A specialty registrar (StR), previously known as and still commonly referred to as a specialist registrar (SpR), is a doctor, public health practitioner or dentist who is working as part of a specialty training programme in the UK. This is known as a training grade as these doctors are supervised to an extent, as part of a structured training experience that leads to being able to undertake independent practice in a hospital specialty or working as a general practitioner. [1]
This training grade was introduced into UK postgraduate medical training in 2007 as part of the Modernising Medical Careers programme with the specialty registrar training places being created instead of the Senior House Officer (SHO) and Specialist registrar (SpR) posts.
In the UK medical system, a specialist is someone who has the necessary experience and qualifications to be placed on the GMC's Specialist Register. [2] Only persons on the Specialist Register can be appointed consultants in the National Health Service (NHS). Training to become a General Practitioner will also involve a Specialty Registrar training scheme and completion will lead to eligibility for entry on the General Practice Register. [3]
Doctors can enter this training grade after completing their foundation training, but need to go through a competitive process of entry into specialty training schemes. [3] Completing the training scheme will lead to the award of a Certificate of Completion of Training (CCT), subject to satisfactory in-training assessment and progress; this is a necessary pre-requisite for entry onto the Specialist Register or GP Register. [3] From 10 May 2013, fees paid by trainees are an allowable tax deduction from employment income, or alternatively are not liable to tax and national insurance as a benefit if paid by the employer. [4]
Specialty Training programmes vary in length and are tailored to the needs of the specialty. The curricula used for the different specialty training schemes are set by the relevant medical royal college. [5] Under the old system, before applying for the old Registrar posts, applicants were required to have sat and passed part, or all, of a medical royal college's membership examinations while still a Senior House Officer. Under the new system Foundation doctors do not need to sit these exams as they play no part in the selection process and are discouraged from doing so. [6] It is, however, still common practice to begin to take these exams during the second year of the foundation programme and is recommended by experts outside MMC. [7] The appropriate royal college exams will now be taken during the first year or two of the Specialty Registrar training scheme. [6]
Year | Current (Modernising Medical Careers) | Previous | ||
---|---|---|---|---|
1 | Foundation doctor (FY1 and FY2), 2 years | Pre-registration house officer (PRHO), 1 year | ||
2 | Senior house officer (SHO), minimum 2 years; often more | |||
3 | Specialty registrar, general practice (GPST), minimum 3 years | Specialty registrar, hospital speciality (SpR), minimum 5 years | ||
4 | Specialist registrar, 4–6 years | GP registrar, 1 year | ||
5 | General practitioner, 4 years total time in training | |||
6–8 | General practitioner, minimum 5 years total time in training | |||
9 | Consultant, minimum 7 years total time in training | Consultant, minimum 7–9 years total time in training | ||
Optional | Training is competency based, times shown are a minimum. Training may be extended by obtaining an Academic Clinical Fellowship for research or by dual certification in another speciality. | Training may be extended by pursuing medical research (usually 2–3 years), usually with clinical duties as well |
A general practitioner (GP) or family physician is a doctor who is a consultant in general practice.
Residency or postgraduate training is a stage of graduate medical education. It refers to a qualified physician, veterinarian, dentist, podiatrist (DPM) or pharmacist (PharmD) who practices medicine or surgery, veterinary medicine, dentistry, podiatry, or clinical pharmacy, respectively, usually in a hospital or clinic, under the direct or indirect supervision of a senior medical clinician registered in that specialty such as an attending physician or consultant.
Within the National Health Service, resident doctors are qualified medical practitioners working whilst engaged in postgraduate training. The period of being a resident doctor starts when they qualify as a medical practitioner following graduation with a Bachelor of Medicine, Bachelor of Surgery degree and start the UK Foundation Programme. It culminates in a post as a consultant, a general practitioner (GP), or becoming a SAS Doctor, such as a specialty doctor or Specialist post.
A senior house officer (SHO) is a non-consultant hospital doctor in the Republic of Ireland and many Commonwealth countries. SHOs usually have a minimum of 1 year post medical school training. SHOs are supervised in their work by consultants and registrars. In training posts these registrars and consultants oversee training and are usually their designated clinical supervisors.
Medical education in Australia includes the educational activities involved in the initial and ongoing training of Medical Practitioners. In Australia, medical education begins in Medical School; upon graduation it is followed by a period of pre-vocational training including Internship and Residency; thereafter, enrolment into a specialist-vocational training program as a Registrar eventually leads to fellowship qualification and recognition as a fully qualified Specialist Medical Practitioner. Medical education in Australia is facilitated by Medical Schools and the Medical Specialty Colleges, and is regulated by the Australian Medical Council (AMC) and Australian Health Practitioner Regulation Agency (AHPRA) of which includes the Medical Board of Australia where medical practitioners are registered nationally.
