UK Doctors’ Titles Explained
Getting to grips with the different titles given to doctors in the UK can be difficult, not least because they may differ from those used in other countries and there may be several titles to describe a certain role.
It is important for overseas doctors to have a working knowledge of the different doctor titles in the UK in order to understand how their experience may translate to the UK in terms of seniority of roles as well as the pay they may be entitled to.
In this blog we will be breaking down all the different names given to UK doctors (both in and out of training), clarifying the meaning of these terms to paint a clearer picture of designations in the NHS.
We will cover these titles within the following groups:
Doctors in Training
Doctors in GMC-approved training programmes have designations according to the period and specific year of their training – generally the abbreviation of the training, followed by a number.
Other Titles / Designations: F1, F2, FY1, FY2, F3+, SHO, Junior Doctor, Trainee
These are doctors in a Foundation Programme, having graduated from medical school. In the UK, this is a 2-year programme equivalent to an internship.
During Year 1 of Foundation Training, doctors are referred to as F1/ FY1 and during Year 2, they are F2/ FY2.
Although Foundation Training lasts two years, doctors who may be unsure of which specialty to pursue may work in non-training jobs before applying to a training post. The naming structure for these roles is the same, depending on the years in their role.
Other Titles / Designations: CT1, CT2, CT3, ST1, ST2, ST3, SHO, Junior Doctor, Trainee
These are doctors in Core Training who are at the initial stage of an ‘uncoupled’ training programme. An uncoupled training programme is one in which there is a break in training where doctors are required to apply to higher specialty training upon completion of core training. Core training usually lasts from two to three years.
For ‘run-through’ training programmes, doctors at ST1 would have come from Foundation Training and have automatic entry into higher specialty training through their initial application to ST1.
Other Titles / Designations: ST3+, StR, SHO, Junior Doctor, Trainee
Higher specialty training generally begins at ST3/ ST4 and can go up to ST9 depending on the specialty.
The curriculum for each specialty will provide the typical training period, however this is indicative (doctors may take longer than this to complete their specialty training for any number of reasons).
The term SHO stands for Senior House Officer, less commonly known as a House Officer. This is an older term for a very junior doctor, typically equivalent to an F1/ F2, although the term can be used to describe doctors up to CT2 (up to higher specialty training).
The term trainee can refer to any doctor in a training programme (generally from CT1 to ST9). These doctors may be referred to as residents in other countries. This can but does not generally include doctors in Foundation Training.
Doctors in non-Training Jobs
Doctors in non-training positions are often given titles which align with their training counterparts, so it’s easier to understand at what level they are practising, but there are no hard and fast rules.
Other Titles / Designations: Junior Clinical Fellow, Junior Doctor, Middle Grade
As with doctors in training, a non-training SHO would typically be equivalent to an F1/ F2, but it may be more common for a doctor not in training to have this title since an equivalent doctor in training would most likely be referred to as an F1/ F2.
Senior Clinical Fellow
Other Titles / Designations: Junior Doctor
This is a slightly confusing term which is usually for doctors at ST3+ level and generally have not completed a UK training programme. The role of these doctors often includes a combination of research and specialist clinical work.
Other Titles / Designations: Senior Doctor, Specialist
SAS stands for Staff grade, Associate Specialist, and Specialty Doctor. These doctors will have at least four years of full-time postgraduate training, two of which have been in their relevant specialty.
They are experienced and senior doctors in fixed term or permanent posts (outside a UK training programme) and can work across primary, community and inpatient care.
Many SAS doctors have made a positive choice to step into a SAS position from a traditional consultant training pathway. This could be for reasons such as geographical stability or wanting to familiarise themselves with the NHS system before working up to a consultant position.
There are also several terms which may more broadly be used to describe a doctor's level.
This term can be used to describe anyone from F1 up to ST9These are qualified doctors in clinical training.
Other Titles / Designations: SpR, Junior Doctor, Middle Grade
This is another slightly older term. Registrar or SpR (Specialty Registrars) refers to the main training grade where doctors are undertaking higher specialty training (this is the earliest you can specialise).
It can refer to both trainees and non-trainees and is generally equivalent to ST3 and above (doctors who have completed their foundation training but are still in training in a specialty area of medicine). This term is therefore commonly used to describe more senior trainees and generally aligns with its use overseas.
Other Titles / Designations: Specialist Grade, Specialty Doctor, Associate Specialist, GP, Consultant
As ‘junior doctor’ and ‘senior doctor’ are indicative of whether or not a doctor is in training, senior doctors are those able to practise independently – those working as a consultant, SAS doctor or GP.
Other Titles / Designations: Senior Doctor
Consultants are senior doctors that have completed full medical training in a specialised area of medicine. They usually work in hospitals or community settings. They have clinical responsibilities and administrative responsibilities in managing SAS and junior doctors.
There are two types of consultants:
Substantive - These are consultant who have been appointed to the Specialist Register for their area of medicine by the GMC. These doctors will either have completed a GMC-approved training programme (CCT) or completed an application for CESR or CESR-CP. You can learn more about Specialist Registration for overseas doctors here.
Locum - These are consultants who are appointed into an equivalent consultant post but are not required to be on the Specialist Register. Locum consultants are unable to take up a permanent position (only fixed term). A locum consultant’s work tends to be more clinical, however there may also be teaching and management responsibilities involved. It is also important to distinguish between two types of locums here: Trust Locums and Agency Locums. As the name suggests, agency locums work with a private agency and will generally receive an hourly wage. Trust locums on the other hand are appointed by the NHS Trust themselves and will be on a fixed-term contract which can be renewed.
GP stands for General Practitioner, and these are doctors who are responsible for the primary care of patients, covering illnesses and ailments across many specialist areas.
GPs are fully trained and are allowed to practice independently without supervision and all qualified GPs are listed on the GMC’s GP Register.
Unlike is often the case in overseas healthcare systems, general practitioners are not synonymous with doctors specialising in general medicine, so a general practitioner overseas may not necessarily have the same title in the UK.
These are doctors who are covering a role within a healthcare setting.
All doctors (aside from F1 doctors) can work as locums. Like all practising physicians, locum doctors are fully registered with, and regulated by, the GMC.
Hopefully, this article goes some way to demystify these terms and titles for international doctors interested in working in the UK. For more information including working in the NHS, doctors' benefits and salaries and how to register with the GMC, take a look through our IMG Resources library.