The College's guide to specialty training provides an overview of the UK medical training system, structure and curricula. 

We provide education to support specialty training and continuing professional development (CPD) for physicians and other health care professionals throughout their careers.

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

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 or Local Training and Education Boards (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.

Training Pathway

Foundation Programme

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

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.

Curricula for specialty training

There are 32 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).

Support from the College

We are a direct provider of education to support specialty training and continuing professional development (CPD) for physicians and other health care professionals throughout their careers.

We host educational events, including Evening Medical Updates (aimed at trainees) and specialty symposia. Selected event lectures are presented on our Education Portal along with specialty modules, interactive cases and self-assessment.

Membership of the College, from as little as £5 per month, provides you with access to this material.

Membership for Students and Foundation Year doctors (or international equivalent) is free.