Modernising Medical Careers (MMC) is a programme for postgraduate medical training introduced in the United Kingdom in 2005. The programme replaced the traditional grades of medical career before the level of Consultant. The different stages of the programme contribute towards a "Certificate of Completion of Training" (CCT). It has been dogged by criticism within and outside the medical profession, and an independent review of MMC led by Professor Sir John Tooke criticised many aspects of it.
Medical education in the United Kingdom includes educational activities involved in the education and training of medical doctors in the United Kingdom, from entry-level training through to continuing education of qualified specialists. A typical outline of the medical education pathway is presented here. However training schemes vary in different pathways may be available.
The Royal College of General Practitioners (RCGP) is the professional body for general (medical) practitioners in the United Kingdom. The RCGP represents and supports GPs on key issues including licensing, education, training, research and clinical standards. It is the largest of the medical royal colleges, with over 54,000 members. The RCGP was founded in 1952 in London, England and is a registered charity. Its motto is Cum Scientia Caritas – "Compassion [empowered] with Knowledge."
The Royal Australian College of General Practitioners (RACGP) is the professional body for general practitioners (GPs) in Australia. The RACGP is responsible for maintaining standards for quality clinical practice, education and training, and research in Australian general practice. The RACGP represents over 40,000 members across metropolitan, urban, rural and remote Australia.
The Certificate of Completion of Training (CCT) is the certificate that medical doctors in the United Kingdom receive to indicate that they have completed training in their chosen specialty and are therefore eligible for entry onto the specialist or GP register. This registration is needed to apply for posts as a consultant or a general practitioner (GP) respectively.
The Medical Training Application Service was an on-line application system set up under the auspices of Modernising Medical Careers in 2007 and used for the selection of Foundation House Officers and Specialty Registrars, and allocating them to jobs in the UK. Its implementation was heavily criticised both in the press and within the medical profession, and its operation was marked by the resignation of key staff and serious security breaches. The system affected junior doctors, and so every qualified doctor in the UK who had not yet attained Consultant status.
The Postgraduate Medical Education and Training Board was the non-departmental public body responsible for postgraduate medical education and training in the United Kingdom (UK). The General Medical Council (GMC) took over the functions of PMETB on 1 April 2010 when the two organisations merged.
The Foundation Programme is a two-year structured programme of workplace-based learning for junior doctors that forms a bridge between medical school and specialty training. The programme aims to provide a safe, well-supervised environment for doctors to put into practice what they learned in medical school. It provides them with the generalist medical knowledge and skills to meet the requirements of the General Medical Council (GMC) The New Doctor (2007) and the Foundation Programme Curriculum (2007) and prepares them for entry into specialty training. All medical graduates must undertake, and complete the Foundation Programme in order to progress onto specialist or a general practitioner training in the UK.
Non-consultant hospital doctor (NCHD), sometimes also referred to as junior doctor, is a term used in Ireland to describe qualified medical practitioners who work under the supervision of a consultant in a particular speciality. It is an umbrella term, encompassing doctors on formal postgraduate training schemes as well as doctors in "service" roles outside of postgraduate training.
Core Medical Training was the two-year part of postgraduate medical training following Foundation Year 1 and 2, successful completion of which is required to enter higher training in the medical subspecialties. The programme is overseen by the Joint Royal Colleges Postgraduate Training Board, which represents the three medical Royal Colleges in the UK: the Royal College of Physicians of London, the Royal College of Physicians of Edinburgh and the Royal College of Physicians and Surgeons of Glasgow.
Medical education in Ireland is the education of medical students and qualified medical doctors across the island of Ireland.
Membership of the Royal College of General Practitioners (MRCGP) is a postgraduate medical qualification in the United Kingdom (UK) run by the Royal College of General Practitioners (RCGP). On successful completion of the assessment, general practitioners are eligible to use the post-nominal letters MRCGP that indicate Membership of the RCGP.
The Shape of Training was a review of postgraduate medical education and training in the United Kingdom, which reported in 2013. The review was undertaken to consider workforce issues, such as the balance between specialisation and generalism in medicine. The review was supported by a range of organisations concerned with medical education and had an independent chair, Professor Sir David Greenaway.
Medical education in Wales is the education of medical students and qualified medical doctors in Wales.
Medical education in Scotland includes the education of medical students and qualified medical doctors in Scotland.