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:
*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.
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.
CMT, IMT and CST
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.
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.
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.
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.
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.
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.
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:
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.
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.
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.
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.
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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
By now you are probably wondering what the best first job to start in as an IMG? Read our guide here where we break it down in accordance to your level of experience.