Understanding the UK
In the UK, just like in many other countries, there are many different kinds and grades of doctor posts and the post for which you decide to apply will depend on your personal choice and how much experience you have had in the past.
It is important as a medical expat to understand the different post types and also to know what post would be most likely matched to your level of competence. This is because seniority is ideally based on the level of competence and not just years of service. Occasionally, people base their decisions to apply for a post on the perception that they were at a similar level in their home country without given much thought to the responsibilities of the new post. The problem with such decisions is that you not only might struggle at that post, you could also be putting yourself or your registration at risk.
What are the different grades for doctors in the UK?
Foundation year 1. The old terminology for this grade was House officer. Notwithstanding, a lot of people still refer to it this way.
This is the first year after graduation from medical school. At this stage, doctors hold a provisional license and there are limitations to what they can do independently.
Foundation year 2. This was known as SHO previously and it is the second year after graduation from medical school. At this stage, you have more responsibilities and are much more experienced as a doctor.
The term SHO is often used generically as well for doctors who are above the F1 level but not higher specialty registrars yet. This is usually from the F2 level to CT2/CT3.
Specialty registrar. This is used to refer to the years during specialty training. For medical, psychiatry and surgical specialities there is usually a period of core training (CT1, CT2, CT3) where trainees have not yet taken to a particular sub-specialty path.
Higher training usually starts from the third year for most trainees in medicine and surgery. That is from ST3 upwards and becoming a higher trainee usually means you have attained the competencies required including passing the royal college exams.
For trainees in general practice, there are only three specialty levels ST1 to ST3.
The above gives a brief overview of the different training stages. If you are applying for non-training posts, the expected grade for this post will usually be stated in the advert. Occasionally, however, employers would use the term clinical fellow to refer to “SHO” posts.
Doctors who have completed training either become consultants or General Practitioners. There are however doctors who are not in training and who are not consultants but regarded as specialists as well. These are usually doctors who have achieved the competencies required to be a specialist and often have many years of experience either in the UK or from other countries. These doctors are referred to as Staff grade, Associate specialists, or Specialty doctors.
So, if you decide to apply for a non-training post initially, it might be useful to understand the competencies and the responsibilities expected for that post so that you can ensure you are applying for the right post for you.