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Post-graduate training in medicine related specialties are very coveted by doctors in the UK. It is important to note that 'post-graduate training' and a 'post-graduate degree' are not the same thing. A 'degree' is awarded following an exam; training is what you gain form your work-experience and other necessary courses laid out by your training curriculum. For example: MRCP is a post-graduate degree/qualification and Acute Medicine speciality training is a post-graduate training.
You can obtain certain post-graduate degrees without being in an approved training post. Again, you may have to obtain some degrees according to your training curriculum. So, both go hand in hand in order to obtain specialist registration under GMC.
How training in medical specialties is structured in the UK
This post is regarding training in medical specialities only. So, training in the UK is divided into three parts:
- Foundation training
- Core training
- Speciality training
If you are a non-UK/EEA medical graduate, then you have three options:
- Obtain the equivalent of foundation training outside UK
- Obtain the equivalent of foundation training inside UK
- Getting into the foundation training by UKFPO.
You can get the certificate of readiness to enter speciality training (CREST) form signed by your overseas consultant if you had worked under them for at least three months after completion of your formal internship/house job.
The same way, you can start working in the UK as a non-training doctor and after working under a consultant for at least three months, you can get those competences signed off.
More information regarding GMC approved Internship and UKFPO foundation training can be found here.
Getting into UKFPO's two year foundation training is not applicable for those who have finished formal internship/house job following their graduation. If you hadn't done your formal internship/house job after graduation for any reason (like taking USMLE, etc), you should do it before you think about moving to the UK. The reason for this is that until or unless you have a right to work i.e. having UK nationality or having spouse visa (NOT dependent visa), it is very difficult to get a post in the foundation training by UKFPO. You will have to take PLAB both ways (UKFPO or home country's internship), as you did not graduate from UK/EEA.
Core training (Internal Medicine Training)
Core training portion in medical specialities is called "Internal Medicine Training" (IMT). It is a 2 year or 3 year training program, depending on which speciality you want to pursue after that.
For group 1 specialities to pursue following IMT, it will be a 3 year of Internal Medicine Training:
- Acute Internal Medicine
- Clinical Pharmacology & Therapeutics
- Endocrinology & Diabetes Mellitus
- Genitourinary Medicine
- Geriatric Medicine
- Infectious Diseases (except when dual with Medical Microbiology or Virology)
- Palliative Medicine
- Renal Medicine
- Respiratory Medicine
For group 2 specialities, internal medicine training is for 2 years:
- Audiovestibular Medicine
- Aviation & Space Medicine
- Clinical Genetics
- Clinical Neurophysiology
- Infectious Diseases (when dual with Medical Microbiology or Virology)
- Medical Oncology
- Medical Ophthalmology
- Nuclear Medicine
- Paediatric Cardiology
- Pharmaceutical Medicine
- Rehabilitation Medicine
- Sport and Exercise Medicine.
Internal medicine training is the time when a junior doctor gradually becomes a medical registrar. During this time, a doctor will have to follow the curriculum and finish their MRCP exams in order to be eligible to apply for further speciality training in different branches of medicine in the UK.
Acute Care Common Stem (ACCS) - AM (Acute Medicine)
Read in detail about ACCS-AM in the official website.
Already mentioned above the different branches of medicine which you can pursue after your internal medicine training. Currently the length of that training is indicative 4 years. During this time you can have special interest in other super-special branches of medicine and you can pursue that as well.
For medicine realted specialty training application in the UK, check here for the eligibility.
After successfully completing all of that, you would be awarded a certificate of completion of training (CCT) with which you can apply to registered as a specialist under GMC and take up a Consultant job. If you bypass IMT, you can go for CESR-CP route of specialist registration.
A flowchart for training in medical specialties
How to get into medicine training in the UK as an IMG
- Obtaining GMC registration
You have to have GMC registration as a medical practitioner before you can start working as a doctor in the UK. There are three way you can get GMC registration. For more details, How to apply for GMC registration.
- Getting CREST signed
Certificate of Readiness to Enter Speciality training (previously known as alternative evidence of foundation competences) needs to be signed off before you can apply for internal medicine training in the UK. You should also utilise the opportunity of working as a non-training doctor to get CREST signed, bolster your application by doing audits, presentations, taking part in teaching and doing different training courses.
Take this course CREST & Portfolio: A Comprehensive Guide for IMGs to enable you to understand how you can achieve that.
- Internal Medicine training
The training doesn't require any exam to get into. Application > Long-listing > Short-listing > Interview > Offers. The interview along with your application scoring makes you a better candidate than others and thus you will be ranked higher to get into your desired programs throughout the country.
- Getting Core Competences signed
If you choose not to take the IMT route, you can still can continue doing trust-grade jobs and get yourself an e-portfolio (the ones the IMT trainees use) and continue to work towards getting your core competences signed. Also in the background study towards finishing your MRCP exams. That way, you will become eligible to apply for ST even though you didn't go through IMT.
- Speciality Training
Again, no exam to get into the specialty training. You will be ranked based on your application scoring and interview. Special interest in related sub-specilties can be pursued here.
Frequently Asked Questions
If you fulfill all the eligibility, you 'can' apply. But whether you 'should', that is the question. Training posts are important pillars of your future career. You have to train in a certain area for a long three years. Without being exposed to the NHS healthcare system, starting directly in a training post can prove to be a rash decision. Your peers might have already worked 2-3 years in the system and you may feel constantly lagging behind. So, my personal opinion is to start with a non-training job to get acquianted with NHS and do ground work for application for training posts.
Yes you can. If you already passed full MRCP or 2 parts of MRCP and only PACES away from MRCP, 3 years of IMT might seem really lengthy for you. As mentioned earlier in the post, you can get an e-portfolio (the ones IMT trainees use) and work towards getting your core competences signed while being on a non-training job. After getting that signed and completing MRCP (if not already), you can directly apply for specialty training.
The pay range will be as for CT1 level post. The enhancements will be added according to your rota. Please look for more information here, A doctor's pay in the UK.
Some specialties are more competitive than others. But, I beg to differ terming any specialty as IMG Non-friendly. Yes, for visa issues it can prove difficult, but it is not impossible for IMGs to get into those competitive specialties. Please read Speciality Training Opportunities in the UK.
So there you have it! A relatively concise breakdown of how to enter into medical specialty training. Hopefully any questions or concerns that you had have been addressed. Good luck!