Specialty Training

Training programmes are either referred to as:

• run-through - where you only need to apply once, for example general practice, public health and paediatrics

OR

• 'core' plus 'higher' training (sometimes referred to as 'uncoupled' training) where you complete two to three years of core training and then apply again for higher specialty training. For example, internal medicine training (IMT), core surgical training (CST), core psychiatry training (CPT) and acute care common stem training (ACCS) (leading to further training in emergency medicine, intensive care, anaesthetics and acute internal medicine).

Please note: Some specialty training programmes may offer both run-through and core plus higher training programmes. Some specialties may also recruit doctors who have trained in a different specialty initially (eg. Paediatrics to GP)

You can find a representation of all specialty and sub-specialty pathways on the GMC website.

According to the GMC, there are currently around 65 specialties and 31 sub-specialties in the UK. Therefore it’s never too early to find out about them.

One of the best ways to research a specialty is to spend time in it, and to spend time talking to doctors training and working in that field.

You will spend time in some of them during your medical degree and will get the opportunity during your Clinical Phase to choose a specialty and location in which to do your Elective placement. You also have the chance to undertake Special Study Modules (SSMs) of your choice where you could find out more about a particular specialty that interests you.

Outside of your clinical placements you will have the opportunity to talk to doctors from various specialties during careers fairs and other careers activities within the curriculum and at events organised by medical student societies.

Some Specialty Training Programmes offer 'dual' accreditation, for example, you complete your training in specialty A and B (known as Dual Certificate of Completion of Training, or Dual CCT). This means you cover all the competencies required for both specialties.

GMC - Dual CCT

More information

Special Study Modules Final year electives Explore the specialties Person specifications Health Careers: Explore the different specialties in more depth

Your choice will depend on a number of internal and external factors. One approach is to the follow this four step model:

1. Self-exploration – do you know what you want, what you are good at and what you enjoy?
2. Option exploration – do you really know what options exist and is your information accurate or based on stereotypes?
3. Decision-making – there may be several specialties which could make a good fit for you. Do you know how you make good decisions and what might help you make an informed decision?
4. Implementation – having decided what to go for, how will you get there? What do you need to do before even applying?

Key questions

There are some key questions to consider at the decision-making stage, based on your self-exploration and your research of options whether you have a clear idea already or yet to decide from a longer list of specialties.

• Do you think you have the required experience and skills for the specialty?
• Will the work interest you enough and provide enough job satisfaction?
• Do your core values and the things that matter to you most 'fit' with this type of work?
• Do your potential colleagues share your values?
• How will this specialty impact on your broader home life and how much of a factor is this for you?
• What kind of patients will you treat in this specialty?
• What does the training pathway involve?
• What changes do you envisage in the specialty over the course of your career, and how might that impact on you?

It is likely you will have more key questions which are important to you.

For example, if patient contact, high salary or the opportunity to work part-time are important to you, you may target some of your thinking around these factors when comparing specialties.

Top five tips from the BMA

The BMA offer the following top five tips for choosing a career.

1. Research your options carefully and use all sources of career advice available
2. Think about options that will suit your lifestyle
3. Don't rush into making a decision
4. When considering posts ensure that the contract and the conditions of service are fully understood
5. Think about your future and how the specialty will change over time

Competition for specialties

One factor you may consider is the availability of specialty training posts and the competition for these places. 

Every year Health Education England produce competition data for the different specialties which detail number of applications, posts and overall competition ratio for each specialty.

More information on choosing a specialty

Career planning for medicsPlanning your career - Health CareersRoyal Medical Benevolent Fund - choosing the specialty that's right for you

If you wish to go straight from Foundation Training to Specialty Training, you will usually apply for training programmes around October or November of your Foundation Year 2 (FY2).

Taking time out

We know from the F2 Destination Reports that many doctors decide to take time out between Foundation Training and Specialty Training; informally known as Foundation Year 3 (FY3). For example, to pursue clinical work abroad, work in a service related post (non-training grade post) or pursue other interests such as a teaching fellow, undertake further study or go travelling.

