The Savvy IMG

UK doctor titles 101

Understand all the titles for medical doctors in the UK including FY1, F2, SHO, clinical fellow, specialty doctor and more.

Table of Contents

It’s an alphabet soup out there in the world of doctor titles. Designations in the NHS come in so many forms with letters, numbers, and abbreviations. You’ll come across them in job advertisements, ID badges, and in conversation so the sooner you get a handle on what they all mean the better!

And if isn’t already confusing, keep in mind that non-medics – including colleagues and patients – do not understand all the titles so you may need to be aware of other titles they might be familiar with to describe yourself.

If you’re looking for a super quick guide, here’s a summary:

Titles for different levels of medical doctors in the UK
Titles for different levels of medical doctors in the UK

 *These terms were used prior to Modernising Medical Careers (MMC) which came about in 2005. They are still commonly used today. See below for further explanation.

If you want to know about each title in a bit more detail keep on reading!

We cover titles relating to:

Doctors in training jobs

Since medical training was reformed through Modernising Medical Careers (MMC) in 2005, doctors in official GMC-approved training programmes have been assigned titles according to the specific year of their training. The format is 1 or 2 letters, followed by a number.

F1, F2, FY1, FY2, FY

All these terms refer to doctors in the UK Foundation Programme. It is a 2-year programme in which the first year is a postgraduate internship referred to as Foundation Year 1/ FY1/ F1, and the second year is referred to as Foundation Year 2 / FY2 / F2.

Some colleagues, typically not doctors in training eg. Consultants, nurses or physiotherapists, may refer to doctors in FP as an FY doctor.

Related: Standalone FY2: Your chances as an IMG and how to optimise your application

CT1, CT2, CT3

CT stands for Core Trainee and refers to doctors in the first few years of an “uncoupled” specialty training programme. An uncoupled specialty is one in which doctors have to apply to a Core Training programme first, and then apply separately to higher specialty training. Most Core Training specialties are 2-3 years in duration.

Related: How specialty training (residency) works in the UK: A complete beginner’s guide


These stand for Core Medical Training (known as Internal Medicine Training), and Core Surgical Training. Doctors are not usually referred to as CMT1 or CST1, rather they are called CT1 or CT2 regardless of whether they are medical or surgical.

ST1 & ST2

ST stands for Specialty Trainee. ST1 and ST2 are doctors in the first couple of years of a “run-through” training programme. In a “run-through” programme, the doctor only has to apply for ST1; entry into higher specialty training is automatic.

ST3 up to ST9

Higher specialty training usually starts at ST3, but for some specialties it starts at ST4. Doctors at this stage of training take on much more responsibility in the medical team. They are often the most senior doctor on site for that specialty, particularly on nights and weekends.


LAT stands for Locum Appointment for Training. These are 12-month posts which allow the doctor to be part of a training programme for just one year. These types of jobs often arise when official trainees go out of programme for things like research, sick leave, maternity leave, etc.

Related: What IMGs need to know about applications to specialty training in the UK

PRHO, house officer

This is a pre-MMC term. PRHO stands for Pre-Registration House Officer. You may come across PRHO or HO in writing although never actually hear anyone say it out loud, people are more likely to say “house officer”. The updated title for these doctors is FY1 or F1.

Post-CCT clinical fellow

After a UK doctor has completed their training programme, they may wish to pursue even further subspecialty training. This training is often known as a “post-CCT fellowship”. CCT stands for “Certificate of Completion of Training” which is what trainees get after completing the programme. Doctors in these roles are referred to as fellows, post-CCT fellows, or clinical fellows.


This refers to any doctor in any postgraduate specialty training programme. It is equivalent to the term “resident” and typically includes those from CT1/ST1 up to ST9. These doctors will have been working as a doctor for 2-11 years.

Foundation doctors are not often included under this umbrella term “trainee” but they can be.

Related: How much do doctors in specialty training (residency) earn in the UK?

Doctors in non-training jobs

There are no set rules regarding titles for doctors who are in non-training jobs. They are often given the same designation as trainees just so it’s clearer what level they’re at.

Be aware that there are many job titles that can all mean the same thing. The important concept for non-training jobs is to know the equivalent level in a training post, it will then be easier to understand what is expected of a doctor of this grade.


The pre-MMC term “SHO” stands for Senior House Officer. You will find that many people including colleagues and patients, still use and understand this term day-to-day. It refers to a junior level role and is the most common type of job that IMGs start with in the UK.

If someone is referred to verbally as an SHO it doesn’t necessarily mean they are in a non-training job, SHO can also refer to trainees at the following stages of training: FY2, ST1, ST2, CT1, and CT2.

If the official name badge and title reads SHO though, it usually means the doctor is in a non-training job since official trainees will be given a full designation depending on their year.

