User:Matt641/Medical training in the United Kingdom

Medical training in the United Kingdom covers the activities involved in the training of medical doctors in the United Kingdom.

Medical School
Entry to medical school in the United Kingdom is a process administered by the Universities & Colleges Admissions Service. Entry is competitive, with over ### students applying for ### places and typically requiring high grades at both GCSE and A-level as well as evidence of extra-curricular activities and achievements. The majority of medical schools in the United Kingdom are affiliated to one or more universities, with the exception of St George's Medical School, London. All are public institutions.

Although teaching methods, curricula and experiences differ between schools, the core medical school requirements are laid down by the GMC's publication Tomorrow's Doctors. This is designed to provide a minimum safe standard for clinical practice and entry into the foundation programme. Regulation of medical schools in the UK is the responsibility of the GMC's Quality Assurance of Basic Medical Education (QAMBE) programme.

Students at this stage in the UK are known as Medical Students or Student Doctors.

Foundation Programme

 * See main article: Foundation House Officer

Upon graduation from medical school, doctors in the UK obtain provisional licensing with the GMC, allowing them to practise medicine in hospital provided they are enrolled in a specific training programme. This is known as the Foundation Programme and is administered by the UK Foundation Programme Office (UKFPO) and as of 2010 is regulated by the GMC. This programme is compulsory for all newly qualified UK doctors wishing to practise in the UK.

Application to the Foundation Programme is competitive and based on a standardised application form. Based on a score out of 100, applicants are allocated to to a deanery that covers a geographic area of the United Kingdom. Applicants are then competitively allocated to training programmes, again based on their score.

Training programmes differ between deaneries, but over the 12 months of the F1 year at least 3 months of surgery and 3 months of medicine in 2, 3 or 4 rotations are typically offered. At the end of the first year, doctors are eligible for full GMC registration. During the F2 year, trainees complete another three 4 month rotations.

Doctors at this stage of training are termed 'junior doctors' and are designated F1/F2 or FY1/FY2 doctors or Foundation House Officers. Responsibilities at the F1/F2 level typically involve providing care for patients as part of a 'firm' of other speciality doctors, completing that firm's administrative tasks, being the first point of contact for medical problems on the ward arising during the day, and providing 'on-call' cover to the wards and acute medical unit out of hours.

Speciality Training

 * See main article: Specialty registrar

On completion of the Foundation Programme, doctors are eligible to apply to further post-graduate training in their chosen specialities. The pathway for training as well as time required until completion of training depends on the doctor's desired career. Training programmes available at this point are 'uncoupled' posts, which involve a 'core' period of training (2-3 years) before further application to speciality posts (4-6 years), or in some specialities, 'run-through' training is available which does not require further competitive entry.

Medicine
Doctors wishing to practise hospital medicine must enrol into the Core Medical Training (CMT) programme which lasts for 2 years and is designed to fulfil the competencies required for a doctor applying to further specialist training at ST3 level. Entry to the Acute Care Common Stem pathway is also an option for acute medical specialities. Trainees usually complete the first part of their examinations to the appropriate Royal College at this stage.

Entry to ST3 level after core training is competitive. The career options available to a trainee depend on their choice of ST3 training programme, with programmes allowing the acquisition of different competencies and sub-speciality knowledge, as well allowing dual or triple certification on completion, depending on a trainee's desired career path.

Surgery
Doctors wishing to become surgeons must enrol into the Core Surgical Training (CST) programme which lasts for 2 years. Further training depends on sub-speciality, but is typically 6 to 8 years.

General Practice
Doctors wishing to become General Practitioners apply directly to the GP Speciality Training program which lasts for 3 years, normally comprising 18 months of hospital medicine and 18 months based in a training practice.

Others
Anaesthetics trainees enter core anaesthetics training (2 years) or ACCS before a further 5 years of training. Emergency medicine trainees must complete ACCS before a further 6 years of training. Occupational Health trainees complete CMT or ACCS before a further 4 years of training. Oncology trainees complete CMT or ACCS before a further 5 years of training. Psychiatry trainees complete 3 years of core training before application to psychiatric specialities, 5 years. Run through training is available to public health and radiology trainees who enter directly into 5 years of training; obstetrics and gynaecology, neurosurgery and ophthalmology 7 years; paediatrics 8 years. In these specialities, Fixed Term Specialty Training Appointments (FTSAs), usually lasting a year, are available to those who wish to gain more experience before progressing.

Assessment of doctors during this period is carried out by workplace assessments, demonstrating that doctors fulfil the required competencies for their level of training, as well as completion of the relevant post-graduate examinations. Although the training times described above are the minimum specified by the GMC, training may take longer if the required competencies are not met during this time or a trainee decides to lengthen training through research. Upon completion of speciality training, doctors are awarded the Certificate of Completion of Training (CCT) which enables their entry onto the specialist register and application for consultant posts.

Doctors at this stage of training are termed 'middle grade doctors' and are designated CT1-3 (if enrolled into a core training programme) or ST1-8 doctors, depending on the training pathway, with the number denoting which year of speciality training they are in. The new title (post MMC) for these doctors is StR (Specialist Training Registrar). However, the old SHO (Senior House Officer) and SpR (Specialist Registrar) titles are frequently used to refer to doctors in their core and later years of their speciality training respectively. Responsibilities of doctors at this stage of training vary widely according to speciality, hospital and individual competence. Typically in a hospital setting, an SHO. A SpR would be expected to conduct the day-to-day management of the vast majority patients under that firm's care, see outpatients in clinic and provide 'on-call' cover for their speciality.

Consultant

 * See main article: Consultant (medicine)