Introduction

A core component within the multidisciplinary public health agenda from the start was to widen training opportunities for public health practitioners outside medicine with an eye to breaking the glass ceiling in public health at the highest level. The early 1990s had seen the opening up of Master's courses in public health to those without a medical degree but the route to specialist jobs in public health was exclusively through specialist registration with the General Medical Council (GMC), which was normally achieved via a formal training scheme in public health medicine that was only open to medical graduates.

Following the publication of Saving lives: our healthier nation (DH, 1999a), as we have seen earlier, public health consultant posts in health authorities began to be advertised to suitable candidates both with or without medical qualifications, and in 2003, a retrospective route to voluntary specialist registration via portfolio assessment was opened for senior non-medical people in public health, previously working, but not previously recognised as being, at specialist level. This was seen as a time-limited, ‘catch-up’ exercise, and those working to develop the public health workforce foresaw the need to develop, in parallel, a prospective training route to specialist appointments to develop the next generation of multidisciplinary public health specialists. It is the evolution of these multidisciplinary higher specialist training schemes that is the focus of this chapter.

As will be shown, the creation of a single, nationwide multidisciplinary higher specialist training scheme in public health took a number of years. It evolved in a piecemeal fashion against the backdrop of the rising attention being paid to the inequalities in training, development and accreditation of those working in public health outside of medicine, and the work of the Multidisciplinary Public Health Forum (MDPHF) and the Tripartite Group outlined earlier in the book. Many of the early training schemes for those from backgrounds other than medicine that emerged little resembled their medical counterparts, but, over time, they evolved into something that was equivalent and, later, fully integrated with medical training in public health: a unique outcome within a medical specialty.