Career Pathway for a UK Doctor in Training
- October 18, 2022
The NHS offers extensive training schemes and career development for all of its doctors, and such programmes are recognised as a gold standard across the medical world.
Training in the NHS is always in keeping with advances in medical sciences and the progressive landscape of the medical profession, including the more complex ailments of a growing and ageing population. The NHS frequently updates and develops its training programmes, making them attractive to UK graduates and doctors, as well as overseas doctors seeking the very best training.
In this article we will cover the following topics:
- The NHS Training Pathway
- Graduation to Foundation Training
- Specialty Training Programmes
- Different types of Specialty Training programmes
- Completion of Specialty Training Programme
- Should I apply for a training or service post?
- As an IMG, can I get onto the specialist register?
- How do I secure a service post?
Skip ahead to the relevant section if you know what you're looking for.
The NHS Training Pathway
Many IMGs looking to move to the UK (particularly more junior doctors) will be keen to enter into UK Specialty Training at some point, and as such it is important to understand the UK training pathway from start to finish in order to map your NHS career effectively.
Furthermore, greater understanding of the NHS structure and training offered to doctors in the UK will help an IMG to understand at what grade they can likely enter the system and the salary most appropriate for them.
The NHS Training Pathway describes the journey from medical school to completion of specialist training and is the path most commonly followed by UK trainees.
Graduation to Foundation Training
After graduating from a medical school, doctors gain provisional registration with the GMC allowing them to enter the Foundation Programme - a two-year work-based training programme.
Upon completion of the first year (FY1 or F1) doctors will gain full registration with the GMC and can apply for further study and training in a specialised area – known as Core or Specialty Training, depending on the specialty.
Specialty Training Programmes
Completion of the Foundation Programme allows doctors to apply for Specialty Training in an area of medicine or general practice. There are 60 different specialties to choose from.
A doctor entering year one of Specialty Training is known as an ST1 or CT1 doctor.
Specialty Training programmes can take between three and eight years depending on the specialism chosen.
Doctors can pass through the training quicker depending on how fast they achieve their competencies.
Sometimes doctors do not complete the training pathways in the indicated time for a variety of reasons and it can take between 1 - 4 years longer than indicated in the curricula.
Types of Specialty Training Programmes
There are two different structures for Specialty Training programmes, and these vary between specialties.
Run-through Training Programmes
For these training programmes, you only have to apply once at the beginning of the programme. This is because you are recruited for the full duration of Specialty Training.
These training programme can last from approximately three years for general practice, to five or seven for other specialties such as histopathology.
Uncoupled Specialty Training Programmes
These programmes are split into Core Training and Higher Specialty Training.
Core Training lasts for either two or three years and once complete, allows you to apply for Higher Specialty Training, which can take from three to five years.
Overall, Specialty Training programmes can take anywhere from 5 – 8 years in their entirety, depending on your medical specialty, for example 6 years for psychiatry.
Doctors are known as ST1-3 or CT1-3 during their Core Training and ST4+ level during Higher Specialty Training programmes.
Higher Specialty Training programmes are very competitive, and completion of a UK Core Training programme does not guarantee a Higher Specialty Training post. 
Completion of Specialty Training Programme
Upon successful completion of either a run-through or coupled training programme, doctors are awarded a Certificate of Completion of Training (CCT).
At this point doctors are able to make an application for Specialist Registration (or GP Registration) and are able to take up permanent consultant posts.
Training Positions vs Service Posts
As above, competition for places on training programmes within the NHS is very high. As such, we advise that IMGs who are interested in entering core or specialty training in the NHS first obtain a service post for 1 – 2 years.
Following this contract, you can apply for a training post, for which you will be given priority. Not only will this approach give you the best chance of securing excellent training and career progression opportunities in the NHS, it will also give you the chance to settle in to the UK and the NHS system, and help you understand the training post that will suit you the most.
Service posts also offer very competitive rates, so whilst you are getting to know the NHS and settling into life in the UK, you can also ensure that you are financially rewarded.
Specialist Registration for IMGs
IMGs that enter the UK training programmes later on and have not completed the full programme can still get on the specialist register via the CESR-CP route (Certificate of Eligibility for Specialist Registration via a Combined Programme)
Check to see if you're eligible for CESR-CP via the GMC website or read through our detailed blog through our IMG Resources library.
Secure a Trust Doctor Post (with the view to securing a training post at a later date)
You can apply for Trust Doctor or Service Role online via the NHS Jobs website.
