After completing the Foundation Programme in the United Kingdom, doctors progress further into postgraduate medical training, which involves specialty training and ultimately may lead to becoming a consultant. The structure of postgraduate training can vary depending on the chosen specialty, but the following is a general overview:
1. Specialty Training (ST):
- Core Training (CT): Many specialties start with core training, typically lasting 2-3 years. Core training provides a broad foundation in the chosen specialty and includes rotations in various subspecialties.
- Higher Specialty Training (HST): After completing core training, doctors move on to higher specialty training, which is more focused on a specific area within the chosen specialty. This stage can take between 4 to 6 years, depending on the specialty.
2. Assessments
Throughout the entirety of training doctors are expected to pay for and maintain both a logbook of activity and a portfolio of assessments. These assessments include case discussions, observation of procedural skill and clinical interactions. Different specialties have additional requirements such as video recording of clinical interactions.
3. Portfolio Activities
These include the completion of regular audit and research projects, presentations and posters at national and international conferences, peer reviewed publication, additional qualifications (including diplomas, certifications, postgraduate degrees)
4. Exams and Assessments:
Throughout specialty training, doctors are required to pass relevant examinations, often including written, clinical, and practical components. Successful completion of these exams is crucial for progression in the training pathway. These exams are challenge candidates with both breadth and depth of knowledge. Many specialties have two sets of exams, one at the beginning of training (completed at CT2 level) and an exit exam completed midway through Higher specialty training.
3. Certificate of Completion of Training (CCT):
Upon successful completion of specialty training, doctors are awarded a Certificate of Completion of Training (CCT), which allows them to apply for consultant posts. The CCT signifies that the doctor has completed the required training and is eligible for entry onto the Specialist Register with the General Medical Council (GMC).
An alternative pathway – CESR (Certificate of Eligibility for Specialty Registration) – also allows doctors who do not follow the pathway above to attain specialist registration. The requirements are the same, but offer some flexibility as compared to the often rigid nature of traditional training posts.
4. Fellowships
With the complexity of the demographics and the conditions now present many doctors opt to take on a fellowship opportunity for super specialist training either in the UK or at recognised centres of excellence around the world. These are often highly valued and highly competitive posts that have a waiting list of applicants. This is more applicable to hospital based doctors.
5: Applying for Consultant Posts
Once ready, a doctor on the specialist register or GP register is eligible to apply for a consultant post in hospital or primary care.