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The training pathway for newly qualified doctors was reviewed in 2005, and the traditional grades of medical
career before the level of consultant have been changed.
Modernising Medical Careers (MMC) is a new programme for postgraduate medical training: www.mmc.nhs.uk.
After completing your pre-clinical and clinical university course, it takes 5 further years to become a
qualified GP and 7-9 years until you are a consultant in a hospital.
Bridging University and Specialist Training
On completing medical school, junior doctors enter a vocational training phase. Newly qualified doctors
apply for a place on a 2-year Foundation Programme. This is a bridge between university and specialist training.
It consists of a series of placements in a variety of healthcare specialities to give you a broad insight
into the different areas of medicine and enable you to decide the specific area on which you wish to focus.
Foundation House Officers (FHO1 and FHO2)
During the F1 and F2 years, doctors are "Foundation House Officers" (FHO1 and FHO2). This replaces the traditional
grades of Pre-registration House officer (PRHO) and Senior House Officer (SHO).
During the F1 year, student only hold provisional registration with the General Medical Council - full registration
is granted on completion of the first year. During F1, students rotate through 3/4 jobs in different hospital
specialities.
The GMC specifies that these must include General Medicine and General Surgery (General Practice is not allowed).
The focus of the F2 year is the assessment and treatment of the acutely ill patient and also encompasses generic
skills such as teamwork, time management, communication and IT skills.
Achieving your Certificate of Completion of Training (CCT)
Following the Foundation Programme is a training period known as Speciality Registrar (StR). This involves structured
specialist or general practitioner training programmes and leads to the award of a CCT - Certificate of Completion of
Training.
To become a GP you must spend 3 years as a Speciality Registrar; for a hospital speciality, you carry out 6 years of
training before qualifying as a Consultant.
Previously doctors were required to take the relevant Medical Royal College membership examinations whilst still an
SHO, but under the new system, the exams are taken later on during year 1/2 of the Speciality Registrar Training Scheme.
Criticisms by the BMA and Others
Concerns have been expressed by the BMA that the changes to the training programme have not been thought through and
may worsen the training situation for junior doctors.
Criticisms have been made about the new MMC system. There have been technical problems with the application procedure
for Speciality Registrar positions and also a huge reduction in the number of posts available.
On 17th March 2007 doctors marched in mass protest orchestrated by Remedy UK (pressure group representing junior doctors)
against the system.
The recently proposed Health and Social Care Bill also has implications for training and career paths in medicine so you
are advised to keep up-to-date with developments by reading the national press and periodically reviewing the
websites below:-
Royal Colleges
- College of Emergency Medicine (Accident and Emergency/trauma);
- Royal College of Anaesthetics (Anaesthesia/pain management);
- Royal College of General Practitioners (GP);
- Royal College of Obstetricians and Gynaecologists (sexual and reproductive health);
- Royal College of Ophthalmologists (Eye disease);
- Royal College of Pathologists (Diagnosis of disease);
- Royal College of Paediatrics and Child Health (Child health);
- Royal College of Psychiatrists (Mental health);
- Royal College of Radiologists (Medical imaging);
- Various colleges of physicians and surgeons depending on location.
Career Path Options
The diagram below illustrates the options and timescales available for a medical student.
Medical Career Path Options
Click Image to Enlarge
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