However, working with IMG Connect can offer more jobs than are available online with the added benefit of an IMG Consultant speaking directly with services on your behalf to expedite the process and negotiate the best doctor salary for you.
Getting started
Read more useful articles on finding an NHS trust doctor job, training pathways, doctor salaries in the UK, relocation and much more!
Don’t hesitate to get in touch with our team to learn more about the opportunities available to you once as an IMG new to the UK.
For the latest news and updates, including the Royal College, GMC registration and the NHS, follow us on social media and join the conversation:
Relevant Jobs
This is a unique opportunity to work in a developing initiative that will bring immense social good to the local the people of Wales.
Short / mid / long-term ambitions for this role.
Short-term, there is the opportunity to work a close group of four international doctors, with specialist qualifications in histopathology including FRCPath. You\'ll have the opportunity to shape the careers of hungry pathologists ready to absorb all the knowledge and experience from an experienced NHS colleague like yourself.
Mid-term you\'ll be jointly responsible for the successful portfolio submissions for these individuals, helping the laboratory at Glangwili General Hospital to establish a newly qualified consultant team to provide stability and excellent pathological services for the patients of Wales, UK.
Long-term, the potential is enormous. As part of ‘A Regional Collaborative for Health’ or ARCH a regional hub for South and West Wales is being built in Swansea, to house a 30-35 consultant lead service for histopathology alone. Fully digitalised regional services for half the Welsh landmass would be provided via one central and digitalised hub.
Life in the area
It\'s a beautiful life with Wales offering beaches, beautiful forest, lakes and mountains all available to you in your free-time. It\'s a low cost of living and a a bit of a dream for the right person. We can chat more about that over our call.
The UK Lab is based in Surrey, and the facility is ISO 15189 accredited and ISO 27001 certified.
The department provides the latest technology and several years of extensive research offering highly effective treatment solutions to cancer patients for whom, multiple lines of treatment have failed.
The UK lab receives samples that are received from private practices around the UK, Europe and USA.
Responsibilities:
With roughly two hours of work needed per day, mostly remote, with twice weekly attendance onsite likely required, the pathologists responsibilities will be along the lines of the below.
- Authorisation of reports (molecular and tissue)
- Sectioning slides / assessing tumour content - to help identify which sections can be used for processing samples.
- Approving & signing reports.
- Signing out molecular reports - training will be given.
- Signing out solid organ cancer reports
- Turnaround time is required within 24-hours.
Eligibility:
- GMC registration
- Right to work in the UK
- Ability to travel twice per week to Surrey, UK.
- FRCPath or Specialist Registration is not required for this post
An exceptional NHS job opportunity awaits a Middle Grade Microbiologist to join the Microbiology Pathology Department at an \"outstanding\" rate NHS Trust.The role involves diagnosing and managing infections caused by microorganisms, contributing significantly to patient well-being.
This is an ideal chance for overseas Microbiologists or Middle Grade Doctors to establish themselves in the UK NHS system, with potential CESR support. Suitable for EEA-specialized candidates or experienced IMGs seeking career advancement.
What is the NHS Foundation Trust like?
This NHS Foundation Trust is a dynamic organization with an £180 million turnover, employing 12,000 staff to serve 500,000 people across acute and community healthcare services. Recognized for excellence by the CQC in 2016 and 2019, it primarily serves an urban population but extends its care across a rural expanse from the River Tyne to the River Tweed, offering picturesque landscapes. The Trust operates three major hospitals and numerous community facilities, including the state-of-the-art Specialist Emergency Care Hospital. With ongoing capital investments, it ensures modern, purpose-built facilities and expands its services to meet evolving healthcare needs.
They provide an extensive array of specialties, boasting some of the region\'s largest specialist departments. These include the foremost trauma and orthopaedics service, a significant cardiology department, and one of the region\'s most expansive units for colorectal surgery services.
The NHS Foundation Trust prioritizes supporting its staff in achieving a healthy work-life balance, irrespective of individual circumstances. Applicants unable to work full-time due to personal reasons will still be considered for the position, and adjustments to job responsibilities can be discussed on a case-by-case basis upon appointment.
What is the Department & Team like?
The Clinical Support and Cancer Services Business Unit manages Radiology, Pharmacy, and Pathology departments, as well as cancer services, across several hospitals. These services also extend to six community hospitals. With modern facilities and dedicated staff, the Pathology department, including the microbiology laboratory, benefits from significant capital investment and supports medical education initiatives.
