

  Find out more about the current pay scales for doctors, and there's more information on the BMA website.

  NHS employers provides useful advice and guidance on all NHS pay, contracts terms and conditions.

  Medical staff working in the private sector, the armed services or abroad will be paid on different scales. Approved occupational medicine specialty training posts can occur in either NHS, private companies, industry or the armed forces. Fully qualified consultants working outside the NHS earn around £80,000 - £90,000 plus per annum.

• Where the role can lead

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  Read about consultant and non-consultant roles in occupational medicine, flexible working and about wider opportunities.

  Trainees and consultants in occupational medicine probably have more opportunity for expanding management roles than in other specialty. In a small specialty like occupational medicine there is more opportunity for involvement in national leadership roles than in many other larger specialties. The fact that half of occupational medicine training posts are outside the NHS is a distinctive feature of this specialty, and indicative of the variety of roles available.

  Consultant roles

  You can apply for consultant roles six months prior to achieving your Certificate of Completion of Training (CCT). You will receive your CCT at the end of your occupational health training.

  Managerial opportunities for consultants include:

  • clinical lead - lead NHS consultant for the team
  • clinical director - lead NHS consultant for the department
  • medical director - lead NHS consultant for the Trust

  Most NHS consultants will be involved with clinical and educational supervision of junior doctors.

  Here are some examples of education and training opportunities:

  • director of medical education - the NHS consultant appointed to the hospital board who is responsible for the postgraduate medical training in a hospital. They work with the postgraduate dean to make sure training meets GMC standards.
  • training programme director - the NHS consultant overseeing the education of the local cohort of trainee doctors eg foundation training programme director. This role will be working within the HEE local office/deanery
  • associate dean - the NHS consultant responsible for management of the entirety of a training programme. This role will be also be working within the HEE local office/deanery

  SAS doctor roles

  There are also opportunities to work at non-consultant level, for example as a SAS (Specialist and Associate Specialist) doctor.

  SAS surgeons (Staff Associate Specialists and Specialty Doctors) work as career grade specialty doctors who are not in training or in consultant posts. You will need at least four postgraduate years training (two of those being in a relevant specialty) before you can apply for Specialty Doctor roles. Find out more about SAS doctors roles.

  The role of an SAS surgeon can vary greatly. Depending on your experience, you might work on complex surgery or relatively minor diagnostic and outpatient work. SAS doctors will frequently participate in routine and elective surgery rather than emergency work. They also train other staff.

  Some surgeons are attracted to the SAS role as the hours are more regular than those of the consultant, and any on-call work and overtime beyond 7am-7pm is paid.

  Other non-training grade roles

  These roles include:

  • trust grade
  • clinical fellows

  Flexible training

  There are perhaps more opportunities for flexible training than other specialties, given that training occurs both within the NHS, in industry and the defence medical services. As with any other specialty, training posts must be GMC approved and appointments must have the approval of the local education and training board (LETB). The fact that half of occupational medicine training posts are outside the NHS is a distinctive feature of this specialty, and indicative of the variety of roles available.

  There is significant scope and opportunity for flexible working throughout your career as an occupational medicine specialist.

  Academic pathways

  If you have trained on an academic occupational medicine pathway or are interested in research there are opportunities in academic medicine.

  For those with a particular interest in research, you may wish to consider an academic career in occupational medicine. Whilst not essential, some doctors start their career with an academic foundation post. Entry is highly competitive. This enables them to develop skills in research and teaching alongside the basic competences in the foundation curriculum.

  Entry into an academic career would usually start with an Academic Clinical Fellowship (ACF) at ST1-2 and may progress to a Clinical Lectureship (CL) at ST3 and beyond. Alternatively some trainees that begin with an ACF post then continue as an ST trainee on the clinical programme post-ST4.

  After completion of the academic foundation trainees can then apply for academic core training posts (instead of normal core training).  A PhD is often taken, either during core or specialty training.

  A number of trainees undertake an Advanced Diploma or Master’s degree in Occupational Medicine during their training,

  Applications for entry into Academic Clinical Fellow posts are coordinated by the National Institute for Health Research Trainees Coordinating Centre (NIHRTCC).

  There are also numerous opportunities for trainees to undertake research outside of the ACF/CL route, as part of planned time out of their training programme. Find out more about academic medicine.

  The Clinical Research Network (CRN) actively encourages all doctors to take part in clinical research.

  Other opportunities

  Occupational medicine offers an exceptionally diverse and interesting career path. You can work in many different settings, including external providers of occupational health services as well as in-house departments in a wide range of industries.

  There is also a high demand for occupational physicians, given the importance of this work in society.

  Occupational medicine consultants may undertake research, which includes collaborating with colleagues in the UK and overseas, writing papers and presenting work at conferences.

  There may also be opportunities to work in the private sector and overseas.

• Job market and vacancies

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  This page provides useful information about the availability of jobs, how to find vacancies and sources of further information.

  Job market information

  NHS Digital regularly publish workforce statistics which show the number of full time equivalent consultants and doctors in training for each specialty: NHS Digital workforce statistics. 

  Competition ratios for medical specialty training places are published on Health Education England's specialty training webpage.  

  Specialty training is open to those who may want to train flexibly on a less than full-time basis (LTFT). You can request and apply for this after you have been offered the job. Restrictions apply.

  On this page we have information for England only. For information regarding Scotland, Wales and Northern Ireland please click on the links below.

  NHS Scotland workforce information
  NHS Wales workforce information
  Northern Ireland workforce information

   

  Where to look for vacancies

  Registration and applications for specialist occupational medicine training is online via Oriel.

  Consultants often find their jobs via referral, word of mouth or jobs advertised on the Society for Occupational Medicine website.

  Northern Ireland has its own recruitment process for occupational medicine. Find out more information on the Northern Ireland Medical and Dental Training Agency website.

• Further information

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  Organisations

  British Medical Association

  BMJ Careers

  Faculty of Occupational Medicine

  General Medical Council

  Society of Occupational Medicine

  Real-life stories

  Occupational medicine: specialty training (BMJ)