Overseas placements

The Faculty of Public Health (FPH) recognises that training in public health takes place in a wide variety of settings and locations, including outside the UK.

Working overseas has the potential to provide excellent opportunities in many of the core public health competencies. In addition, it is likely that the experience and level of responsibility obtained may not be possible while working within the NHS.

As well as offering technical assistance to other countries, working in overseas training posts can also be a rewarding personal experience.

Over the past decade there has been increasing demand for overseas experience in areas including Eastern Europe, developing countries, the European Union, USA, Canada and Australasia. European training programmes specifically aimed at public health training have also been launched.

UK Training Programmes are keen to ensure that these overseas attachments, many of which offer excellent experience, should be recognised as an integral part of their overall training programme rather than viewed as ‘time out'.

It is important that training experience, wherever it takes place, is carefully planned and structured to maximise the training value.

See the Out of Programme experience sections on Approval and Procedure sections for further information.

ADDITIONAL INFORMATION

Language
Health and personal insurance cover
Work permits, medical registration, indemnity
Accommodation
Funding
Returning to the UK training post
Requirements of the overseas post/programme
The training programme
Monitoring the progress of the trainee
Information for overseas institutions
Additional resources for registrars/trainees considering overseas training

Language

Knowledge of the local language is highly desirable so that the trainee can better understand the social and cultural context in which he/she is working. In some instances, such as relief work with a multi-national agency, detailed knowledge may not be a prerequisite. In others, the trainee may be required to have a command of one of the languages of the host country to a sufficiently advanced level to benefit from the training attachment. It is suggested that in these cases, either A levels, or equivalent qualifications should be looked for, or the post-holder should agree to being interviewed in the language in which the training will be conducted.

Health and personal insurance cover

Suitable arrangements should be in place for health and personal insurance cover for the duration of the overseas attachments. Arrangements should also ensure that the trainee has an adequate understanding of the necessary personal health precautions e.g. malaria prophylaxis, advice on schistosomiasis, and HIV infections and that he/she has also been advised about appropriate immunisations and preventive interventions.

Work permits, medical registration, indemnity

In advance of the trainee taking up duties, arrangements should be made to ensure that work permits, medical defence cover, and medical registration are obtained.

Accommodation

Ideally, arrangements should be made to provide suitable accommodation for the post-holder prior to their arrival. The trainee may subsequently wish to make alternative arrangements once they are in situ. Arrangements should be in place to provide support and assistance to the trainee should the need arise. Someone other than the named trainer/supervisor should be identified for this role.

Funding

The local postgraduate dean, usually advised by the Programme Director, determines whether the salary will continue to be paid during the Out of Training Experience (OOPT/OOPR). Other expenses must be paid by the trainee or secured from the overseas institution.

Returning to the UK training post

Suitable arrangements should be in place to safeguard the return of the trainee to their UK training post at the end of the attachment/secondment.

Requirements of the overseas post/programme

Facilities at the overseas training location should ideally be equivalent to the standard of those required in the UK. It is recognised that this may not always be possible, but they should at least be equivalent to those offered to doctors in public health training in the host country.

Agreement should be made on how costs are to be covered, including necessary training activities such as telephone calls, information technology, transport, on duty commitments etc.

If possible, the post holder should not be the sole trainee at a location. It is recognised that this might be very difficult to achieve in many developing countries and it is important that in these instances adequate arrangements are in place to ensure that trainees are not isolated.

An on-site supervisor, trained in public health, should be appointed to supervise and support the trainee on a day-to-day basis. This person must be named and contact information provided to the Faculty Adviser and the Faculty of Public Health (FPH). This supervisor should ensure that liaison with the UK trainer is efficiently organised.

The host department should be actively involved in audit and continuing professional development (CPD) programmes. It is a minimum requirement that the department is able to demonstrate that it takes a critical approach to its work.

The training programme

A provisional training programme should be drawn up in advance and submitted for approval to the post-holder's parent public health training committee. Some trainees are seconded to work on specific projects rather in a more comprehensive training programme. Details of the project, its aims and objectives and a statement of its training value must be submitted to the parent training committee for approval. The Training Programme Director (TPD) and Educational Supervisor (ES) should be notified promptly of major changes to the programme or project that occur during the attachment.

The aims and objectives for the attachment must be specified and agreed in advance of the post-holder commencing the attachment. These aims should include statements about the Learning Outcomes (competencies) that will be addressed. The type of activity and projects undertaken should be appropriate for trainees in public health.

Monitoring the progress of the trainee

The supervisor in the host country and the trainee should send regular progress reports (every six months is recommended) to the trainee's UK Faculty Adviser. A report from the local supervisor referring to how the agreed objectives were fulfilled will also be required promptly following completion of the attachment. The trainee is also required to submit a report.

Information for overseas institutions

Overseas institutions who wish to offer training experience to UK Trainees should refer to the requirements above and ensure that Learning Outcomes for projects are clearly outlined.

In order to submit your application for designation of overseas posts please fill in the Overseas Training Programme form.

The accreditable value of such posts/programmes will be considered on an individual basis. While for some there may be an exact time to training accreditation equivalence, this should not be assumed. The maximum accreditable value given to such posts will normally be 12 months, owing to the overall duration of training programmes in the specialty. Trainees may, by arrangement, stay longer than the training time allowed, but only the agreed amount of time will count towards their CCT.