The Microbiology team offers clinical consultation services through various channels such as ward rounds, telephone, email, and multi-disciplinary team meetings. They collaborate closely with Infectious Diseases, Infection Prevention and Control, Public Health teams, and the laboratory. Encouragement for networking with Consultant Microbiologists in the Newcastle area is given to improve patient care across organizational boundaries.
The microbiology laboratory holds a central position within the hospital complex. It comprises 240 m² of laboratory space and 74 m² of office space, established during the hospital\'s original construction in 1987. Specimens from clinical areas within the North East site are transported to the laboratory via a vacuum air tube system, while collections from GP practices and other hospital sites across the region are managed through regular courier and van services.
Life like in North East
The North East of the UK offers a diverse landscape, blending urban hubs like Newcastle and Sunderland with picturesque rural areas. Residents enjoy a vibrant cultural scene, from historic sites like Durham Cathedral to sandy beaches along the Northumberland coast. The region hosts reputable universities such as Newcastle University and Durham University, complemented by excellent schools. Transportation links are robust, with rail and road networks connecting to major cities and airports like Newcastle International Airport. Housing options range from city center apartments to suburban family homes and quaint countryside cottages, catering to varied lifestyles and preferences.
An outstanding opportunity for a psychiatrist to join Forensic Psychiatry Department as Specialty Doctor that has received outstanding ratings from the CQC on three occasions. You will offer psychiatric input and conduct assessments, both psychiatric and physical, for patients on two wards. One ward is a self-contained low secure rehabilitation unit situated away from the main hospital premises, while the other is a medium secure rehabilitation ward. This role offers exposure to a broad spectrum of clinical presentations, including personality, affective, anxiety, psychotic, neurodevelopmental, and substance-related disorders. Moreover, it provides a platform for developing knowledge and understanding of forensic mental health sections. This position also offers CESR support for those seeking progression within the UK NHS Jobs system.
This is a great opportunity for overseas Specialty Doctors who want to establish themselves in the NHS, and grow their career. The post is suitable for candidates holding specialisation in the EEA, or for experienced IMGs looking to complete CESR.
What is the NHS Trust like?
The Mental Health NHS Trust is a leading provider of mental health service serving a population of 1.2 million. With five main inpatient sites and 25 community locations, they offer comprehensive support for both mental and physical health needs, catering to young people and adults alike. From managing phobias and anxiety to addressing conditions like bipolar disorder and schizophrenia, their services are diverse and inclusive. They integrate community health services with mental health care, enabling simultaneous treatment of conditions such as diabetes and mental health issues, promoting holistic patient care.
Forensic Psychiatry Team & Department
The Forensic Service enjoys a stellar reputation, earning an \'Outstanding\' rating from the Care Quality Commission. The Forensic Service delivers care in low and medium secure environments, featuring specialized facilities such as the National Stalking Clinic and the Fixated Threat Assessment Centre (FTAC). These services focus on evaluating and managing risks for prominent individuals.
The inpatient service consists of one acute assessment and treatment medium secure male 4 4 ward, four treatment and intervention medium secure male wards, one female medium secure ward, one medium secure and one low secure male learning disability ward, one low secure male FICU ward and 4 low secure male wards. There are currently 25 Consultant Forensic Psychiatrists in post, working with 5 senior psychiatric trainees who rotate with posts at other forensic psychiatric services in the region. There are 5 junior psychiatric trainees, coming from the UCH training schemes. The service currently employs 10 specialty doctors, working in the prisons and in the rehabilitation parts of the service.
Life in the area
The area offers a blend of urban and suburban living, providing both rural escapes and city conveniences. Residents can explore scenic parks or enjoy activities at different parks. The area boasts a range of quality schools and easy access to universities like Middlesex University. Transport links are excellent, with frequent trains to central London and nearby cities, as well as efficient connections to major airports. Housing options vary from historic cottages to modern apartments, catering to diverse preferences and lifestyles.
Career Development and Opportunities Available
With an extremely active education/teaching programme supported by the consultant team, there is opportunity to work towards and complete CESR, RCPsych exams, get involved in active research and many aspects of CPD.
Participation in research and educational activities will be encouraged.
ARE YOU ELIGIBLE FOR THIS ROLE?
