Medical Careers

Introduction

So, how do you get from hopeful medical school applicant to top hospital consultant or GP on ?120k? Well, the first thing to say is that getting a medical degree is just the beginning of medical education. Training continues for years after graduation and ultimately culminates in your appointment as a hospital consultant, GP or academic research medic. It takes at least 5 years to become a GP after completing your medical degree, and at least 7 - 9 years to become a hospital consultant.

The second thing to say is that the way in which doctors careers and training is managed after medical school is currently changing dramatically. The old career pathway which has existed for decades is being torn up and re-devised by an organisation called Modernising Medical Careers.

Getting a Medical Degree

The first step is to get into a medical school that is approved by the General Medical Council (GMC). All doctors practising in the UK must be registered with the GMC, which is a kind of regulatory body for doctors. For more information on GMC approved medical schools, click here. All degrees are signified by letters after someone's name, like MB ChB, BM etc. Medical degrees from different medical schools sometimes have different letters to signify them. Don't worry about this - it's irrelevant. As long as the degree is approved by the GMC, then you can practise as a doctor. In addition, the medical school you go to has no bearing on what type of doctor you can become.

Medical degrees last 4, 5 or 6 years. However, those on 5 or 6 year courses can usually add an additional year onto their course during which they gain an extra degree. This is called 'intercalating'. This additonal degree may be in a variety of subjects, depending on the medical school, but is typically in a science subject, e.g. biomedical science. Only a minority of medical students from each year will intercalate.

Medical students undertake lots of exams during their degree. However, the summer exams which are taken in the last year are called 'finals', and you can only become a doctor if you pass these exams.

Applying for your first job

In the last year of the medical degree, medical students apply for a place on the Foundation Programme. The Foundation Programme consists of 2 years (F1 and F2) of work as a junior doctor. The job starts a few weeks after graduating from medical school, however there is usually a short period of 'shadowing', to help new doctors get used to the job.

All medical students in the UK apply for the Foundation Programme in the same way and are all in competition with each other. They apply via an online system click here to go to their website. The application consists of two parts: an academic score and a written application. The application is scored out of a total of 100 points. A maximum of 45 points are for the academic score and a maximum of 55 points are for the written application.

Academic score

All medical schools in the UK have agreed the following system of scoring the academic component of the application form.

Each medical school will choose which exam results and coursework will count towards the score. Whatever exams/coursework a medical school chooses to use, they will rank every medical student in order from top of the year to bottom. They will then divide the year into four equally sized groups. The top group will get 45 points out of a possible 45. The second group will get 40/45. The third group will get 35/45. The fourth group will get 30/45. For this reason, there will only be 15 points difference between the top student and the bottom students. As a consequence, the academic score makes up around 22% of the application.

Applying for a Foundation School

The UK is divided into 17 'Deaneries'. Within each deanery is one or more Foundation Schools. In total there are 25 Foundation Schools in the UK and each school covers a specific geographical area. To see a map of all the UK deaneries and the foundation schools within them, click here.

When applying for the Foundation Programme, each applicant ranks all 26 Foundation Schools in order of preference. Each Foundation School has a maximum number of Foundation Programme places, so if they receive more applicants than there are places, the applicants with the best scores will be offered places.

If an applicant does not get an offer from their first choice, they will be considered for their 2nd choice and so on. Ultimately, there are enough places on Foundation Programmes in the UK so that no medical graduate will be unemployed unless they turn a job offer down.

Applying for a job within a Foundation School

Once an applicant has received a place in a Foundation School, they will then be required to rank Foundation Programme jobs within that Foundation School in order of preference.

These jobs will be in different hospitals within each Foundation School and will vary in terms of the workload, pay and type of work. Their application form score will again be used to rank candidates applying for the same job. Therefore, the higher the score, the more likely the candidate is to get their first choice.

The Foundation Programme

To find out more about the foundation programme, please visit their website:

www.foundationprogramme.nhs.uk

The Foundation Programme is designed to provide structured post-graduate training on the job and lasts 2 years. The first year is called F1. During this year, doctors are provisionally registered with the GMC. Because they don't have full registration, they are sometimes referred to under the old name of 'Pre-registration House Officers' (PRHO).

After successful completion of this year, they will gain full registration with the GMC and then begin their F2 year. The old name for doctors in this year is Senior House Officer (SHO).

F1 year (PRHO)

The F1 year is typically divided into three 4-month posts. These posts will typically consist of 4 months in a medical specialty (e.g. respiratory, geriatrics), 4 months of surgery (e.g. urology, general surgery) and 4 months of another specialty (e.g. psychiatry, GP or anything else).

F2 year (SHO)

The F2 year is typically divided into three 4-month posts. These could be in any specialty, and may include jobs in shortage specialties or academic medicine.

Specialist Training

During the F2 year, doctors can apply for specialist/GP training programme. The GP training programme typically lasts for 3 years, whilst specialist training programmes typically last for 5 to 7 years. Alternatively, doctors may apply for fixed-term specialist training posts which each last for a year. However, only the first 2 years spent in these types of job count towards their training. After completing these jobs, doctors can apply for specialist training programme as normal.

Becoming a GP or Hospital Consultant

Once a doctor has succcessfully completed their specialist training programme, they then receive a Certificate of Completion of Training (CCT). This allows them to apply for GP or Consultant jobs. It may be necessary to gain professional qualifications from a Royal College (e.g. Member of the Royal College of Physicians (MRCP)) depending on the specialty.

Last updated: 11/10/2007

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Useful resources:

In the News: 'Junior doctors protest over jobs', BBC, 17th Mar '07. Climb-down over junior doctor fiasco, Telegraph Online, 7thMar '07. Medical Recruitment Crisis, Sky News, 10th Mar '07.