Specialty training in the UK

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For many doctors, a main career goal is to become a specialist in their chosen field. This is the same for IMGs. Many want to know what the prospects are like in the UK. Some people have a fixed goal in mind while others can be flexible but whatever category you fit into, the bottomline is that you want to know if you would be able to progress your career in a desired field.

In the UK, the medical specialties are as they are found in many other places; General medicine, Medical sub-specialties, Surgical specialties, Paediatrics, O&G and General Practice/family medicine etc. Also in the UK, as it might be in other places, there is a variation in the level of ease or difficulty of getting into the different specialties. This competition ratio also changes slightly every recruitment round but it is important to note that some specialties are generally more competitive than others. In general terms, the surgical specialties tend to be the most competitive and psychiatry and general practice the least competitive; but this might change in the future.

Most specialty training programs go on for an average of 6 years in total but could be more depending on the level of specialisation, whereas, GP training is typically a 3 year program. In addition, these programs are usually in blocks of 2-3 years for which you need to make an application at each stage.

Factors to consider when applying for specialty training spaces

What is your particular interest?

This is a primary consideration as you do not want to end up in a specialty where you feel miserable or unfulfilled. Many people, as early as medical school, already know what they would want to specialise in. If you are one of those people, there is no harm in exploring your chosen path. However other factors may determine if you are actually able to proceed with your chosen specialty or not.

Competition ratios

As earlier mentioned, different specialties have different competitive ratios. This means there may not be as many spaces as the number of doctors trying to get in. So it’s going to be the survival of the “fittest”. But remember that for such specialties the “Resident Labour Market Test” (discussed next) is likely to be an important factor. For doctors who are flexible as to what specialties they are willing to go for, competition ratios might be less of a factor. You can find the competitive ratios of the different specialties on this website.

Immigration status

The UK is about to leave the EU and this might mean immigration rules will again change as regards employment for non-UK/EU citizens. However, as things stand, the ‘Resident labour market test’ is in place; which means that before you can be employed as a non-UK/EU citizen, the employer must ensure that there is no suitably qualified UK or EU citizen for that job. So basically, competition ratios also come into play here. So, where there are already sufficient numbers of UK/EU citizens applying for a post, the chances of a foreign doctor of getting into such a post might be slim. Having said this, it is important to always clarify what you can or cannot do based on your immigration status.

The factors above are common to most IMG applicants, however, everyone’s circumstances are different and there may be other factors which may enhance or impede your journey. This factors need to be worked out as you go along.

Who is responsible for specialty training in the UK?

The body responsible nationally for the post graduate training of doctors in the UK is the Health Education England (HEE), which has smaller local bodies which used to be called “deaneries”. HEE usually advertises the posts available in the oriel website, usually in 2 major recruitment rounds every year. When applying for your specialty, you will also be able to do a ranking of your desired training locations in order of preference. Also useful to know is that you could apply for more than one specialty during a particular recruitment round. This gives you an extra layer of security in case you are not able to get into a particular preferred specialty.

What are the requirements for specialty training?

Different specialties have different person specifications but generally speaking you need to have completed foundation training or its equivalent. As most international doctors usually have completed the equivalent of foundation training, they’ll need to evidence this with a “Certificate of readiness to enter specialty training” (formerly “Alternative Certificate to Foundation Training” ) which can be signed off usually by any consultant whom you have worked with for at least 3 months in the UK or at home and who can sign-off the required competences.

You would also require an Advanced life support certificate before you start your training. This is usually organised in different local hospitals but nationally coordinated by Resus council UK.

For the interviews, you may be required to present a portfolio which is supposed to basically reflect you suitability, experience and interest in the specialty you are applying for. Person specifications of the different specialties can be found on the HEE website.

To conclude, the experience of different people vary when it comes to specialty training program in the UK. For some people it is a generally smooth ride while for others there are many bumps on the way. In any case, it is important to always be up to date with the most relevant information and always enquire where you are unclear about things.

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