EEA Candidates:
- Experience of working in Forensic Psychiatry (Desirable)
Non-EEA Candidates:
- MRCPsych
- Experience of working in Forensic Psychiatry (Desirable)
UK based applicants
- Experience of working in Forensic Psychiatry (Desirable)
An excellent opportunity to join the dynamic team at an esteemed organization recognized for its excellence by the CQC. This is an opportune moment to become part of the Acute Medicine and Medicine Specialties Teams. With a strong history of achievements, they are committed to delivering exceptional patient-centered care. They seek a passionate and driven Acute and General Physicians to contribute to their mission of providing top-tier medical care across various clinical settings. This is a high performing and supportive department for overseas doctors new to the NHS, or UK-based doctors looking to further careers in the UK.
This is a great opportunity for overseas Consultants who want to establish themselves in the NHS, and grow their consultant career. The post is suitable for candidates holding specialisation in the EEA, or for experienced IMGs looking to complete CESR.
What is the NHS Foundation Trust like?
The NHS Foundation Trust stands as one of the nation\'s largest integrated healthcare organizations, delivering both hospital and community services to a populace exceeding 650,000 individuals. Renowned for their ambition and innovation, they boast a skilled workforce comprising over 7,000 dedicated colleagues. Operating across two acute sites for hospital services and encompassing centers and community hospitals in six towns for planned care, they extend their services even to patients\' residences.
Recognized as a high-performing entity with a history of accomplishments, the Trust has functioned as an integrated acute and community services provider since 2011 and achieved foundation trust status in 2007. Guided by their strategic framework \"Our Patients Matter,\" they articulate their short- and long-term objectives and delineate the path to their realization. This framework underscores their commitment to providing the safest, most compassionate, and seamlessly coordinated care to the communities they serve.
Within this NHS Foundation Trust, medical professionals are presented with a plethora of career prospects and exposure to diverse care settings rarely encountered elsewhere. Additionally, they have the opportunity to reside and practice in some of the most culturally rich and picturesque locations across the country!
What is the Department & Team like?
Within the Trust, there are 5 Care Groups: Urgent & Emergency Care, Integrated Medical Specialties, Surgery, Family Health, and Clinical Specialist Services. The Acute Care Team is housed under the Urgent & Emergency Care division. The Acute & General Medicine Department prides itself on delivering comprehensive and compassionate care to patients across a wide spectrum of medical conditions. Staffed by a dedicated team of consultants and junior doctors, the department ensures round-the-clock coverage to meet the needs of their patients. Their department handles a diverse range of cases, including but not limited to respiratory illnesses, cardiovascular conditions, gastrointestinal disorders, and infectious diseases. With access to state-of-the-art diagnostic and treatment facilities, including advanced imaging technologies and specialist clinics, they are equipped to provide timely and effective care to their patients.
The Acute & General Medicine Department boasts modern and well-equipped facilities, designed to optimize patient care and comfort. They have a 30-bedded Acute Medical Assessment Unit. On average, their department handles a significant number of acute and general medicine cases each year, reflecting the trust and confidence placed in their services by the community they serve. They prioritize patient safety, quality of care, and efficient service delivery, ensuring that each patient receives personalized attention and tailored treatment plans to facilitate their recovery and well-being.
The unit is adequately staffed and the working shifts are designed to ensure more doctors are present during the busy period of the day i.e. late evenings. They address the busy winter months by arranging extra locum cover during this busy period. In addition to the acute medicine registrar(s), there is a middle grade doctor, 1 IMT doctor and 4 FY1 doctors with staggered shifts throughout the day. In addition, there will be an on call registrar and 2 on call IMT doctors with staggered shifts. The night team comprises of one registrar, two FY2/IMT and one FY1 supported by an outreach nurse on most nights.
What is life like in the area?
The North East of the UK offers a diverse mix of rural and urban settings, providing doctors with a range of living options. Residents can explore stunning coastal areas like Northumberland\'s beaches or venture inland to scenic national parks such as the North Pennines. The region is home to respected schools and universities, including Newcastle University. Transportation links are robust, with efficient road and rail networks connecting residents to major cities like Newcastle, Durham, and Sunderland, as well as international airports. Housing options range from quaint cottages in picturesque villages to modern apartments in vibrant city centers, catering to various lifestyles.
Career Development & Opportunities Available
ARE YOU ELIGIBLE FOR THIS ROLE?
EEA Candidates:
- Experience of working in Acute & General Medicine
Non-EEA Candidates:
- MRCP
- Experience of working in Acute & General Medicine
UK based applicants
- Experience of working in Acute & General Medicine