Guest blog by Dr Sanjay Kumar
"Once you can do occupational health in the police sector, you can practise occupational health anywhere!" It was these words - uttered by my mentor - that started me on the path to a fascinating and rewarding career in police occupational health. I remember that day well. I picked up his call as a newly qualified diplomate in occupational medicine with no previous working experience of occupational health. This was my first occupational health job, and, through a structured induction programme, I was carefully being transitioned from a GP of 20 years to an occupational health physician (OHP).
"I don't know," I replied, voicing my hesitation. "I hear police work is really difficult. It’s so specialised - surely, I need a good few years doing occupational health in other areas first?" "That's exactly backwards," he said. "The police work will very quickly have you thinking exactly like an OHP should be thinking. In no time, you’ll make it a habit to think in terms of workplace safety, task suitability and adjustments. You’ll rapidly build clinical judgment skills that transfer seamlessly to any other sector. Ah, but I do have one warning for you," he said, adding a dramatic pause, "once you experience it, other occupational health work might seem rather mundane by comparison."
My mentor explained that he had taken the liberty of suggesting me for the role of Force Medical Adviser (FMA) to a large police force. By the end of the call, I was intrigued enough to agree to the role.
The Deep End: First Months as an FMA. My first week was a baptism of fire. I found myself in what felt like a different world with its own unique culture, challenges and even vernacular. The learning curve was steep: familiarising myself with the different police and support roles, balancing work capacity with public safety considerations, navigating police regulations, understanding the real meaning of “risk assessment” and making recommendations that would impact not just careers, but identities. The work was onsite - and I was grateful it was because I was immediately struck by how welcoming everyone was. HR personnel, senior Command Officers, the wider Employee Wellbeing team, including Health & Safety, all took the time to meet with me and help me settle in. From the first day, I was made to feel part of the team.
The first few weeks were all about orientation and included fascinating and varied workplace visit opportunities. I spent time with operational Police Officers, Call Handlers (who take 999 calls), and Firearms Officers. I started conducting clinics under a senior FMA’s supervision. The cases kept coming, each with its own layers of complexity: a detective experiencing insomnia and flashbacks after months of working on a particularly disturbing child protection case; a response officer with deteriorating lower back pain who feared reporting it would mean permanent “desk duty”; a custody sergeant facing hearing loss but resistant to workplace accommodations that might undermine his authority; and so on.
Each assessment required me to understand not just the medical aspects but the physical demands, psychological pressures, and organisational culture that shaped these officers' experiences. I was constantly stretching beyond my comfort zone, developing clinical judgment in situations where there was rarely a textbook answer. Working in the police sector gave me exposure not just to fitness for work assessments but various health surveillance programmes too; a reality that gave rise to an opportunity for a workplace visit to a firearms room where guns were discharged.
As the months rolled on, my diary became more varied exposing me to occupational health (OH) in local authority, NHS and the manufacturing sectors. It was then that I realised the truth that police occupational health had equipped me with an arsenal of transferable skills:
- Nuanced risk assessment. When you've evaluated whether an officer can safely carry firearms following treatment for depression, determining if an office worker can return after stress leave becomes straightforward by comparison. The stakes in police OH demand a level of precision and judgment that elevated my overall clinical approach.
- Crisis-ready decision making. Police work presented urgent situations requiring immediate OH input. A public order incident leaving officers injured, a firearms deployment gone wrong, or a critical staffing shortage during a major incident, all required rapid but thorough assessment and clear recommendations. This ability to make sound decisions under pressure became second nature.
- Psychological health expertise. I developed a deep understanding of trauma, operational stress, and resilience that far exceeded what I might have gained in other sectors. Working with officers exposed to the darkest aspects of human experience taught me to recognise subtle signs of psychological distress and to coordinate the implementation of effective interventions before crisis points.
- Communication across hierarchies. Police forces operate with strict command structures. Learning to effectively communicate health recommendations to everyone from new recruits to chief superintendents honed my communication style while maintaining clinical authority, which has proved invaluable in every workplace setting especially in initiating and navigating case conferences that add value to all parties.
- Balancing individual and organisational needs - balancing the needs of individual officers with the operational requirements of the force and public safety considerations. This complex ethical balancing act developed my ability to see beyond the immediate clinical presentation to the wider implications of OH decisions for both employer and employee.
To spend more time with my family, I made the decision to leave my full-time employment and become self-employed. Whatever type of OH work I became engaged in, I found myself navigating every issue with a confidence and clarity that surprised me.
"How are you making these decisions so quickly?" I was asked by an OH nurse who was escalating complex cases to me on behalf of her employer. We were reviewing a case involving a worker with poorly controlled epilepsy who operated heavy machinery. I smiled, thinking of my mentor. "When you've had to decide whether someone with a medical condition can carry a firearm or drive at high speeds in emergency response situations, the risk assessment frameworks become second nature," I explained. "The principles are the same, even if the context is different."
I found that my police experience had given me an edge. The analytical thinking, the ability to ask the right questions, the skill in communicating difficult decisions, all transferred seamlessly to any new environment.
My mentor had been right.
I soon found myself missing the unique challenges of police OH. I craved the intellectual stimulation and sense of purpose I'd found in supporting police officers and police staff. I missed the complexity of cases that required me to constantly expand my knowledge. I missed the direct impact of helping officers return to roles they were passionate about. I missed being part of a system that supported those who, in turn, selflessly and heroically supported our communities during their most vulnerable moments.
Looking back on my career path, I am proud that I had the courage to step into a sector that would define my professional identity. Police OH has given me not just transferable skills but also a sense of purpose and a never-ending source of intellectual stimulation. Any physician considering this path, I encourage you to embrace the challenge. The complexity that initially seems daunting becomes your greatest professional asset, and the impact you can have on both individual officers and police organisations is genuinely meaningful.
A longer version of this blog has been published by IOH.
Dr Kumar is Director of FMA Services at R-Health, a leading provider of Occupational Health Services for the Blue-Light sector.