{"id":4492,"date":"2010-09-28T13:54:46","date_gmt":"2010-09-28T12:54:46","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=4492"},"modified":"2010-09-29T14:44:12","modified_gmt":"2010-09-29T13:44:12","slug":"esohe-omoregie-what%e2%80%99s-wrong-with-public-health","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2010\/09\/28\/esohe-omoregie-what%e2%80%99s-wrong-with-public-health\/","title":{"rendered":"Esohe Omoregie: What\u2019s wrong with public health?"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/www.bmj.com\/site\/blog\/icons\/esohe.jpg\" alt=\"Esohe Omoregie\" width=\"160\" height=\"110\" align=\"left\" \/>The other day, I had my first weekend on-call as an SHO. My consultant asked me the inevitable question about my career plans. I resisted the urge to stay in line with her specialty of choice, geriatrics. This has often been a tack of mine and many other trainees to facilitate smooth passage through any placement. So one case of acute confusional state, an anaphylaxis, and three\u00a0stroke patients\u00a0later, I decided to be honest. \u201cPublic health,\u201d I want to keep the public healthy.<!--more--><\/p>\n<p>Perhaps it wasn\u2019t the most appropriate setting after seeing five medical emergencies. But even though I didn\u2019t quite see what was wrong with public health, my consultant certainly did. \u201cWell it just sounds like you don\u2019t know what you want to do.\u201d The words stung, but I\u2019ve had worse; \u201cYou\u2019re not a real doctor if you\u2019re in public health,\u201d or \u201cWell I suppose you\u2019re lucky because that isn\u2019t very competitive,\u201d or even \u201cAre there doctors in public health?\u201d The comedy duo <a href=\"http:\/\/www.amateurtransplants.net\/\">Amateur Transplants<\/a> have even dedicated an entire song to the mysteries of public health. To say that public health is stigmatised in the medical arena would be an understatement.<\/p>\n<p>There is support in my corner. For the London Deanery, <a href=\"http:\/\/www.londondeanery.ac.uk\/var\/recruitment\/specialty-recruitment\/files\/2010\/2009-application-competition-ratios.pdf\">competition ratios<\/a> for \u201cpublic holiday\u201d make it one of the more competitive specialties to get into at specialty level. That\u2019s at least one plus. So I\u2019m not the only one who\u2019s clocked onto this supposedly crazy idea. Call me old fashioned but I don\u2019t see what\u2019s wrong with being able to help a lot of people at once. I certainly don\u2019t feel like a sell out, but my colleagues have other ideas. I wonder if it matters what other people think, as long as you\u2019re happy. <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/20674118\">A recent study<\/a> into medical student opinions about career choices ranks public health highly for lifestyle friendliness, but low for prestige in relation to other medical specialties. There seems to be a general feeling of distaste, and that gently empathetic frown I get when I disclose my intentions sums it up quite well.<\/p>\n<p>What\u2019s more disconcerting is that even some public health supporters have tried to rain on my parade, \u201cWell have you really looked into it properly? Most people are very senior in other training before they decide to go into public health. Take me for example; I\u2019ve already got my MRCP&#8230;\u201d<\/p>\n<p>That\u2019s great, but I\u2019m not most people. And what\u2019s wrong with being decisive?<\/p>\n<p>Okay, I\u2019m not the most decisive of people. I\u2019ve gone through multiple medical career transitions, but I think this one\u2019s a keeper. Training should allow us to decide early if we\u2019re ready and spend time browsing if we aren\u2019t, as suggest the results of a <a href=\"http:\/\/www.bmj.com\/content\/341\/bmj.c3199.full\">recent prospective cohort study<\/a>. I\u2019ve done my homework, and in all honesty, if I hadn\u2019t really got stuck in with many different career choices, I wouldn\u2019t have been sure that public health is the one for me.<\/p>\n<p>You need only listen to the news for five minutes before you hear about a public health issue; most recently the BP oil spill, floods in Pakistan, and the ongoing conflict in Iraq. And even on our doorstep, who of us hasn\u2019t seen someone with COPD, or a stroke, or an MI. Those are all potentially preventable diseases, but make up a large proportion of our clinical caseload. I\u2019ve seen a number of my colleagues and seniors complain about the lack of clinical insight that non medically minded managers and NHS workers have into the trials and tribulations of being a doctor. I\u2019ve also seen the same people moan about how busy (or un-busy) their rotas are, and battle with the EWTD for training opportunities. I would\u2019ve thought it would be a good thing for a medic to infiltrate the managerial camp, but apparently not.<\/p>\n<p>\u201cSo\u2026 doesn\u2019t that mean you won\u2019t see any patients?\u201d people ask. This is one of the unfortunate downsides of public health. The majority of time of medical school was spent getting my clinical knowledge up to scratch, and true, the clinical aspect is what most medics want out of their careers. I can understand how this would be a deal-breaker for some, and I respect that. Some would argue that real action only comes from cutting someone\u2019s abdomen open, or putting out a crash call on someone who\u2019s ECG shows ventricular fibrillation. Yes, these are shocking situations, but what\u2019s more shocking is the power that we as doctors have to change the structure in which we provide care and subsequently the health of the population as a whole. And let\u2019s not forget opportunities to work all over the world for different NGOs. Public health is multispecialist, so you\u2019re likely to find something that piques your interest.<\/p>\n<p>A career in public health could give me a career that will develop in ways I can\u2019t even begin to imagine. I think my predilection for multiple projects and seemingly unrelated but deeply connected interests might finally find a home. Isn\u2019t it normal to try something a bit different and like it? Life seems too short not to.<\/p>\n<p><em><strong>Esohe Omoregie<\/strong> is a foundation year 2 doctor in public health at East Kent University Hospitals.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>The other day, I had my first weekend on-call as an SHO. My consultant asked me the inevitable question about my career plans. I resisted the urge to stay in [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2010\/09\/28\/esohe-omoregie-what%e2%80%99s-wrong-with-public-health\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[223,165],"tags":[],"class_list":["post-4492","post","type-post","status-publish","format-standard","hentry","category-guest-bloggers","category-junior-doctors"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Esohe Omoregie: What\u2019s wrong with public health? - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2010\/09\/28\/esohe-omoregie-what\u2019s-wrong-with-public-health\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Esohe Omoregie: What\u2019s wrong with public health? - The BMJ\" \/>\n<meta property=\"og:description\" content=\"The other day, I had my first weekend on-call as an SHO. 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