In this article, we will explain what goes on after medical school and the training process for new doctors in the UK. It is important for you to have an idea of this as a med school applicant, not only to be able to answer interview questions on this when asked but also to be aware of the steps that lie ahead for you in your future career.

At the end of medical school

Let’s start from the very beginning of a Doctor’s journey: finishing medical school. The next step after finishing Med School is going into Foundation training. This is a 2-year program: foundation year 1 and foundation year 2. The new Doctor is working in a post and training at the same time and this has to be done in the NHS. At this point the Doctor hasn’t chosen their specialty yet- this is another step that will come later.

During foundation training, the new Doctors rotate through 6 different specialties. During the F1 year, the young Doctor has provisional registration with the General Medical Council, meaning they are not fully registered yet, it is necessary for the F1 year to be successfully completed in order to obtain full registration for their F2 and beyond.

What happens during Foundation training?

The F1 doctor’s roles include seeing the patients every day with their senior during “ward rounds” and performing day-to-day jobs on the ward like ordering blood tests and imaging, and prescribing medications. Another important role for them is liaising with different members of the team like nurses, physios, dieticians, and admin staff but also with patients’ relatives and GPs (family doctors). When the patient leaves the hospital at the end of their stay the Junior Doctors write a discharge letter and prescribe medications for the patient to go home with. They also have to take part in on-call shifts out of hours, to cover the wards and help with emergencies.

The F1 doctors are there to learn so they often work with their seniors and discuss patient issues with them before making a plan. There are many things in place for the F1s to learn as well like weekly teaching, 1 to 1 mentoring and opportunities to go to clinic or theatre sometimes.

During the F2 year, the Doctor has more responsibilities but still remains very supported. They are sometimes referred to as SHOs (Senior House Officers) and can have a more intense working rota as well. At this stage, the junior Doctor has usually developed an idea of where they want to direct themselves in the future for their career and they start applying for the next stage of their training.

Different options after Foundation Training

After completing 2 years of foundation training, the Doctor goes into the next stage of their training. This is where they decide what they want to specialise in and start training only in this specialty. Some specialties have direct training routes while others require different steps: a Core training stage followed by a Further Specialty training stage, the former lasting 2-3 years and the latter 3 to 6 years. It’s important to remember that throughout training the Doctor is paid and salaries increase with each increase in role and responsibility. Some Doctors decide to take time out after Foundation training and rejoin training a year later or at a later stage, this can also be done at other points during the training programmes.

General Practice

If they have decided to become a GP (General Practitioner or family doctor), the training for this specialty is 3 years after foundation. This training includes some hospital jobs and some GP jobs where the doctor is supervised and then more and more independent in their appointments with patients until they are fully qualified as an independent GP.

More info here:

Qualifying as a GP in the NHS (rcgp.org.uk)

Surgical Specialties:

A doctor interested in a Surgical specialty will go into Core Surgical Training, which is 2 years, a necessary step to go into further Specialty training after this. There are 10 surgical specialties including general surgery, vascular surgery, and orthopaedics, among others.

More info here:

Surgery Career Paths — Royal College of Surgeons (rcseng.ac.uk)

Medical Specialties:

A Doctor interested in Medical specialties like cardiology, respiratory medicine, endocrinology or neurology will go into Internal Medicine Training which is 3 year before again pursuing further specialty training after this in the branch of their choice. Some specialties such as dermatology or haematology require 2 years of Internal Medicine Training not 3 but are otherwise very similar.

More info here:

Shape of Training and the physician training model | JRCPTB

Internal Medicine | JRCPTB

Other routes

There exists more routes such as the Acute Care Common Stem Programme that allows Doctors to then access the Emergency medicine specialty (doctors in A&E) and Anaesthetist training as well.

More info here:

ACCS

Direct specialty routes

There are also direct routes for some specialties such as Paediatrics, Obstetrics & Gynaecology, Ophthalmology, Public health and others. For example, Paediatric training is 8 years and O&G is 7 years.

More info here:

Education and careers | RCPCH

Applying to training

The training programmes described above all have to be applied to after foundation training and applicants go through a process of CV and interviews before getting offered a place. One can apply multiple times to a training programme, working in a non-training job in the meantime which can allow them to gain experience and build their CV for the next application. These posts can be quite competitive especially in big cities.

The end of training

During Further training (after Core trainings steps) the Doctor is referred to as a Registrar as they are registered with the Royal College of their Specialty and have passed some knowledge and skill exams as well. Some specialties with long trainings recognise Junior and Senior registrars. After completing the required amount of time in training but more importantly having acquired all the competencies and passed required exams the Doctor becomes a Consultant, the most senior position of a Doctor and has completed their training fully. Some Doctors may take extra time during their training to undertake research with a PhD or perfect their clinical skills with a fellowship in a specialised centre. Many doctors explain that training is incredibly interesting and a journey that in fact never stops as one always keeps on learning and progressing.

If you want help getting into your dream university then also be sure to check out our Coaching Programme. As part of this programme, you will get in-depth help with the entire application process from whatever stage you join at till you get into the medical school of your choice. This is done through 1-on-1 mentoring, and the founder of the course, Dr Ashley Hilton is always available for any questions. You can find out more about the Programme here.

Written by Marianne Gazet