Related: The best first job in the UK for IMGs

SpR, Registrar

Similar to SHO, this is an old school term. SpR means specialty registrar and refers to doctors in higher specialty training. It can refer to both trainees and non-trainees. The equivalent level in today’s system is ST3 and above.

Again, this term is commonly used by medical and non-medical colleagues, and is often well understood by members of the public to mean more senior trainees.

F3, F4 etc

These terms are a bit tongue-in-cheek. As explained above, there are only 2 years in the Foundation Programme. The next step after completing FY2 is to enter GP or specialty training, but this is not compulsory. Some doctors are undecided about specialty choice and use the time after FY2 to work in different specialties in short-term non-training jobs before making the commitment to apply for a formal training post.

These transition years are often referred to colloquially as F3, F4 or even F5 depending on how long the doctor has been qualified. These jobs would also be considered SHO level.


This stands for Locum Appointment for Service. These jobs are usually temporary and are created to fill a gap in service for the hospital. A “gap in service” means that there are not enough doctors to provide the requirements of the health service.

Trust grade

Again, this means that the job is a non-training job. You will often see job ads stating the role is for a “trust grade CT1” or “trust grade ST3” meaning the job is at the level of CT1 or ST3 but it is not a training job.

Junior clinical fellow

Junior clinical fellow is just a fancy term for SHO. Whereas SHO can refer to doctors both in training and not in training, junior clinical fellows are always non-training roles.

Senior clinical fellow

I mentioned in the section above for doctors in training that clinical fellows are doctors in further subspecialty training, usually after completion of a UK training programme. However, jobs that are advertised as senior clinical fellows are usually at the level of ST3+ and are aimed at doctors who have not completed a UK training programme.

Related: A guide to short-term training in the UK including fellowships, scholarships, and GMC-sponsorships

The term “Junior Doctor”

The term junior doctor refers to any doctor below Consultant level, from FY1 to ST9, whether training or non-training. It doesn’t include SAS or middle grade doctors which are discussed below.

The general public, and even non-medic colleagues, often think that junior doctors are either medical students, or newly qualified doctors. But as we all know, this couldn’t be further from the truth.

A doctor who has completed 5 years of medical school, 2 years of foundation training, and 8 years of specialty training would still fall under the term “junior doctor” of course,in reality, they are very senior and soon to be a Consultant.

However, for the purpose of employment contracts, all doctors in a training programme are classified as a Junior Doctor no matter how senior they are.

Related: How much do doctors in specialty training (residency) earn in the UK?

Senior doctors


General Practitioners in the UK are family and community medicine specialists who have completed 5 years of postgraduate training. This includes 2 years in the Foundation Programme and 3 years of GP training. 

If you were practising as a GP in your home country but you have not completed any postgraduate training in general practice or family medicine, then it is unlikely that you will be able to directly work in the UK as a GP. You will most probably need to complete the UK GP training programme in order to become a UK GP. 


Consultants are specialists who have completed all the training requirements for their specialty.  They carry heavy responsibilities in the hospital and are in charge of overall patient care. They assess patients directly as well as having roles in teaching, management, and administration.

There are different types of Consultants:

Substantive Consultant

This is the permanent Consultant role that most doctors strive for. Once you secure a substantive post you will generally have job security for the rest of your career. To take up this type of post you need to be on the Specialist Register which means you have provided evidence that you have completed a UK training programme or the equivalent.

Locum Consultant

This is a temporary job that can be terminated at any time. Locum consultants tend to deal more with the clinical side of medicine but can have teaching, management, and administration responsibilities too. You do not need to be on the Specialist Register to take up a job as a locum Consultant but you must of course have the appropriate experience to be accepted for this type of role.

Related: How to become a UK specialist without entering a UK training programme


SAS stands for Staff grade, Associate Specialist, and Specialty Doctor. These doctors have at least four years of postgraduate experience. This includes internship and at least two years in the specialty they are working in. They are technically classified as senior doctors and are not on the training pathway. Their experience and level of work is generally at registrar level.

SAS doctors have permanent jobs. This is unlike most of the other jobs mentioned above under the section Doctors in non-training jobs which are usually fixed-term contracts of 6 months to 2 years.

Although SAS doctors are in non-training roles, they maintain their skills through the CPD system and can, if they wish, pursue registration as a Consultant once they complete all the requirements for that specialty.

Middle grade

These doctors are essentially the same as SAS. They have permanent jobs, they often have many years of experience, and they have chosen not to pursue registration as a Consultant. Their level of work is generally that of a registrar, but can sometimes be similar to a Consultant.

Suggested: The cheapest way to transfer money back home


Doctor titles can be a very confusing area, but can generally be broken down into titles for doctors in training vs. non-training, and further subdivided into junior and senior doctors. Give it due time and you will get used to it.

