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WellbeingOccupational HealthOpinion

OH is missing out on registered specialists

by Dr Richard Preece 2 Feb 2009
by Dr Richard Preece 2 Feb 2009

Occupational health is not a multi-disciplinary speciality. It is a health speciality of doctors and nurses.


Specialist doctors in occupational health enter a postgraduate training programme that normally lasts about four years. During this period, speciality trainees follow an approved curriculum, are supervised and assessed, and take examinations. Programmes are monitored by the General Medical Council (GMC). On completion of the training programme, they are eligible for entry onto the specialist register of the GMC. The process is broadly the same throughout Europe.


Specialist nurses in occupational health enter a graduate training programme. During the training period they follow an approved curriculum, are mentored and assessed, and take examinations. Programmes are monitored by the Nursing and Midwifery Council (NMC). On completion of the training programme, they are eligible for entry onto the specialist register of the NMC.


There are many specialist OH doctors and nurses who trained under previous regimes, but these are the current processes. There are also numerous doctors and nurses with a strong interest and experience in occupational health, but these are non-specialists (at least in professional registration terms).


There are many people working in other professions who have a strong interest in OH. However, there is no UK-approved curriculum for OH specialisation in these professions. Both the College of Occupational Therapists and the Chartered Society of Physiotherapy have sub-groups for those interested in workplace health. However, occupational therapists and physiotherapists interested in occupational health have no approved route to specialisation, and no professional body where this can be registered. As far as I’m aware, there are no UK undergraduate or postgraduate programmes for workplace occupational therapy or occupational physiotherapy. Despite considerable expertise, these people cannot become registered specialists.


In addition, safety advisers, hygienists, workplace counsellors and occupational psychologists (or even clinical psychologists specialising in occupational matters) don’t have a professional body in which to register their training and expertise that can be equated to the NMC, GMC or Health Professions Council (HPC).


People from many different backgrounds have made important contributions to OH, including scientists, engineers, social reformers and politicians. Nobody would dispute the importance of their contribution, but they aren’t part of a multi-disciplinary speciality. They are no more a part of the OH speciality than walking stick manufacturers are part of the orthopaedics speciality. It doesn’t mean these people don’t have a special interest, they are just not specialists.


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It would not matter who is part of a multi-disciplinary speciality if occupational health was to carry on as it has before. However, it is no longer an academic debate as a College of Occupational Health has been suggested (and the Board of the Faculty of Occupational Medicine has already decided this is a long-term ambition). This might be a good idea, but it might not.


Who should be eligible to join a College of Occupational Health? Who should not? Should we have levels of membership with a ‘higher’ one for worthy members of the multi-disciplinary team? Start preparing your applications.

Dr Richard Preece

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