SPECIALTY TRAINING IN MEDICINE

UK MEDICAL TRAINING: OVERVIEW

Postgraduate medical education and training in the UK is the joint responsibility of the four Departments of Health (in England, Northern Ireland, Scotland and Wales), the General Medical Council, Postgraduate Deaneries and the Royal Colleges.

Departments of Health

Whilst training remains a reserved issue, under the control of the UK Government, the four Departments of Health are responsible for overseeing the administration and implementation of the overarching training programme in their respective countries. Details of these programmes can be accessed below

• Medical Specialty Training (England)

• Scottish Medical Training

• Specialty Training Wales

• Northern Ireland Medical & Dental Training Agency

The General Medical Council (GMC)

The GMC regulates medical training and education in the UK and runs quality assurance programmes for UK medical schools and postgraduate deaneries to ensure that these standards and outcomes are achieved. Further information can be accessed on the GMC website.

Postgraduate Deaneries

Training for doctors who have completed their pre-registration year is co-ordinated and delivered through the local postgraduate deanery. There are 19 deaneries in the UK (see list of deaneries).

Royal Colleges

The Royal Colleges are primarily responsible, in a training sense, for developing and overseeing the specialty curricula within these training programmes. For medicine this is overseen jointly by the 3 Royal Colleges of Physicians in the UK (in Edinburgh, Glasgow and London) who undertake this responsibility through the Joint Royal Colleges of Physicians’ Training Board. It is a mandatory requirement that all Trainees undertaking medical training in the UK should be enrolled with JRCPTB.

SPECIALTY TRAINING STRUCTURE

The following diagram outlines the structure of specialty training –

Foundation Programme

At present, medical graduates enter two-year Foundation Programmes designed to give trainees exposure to a range of competencies across a broad spectrum of specialties. During this period trainees are designated as Foundation Training Year 1 or 2 (FY1 or 2).  For more information visit the Foundation Programme website.

Core Medical Training and Specialty Training

Foundation Training is followed by Core Medical Training (CMT) and then Specialty Training (ST).  CMT is the first common period of Specialty Training following selection out of Foundation Training. Entry to core and specialty training is by open competition and appointments are to training posts at the relevant Specialty Training level (eg ST1, ST2 etc). 

Competition Ratios

Links to the competiton ratios in the four UK home countries will be posted here as they are available.

• England

• Scotland

CMT Programmes are designed to deliver core training in General Internal Medicine (Acute Medicine). During the programme Trainees will continue to acquire generic competencies by following the Generic Curriculum for Medical Specialties, which provides a sound professional, moral and legal framework for practice, as described by the General Medical Council’s ‘Good Medical Practice’.

For the medical specialties, each trainee is currently required to acquire the level 1 competencies as defined in the General Internal Medicine (Acute Medicine) curriculum.  It is anticipated that these will be achieved as part of a two year CMT or Acute Care Common Stem (ACCS) training programme before entry to specialty training at ST3. Depending on the specialty, these training programmes will usually take a further four to six years. Those trainees in acute specialties who plan to take part in the acute medical take in their consultant working lives have to acquire the level 2 competencies defined in the General Internal Medicine (Acute Medicine) curriculum.  It is anticipated that this will usually require a further two years’ training in General Internal Medicine (Acute Medicine) during the specialty training period.

Assuming relevant competencies are achieved, each trainee will achieve a Certificate of Completion of Training (CCT) in their specialty and will receive a certificate of credential in General Internal Medicine (Acute Medicine).  The former facilitates entry to the Specialist Register of the GMC.

Please note that there is a mandatory requirement for all trainees entering Specialty Training in the medical specialties in the UK to enrol with the Joint Royal Colleges of Physicians’ Training Board (JRCPTB) (see below for further information re JRCPTB).  Details of how to enrol with JRCPTB, and offset your training fees through RCPE membership, are provided here.

CURRICULA FOR SPECIALTY TRAINING

At the last count there were 30 medical specialties or sub-specialties in the UK.

Curricula for specialty training programmes in medicine are drawn up by national Specialist Advisory Committees (SACs). SACs comprise representatives of the Colleges, the Deaneries and the relevant specialist societies. The co-ordinating body for the work of these Committees is the Joint Royal College of Physicians’ Training Board (JRCPTB) which operates on behalf of the three Royal Colleges of Physicians in the UK (Edinburgh, Glasgow and London).

As well as drawing up the curricula, JRCPTB has piloted and implemented a range of Workplace Based Assessments that will help trainees to provide evidence of competence acquisition and has developed an e-portfolio to support CMT (under development for post-CMT specialty training). Completion of all parts of the MRCP(UK) examination is a mandatory requirement for entry into ST3 in all medical specialties. 

In addition, Specialty Certificate Examinations (SCE), to be taken during specialty training, are being phased in for the different medical specialties – successful completion of the SCE for the relevant specialty will be mandatory for award of a Certificate of Completion of Training (CCT). 

RCPE SUPPORT FOR TRAINEES

The RCPE is also a direct provider of education to support this training and helps physicians and colleagues in other health care professions to keep up-to-date with new developments throughout their careers, as part of Continuing Professional Development (CPD). We do this in a number of ways including hosting a number of educational events, ranging from Evening Medical Updates (aimed at Trainees) to specialty-based symposia, making available archived wbestreamed presentations of lectures given at RCPE events and providing an online General Medicine CME programme which covers all of the main specialties and includes material relating specifically to CMT. All of these services and more are available to Members of the RCPE, with membership starting from as little as £5 per month.

FREE RCPE MEMBERSHIP FOR MEDICAL STUDENTS & FOUNDATION TRAINEES

The RCPE offers a range of membership grades at competitive rates which we have developed to support doctors throughout their training. This includes our e-Associate grade which offers a range of educational, professional and personal benefits to students and Foundation Year doctors (or international equivalent) FREE.  Access How to join for further details of our membership grades and benefits for Trainees.