It is also a good idea to know the different medical organisations relevant to you as a UK doctor. This article will help you out: 8 organisations you will encounter as a doctor in the UK

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18 Responses

  1. What are the options for UK medical graduates who move abroad? Are they allowed to return, and take up a senior doctor position or will they have to start from CT1 onwards?

  2. Hi, thank you for your informative topic,
    In NHS job ads I sometimes see a great range for the salary, maybe up to double in some jobs, Can I know what do they depend on in specifying the salary?

    1. Hi there, it depends on the grade of the job, the number of years of previous experience of the doctor, the number of hours worked and number of on calls.

  3. Hi Nick Tan,
    I am Dr. Ravi Kumar, MBBS MD Internal Medicine from India. I have 8 years experience after post MD and I want to relocate to UK and work as a consultant in Internal Medicine can you advice the best pathway. Thanks in advance.
    With regards
    Dr.Ravi Mallelli

    1. Hi there, it works a bit differently in the UK. There are no IM consultants directly after IM training here, doctors need to complete subspecialty training of Acute Internal Medicine (AIM) which is 4 years of additional training after IM. So it depends on what you want to do – enter UK training to become a Consultant or go through the CESR route for AIM to become a Consultant. You can read about CESR here: Best of luck!

  4. Hi Nick,
    this dr.Eiman from India..I had a query- I have finished my MBBS,MD Psychiatry in India and have 3 years of post MD experience.I have also finished paper A and B of MRCPsych.I wish to become a Consultant in UK.What would be the easiest route for me to get GMC registered?
    MTI scheme?
    Mmed Psychiatry?
    directly applying for Specialist training?

  5. Can you guide me as where to find complete information to the various types of contracts available ( permanent, fixed-term, etc…) and what each involves?

    1. Hi Amal, we’re working on a post for that! Keep checking back for when it’s published. In the meantime you might want to check out the NHS employee website.

    1. A locum consultant would be at the same level as a consultant, they’re just not permanent employees. Any job can be locum, eg. locum SHO, locum registrar, locum fellow etc. It’s just a term that means they’re not permanent staff members. Hope that’s clear!

  6. Hi Dr. Nick,

    You said that LAT vacancies are created as a result of things like the official trainee (on whose post the LAT-appointee will work) taking Out of Programme leave for any of the allowed reasons.

    But how are Trust Grade, LAS, Junior/Senior Clinical Fellow, non-training registrar and other non-training fixed-term posts/vacancies created?

    I can understand that SAS doctors are part of the “NHS-system”, that ARE required to provide service BUT not be put on approved-training, right? (Or not?)

    In this relation, why are doctors required for such temporary (fixed-term) posts which are not even training posts ? (like the case of LAT where a trainee opts for OOP and the newly created vacancy is filled by an appointee who will have the privilege to work in a post that was left temporarily by an official trainee and hence the appointee will get to receive training in place of the official trainee)


    Dr. Jainal

    1. Hi, all posts in the NHS exist primarily because there is a need to provide a health service. If a hospital needs more doctors to provide the service, they’ll recruit more doctors. They are not required to make it a training post, for that it would have to go through a full process for approval. Only some posts are approved for training, the rest remain centered around service. But a lot of hospitals do provide educational support for doctors who are not in approved training posts which may include access to study leave, study budget, supervisors, portfolios etc. It’s just not an official approved training post and does not lead to CCT.

      1. Thank you for your response.

        I see.
        But I wonder why so many *non-training jobs* are *fixed-term*? If a hospital needs a doctor to provide a heathcare service, then why would it require to do the service for only a fixed time? If the service is done for a fixed time, then who will do that after this service tenure?


        Dr. Jainal

        1. Service needs change all the time so fixed-term posts allow for flexibility. Also not all unfilled training posts go out as LAT, if they can’t find someone to take up the LAT post within the recruitment timeline for a training job, then it will become a LAS fixed-term post. So after a year if they do fill that post again, then they won’t need the fixed post. Within a year a hospital can also restructure the workforce so that these fixed-term posts are no longer needed. For example, a hospital could obtain approval to employ more permanent middle-grade doctors and therefore won’t need fixed-term doctors. Or they could decide that some of the roles of the SHO will now be taken over by a highly trained specialist nurse or physician associate so they only need 2 doctors now instead of 4. Or the hospital received approval to have 4 trainees instead of 2 so they don’t need the other 2 fixed-term posts. Those are just some examples, hope that helps!

  7. what are the requirements for an img with MRCS to apply for SAS grade permanent post? what is the initial average earning per year for that post?

    1. It depends on the job requirements. Please search for jobs on the NHS jobs website for details about requirements and salary.

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Meet the Team

Hi, we’re Drs Nick & Kimberly Tan, the two IMGs behind The Savvy IMG. We write comprehensive guides, create courses, and provide one-to-one guidance to help other overseas qualified doctors on their journey to the UK.
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