Postgraduate Medical Education (PME) Project
The information listed for the United Kingdom was provided by individuals knowledgeable about PME in the United Kingdom. If you note errors or omissions or would like to provide additional information, please click here.
- Duration of studies
- Trainee selection process
- Specialty curriculum authority
- Licensing authority
- Areas of specialization
- Legal references
Duration of studies
General practice (3 years)
Higher specialist training is not required for doctors wishing to enter general practice. The requirement is to complete two years in an approved senior house officer post and one year as a General Practitioner (GP) trainee. After this, a Certificate of Prescribed Experience (CPE) or of Equivalent Experience (CEE) is issued.
To become a trained specialist in the hospital service in the United Kingdom (UK), doctors must obtain qualifications and experience in addition to their primary medical qualification (first degree in medicine).
Training is carried out in two stages after the pre-registration (internship) year has been completed:
- Basic Specialist Training (At Senior House Officer [SHO] in hospital grade): 2 years
- Higher Specialist Training (At Specialist Registrar [SpR] in hospital grade, and Consultant): 4-6 years
The successful completion of training will take at least six to eight years (two years in SHO grade and four to six years in SpR grade). A doctor can then apply to the Specialist Training Authority (STA) of the Medical Royal Colleges for a Certificate of Completion of Specialist Training (CCST). When this certificate has been awarded, the doctor may then apply to the General Medical Council (GMC) for inclusion in the Specialist Register, after which doctors may become candidates for substantive and honorary consultant posts in the National Health Service (NHS). This procedure became a legal requirement at the beginning of 1997.
Trainee selection process
Access is through the basic specialist training. Once completed, it is necessary to do one year as a General Practitioner trainee. Some doctors who become General Practitioners may wish to study for examinations of the Royal College of General Practitioners (RCGP); however, this is not obligatory. Others may wish to obtain Membership of the Royal College of Physicians (MRCP) or Membership of the Royal College of Obstetricians and Gynaecologists (MRCOG), or other specialist qualifications as a useful addition to their training.
Doctors should be aware that appointment to a post is competitive, although from time to time and for varying reasons, the degree of competition may change; i.e., a post may become more or less freely available.
Basic Specialist Training
Training usually takes place during the two or three years after registration. In practice, the period may be longer due to shortages of suitable vacancies in certain popular specialties at the higher level. During this period, doctors obtain three or four training posts approved by the Postgraduate Dean in the SHO grades. These posts are advertised in the British Medical Journal, The Lancet, and others journals. Posts are filled through open competition, and doctors are usually required to attend an interview. These posts, which are salaried, serve to broaden their experience. In-service training and short courses are arranged by the hospital to supplement the working experience.
Higher Specialist Training
Higher specialist training is very competitive. Although there is a special grade called Visiting Specialist Registrar (VSpR), the availability of these posts is very limited, and the regulations with regard to them appear to vary in different parts of the country and health service. Unfortunately, it does not follow automatically that, upon passing the MRCP or Fellowship of the Royal College of Surgeons (FRCS) there will be easy or immediate access to training at the higher level.
Doctors in higher specialist training will be eligible to apply for an initial grant of three years permit-free training on first entering the UK or after completing basic specialist training (where this is appropriate) with provisions for further extensions of stay, each not exceeding three years, depending on the requirements of their training program. The amount of time will be closely allied to the training program, enabling doctors to pursue the CCST where this is appropriate.
The revised arrangements do provide for doctors to move from basic to higher specialist training. Doctors moving to higher specialist training after four years in basic training are eligible to apply for an extension of up to three years and further extensions as appropriate. Doctors moving during an existing permit-free training period continue in that period until expiry, at which time an application can be made for an extension of up to three years with further extensions as appropriate. All extension requests must have the support of the Postgraduate Dean.
Specialty curriculum authority
Basic and higher specialist training in almost all specialties is controlled by the various Royal Colleges and Faculties, who regulate their own examinations.
Doctors requiring higher specialist training are supervised by Postgraduate Deans with the guidance of the Royal Colleges and Faculties.
Areas of specialization
Basic Specialist Training
The list below is a selection of qualifications that may be obtained during basic specialist training. The MRCP is considered essential for doctors aiming at higher specialist training in a medical specialty and is also a useful additional qualification for those wishing to enter other specialties. Doctors intending to pursue a career in surgery initially take the Membership of the Royal College of Surgeons (MRCS)/Associate Fellow of the Royal College of Surgeons (AFRCS) examinations (two to three years). For other specialties, the doctor takes the examinations appropriate to those areas.
- MRCP - Membership of the Royal College of Physicians
- MRCS - Membership of the Royal College of Surgeons
- AFRCS - Associate Fellowship of the Royal College of Surgeons
- MRCOG - Membership of the Royal College of Obstetricians and Gynaecologists
- MRCGP - Membership of the Royal College of General Practitioners
- FCAnaes - Fellowship of the College of Anaesthetics
- MRCPath - Membership of the Royal College of Pathologists
- Primary examinations
- First examinations
- AFOM - Associateship of the Faculty of Occupational Medicine
The second parts of the MRCPath and the Membership of the Faculty of Occupational Medicine (MFOM) exams, are taken during the period of higher specialist training.
Higher Specialist Training - Certificate of Completion of Specialist Training (CCST):
- Accident and Emergency Medicine
- Audiological Medicine
- Cardio-vascular Disease (Cardiology)
- Chemical Pathology
- Child and Adolescent Psychiatry
- Clinical Cytogenetics and Molecular Genetics
- Clinical Genetics
- Clinical Neurophysiology
- Clinical Pharmacology and Therapeutics
- Communicable Disease (Infectious Diseases)
- Community Medicine (Public Health Medicine)
- Diagnostic Radiology (Radiology)
- Endocrinology and Diabetes Mellitus
- Forensic Psychiatry
- General Medicine
- General Surgery
- Immunology (Immunopathology)
- Medical Handicap Psychiatry
- Medical Microbiology (Medical Microbiology and Virology)
- Medical Oncology
- Medical Ophthalmology
- Morbid Anatomy and Histopathology
- Neurological Surgery (Neurosurgery)
- Neurology Nuclear Medicine
- Obstetrics and Gynaecology
- Occupational Medicine
- Old Age Psychiatry
- Oral and Maxillo-facial Surgery (Basic Medical and Dental Training)
- Orthopaedic Surgery (Trauma and Orthopaedic Surgery)
- Paediatric Surgery
- Palliative Medicine
- Plastic Surgery
- Psychiatry (Mental Illness)
- Renal Disease (Nephrology)
- Respiratory Medicine (Thoracic Medicine)
- Thoracic Medicine (Cardio-thoracic Surgery)
- Tropical Medicine
- Venereology (Genito-urinary Medicine)
There is also a Specialist Training Certificate in General Practice.
There are also opportunities to study for postgraduate degrees and diplomas, for example:
- Diploma in Tropical Medicine and Hygiene (DTM&H)
- Doctor of Medicine (MD)
- Master of Surgery (ChM or MS)
- MSc in Cardio Vascular Studies
- MSc in Chemical Pathology
- MSc in Haematology
- MSc in Immunology
- MSc in Medical Microbiology
- The Medical and Health Ordinance 1997
- Legal Notice N° 25 of 1997