If you decide to take time out between foundation and specialty training, you need to be aware of any restrictions on how much time you can spend working in a specialty before applying to it in the future. It is important to check the person specification of the specialty/ies you are interested for the most up-to-date information. For example, some specialties may stipulate no more than 18 or 24 months of relevant experience by the intended start of date of the post.  

You cannot defer your place to Specialty Training unless for statutory reasons such as maternity, paternity, adoption leave or ill health as detailed in the 'Gold Guide' (Reference Guide for Postgraduate Specialty Training in the UK).

Find out more about taking time out.

Start of training

Specialty Training generally commences in the first week of August each year with the main application rounds opening in October or November of the preceding year.

Some specialties may also have further rounds of recruitment throughout the year, with different start dates.

Medical Specialty Training

In the main recruitment round for CT1/ST1 posts, applicants complete an online application form on Oriel around October or November and are usually invited to interview between December and March.

Most specialty recruitment processes shortlist applications against the nationally agreed person specification.  The top-scoring applicants are then invited for assessment or interview.

The next step in the process varies depending on the specialty and deanery. The main recruitment methods are:

• the Multi Specialty Recruitment Assessment (MSRA)
• verified self-assessment
• interviews

The verified self-assessment requires applicants to upload evidence to an online portal to support your application.

It is therefore helpful to start gaining and gathering evidence of the required experiences, skills and attributes for the specialty to which you are applying as soon as possible (particularly during Foundation Training but also in medical school). 

Interviews take place online, but the structure and content vary across specialties. For more information on interviews and the selection process see the specialty recruitment applicant guide.

Medical CVs and portfolio - advice and top tips

CVs for graduate roles - advice and tips

Applying for multiple specialties

You can apply for as many specialty training programmes as you wish. However, there is a lot of work involved in each application. You may also want to consider the level of competition for different specialties.

Due to increased competition for specialty training posts in recent years, more applicants are now applying for multiple specialties than in previous years.  To help ease this pressure the UK government’s 10 Year Health Plan for England includes a commitment to create 1,000 additional specialty training posts over the next three years. 

Medical Specialty Training

From time to time doctors who have embarked on specialty training change their mind about the specialism they want to work in and want to switch. As a doctor training it is possible to change to a different training programme.

You will usually be extending the overall time you will spend in training before achieving a Certificate of Competence. However, you will not necessarily have to start from scratch again in a new specialty; it will all depend on the relevance of your previous training experience. You can “carry over capabilities and competencies” should you choose to change your specialty. This will be easier in some specialties than others.

For further guidance refer to the BMA’s guidance

Academy of Medical Royal Colleges – Guidance for flexibility in PG training and changing specialties

Healthcareers – Switching medical specialty

If you are considering training in another country, you need to find out if:

• your UK Foundation Training is recognised by the country you want to train in
• you need to take any additional exams
• specialty training in that country would be recognised by the UK if you returned to work here

Countries in the European Economic Area (EEA)

UK medical graduates can still work in many EEA countries, but they are no longer automatically entitled to registration under EU law since the UK left the EU and the EEA. Instead, each country now applies its own national rules for recognising UK qualifications.

Countries outside the EEA

Other countries outside of the EEA recognise UK training and take UK trained doctors onto their specialty training programmes.

For example, if you hold a UK medical degree, you may be eligible to register and practise in Australia or New Zealand without needing to sit additional exams. Both countries recognise UK qualifications through their Competent Authority Pathways, which streamline the registration process for doctors trained in certain countries, including the UK.

However, each specialty college in these countries has different eligibility requirements. And, as with specialty training in the UK, some training programmes are more competitive than others.

If you're considering specialty training in a country that doesn't have a mutual recognition agreement with the UK, it's important to start by checking the official guidance from the relevant medical board or specialty college in your destination country. They will outline the licensing process, eligibility criteria, and any exams or documentation required. It’s also a good idea to connect with UK-trained doctors already working there -they can offer valuable insights into the process and what to expect.

BMA advice - Working and training abroad

Medical experience outside the EEA