Once you have successfully completed the Foundation Programme you can then apply to train in a specialty of your choice.
Training Programmes differ in length and structure according to the specialty. For example, full-time general practice training lasts for three years whereas other specialties can last from five to eight years or longer if sub-specialising.
Training programmes are either referred to as:
- run-through - where you only need to apply once, for example general practice, public health and paediatrics
- '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)
This diagram provides a simple illustration of how postgraduate medical training is broadly structured
You can also find a representation of all specialty and sub-specialty pathways on the GMC website.
Finding out about specialties
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 can 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.
How to choose a specialty
Your choice will depend on a number of internal and external factors. One approach is to the follow this four step model:
- Self-exploration – do you know what you want, what you are good at and what you enjoy?
- Option exploration – do you really know what options exist and is your information accurate or based on stereotypes?
- 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?
- Implementation – having decided what to go for, how will you get there? What do you need to do before even applying?
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.
- Research your options carefully and use all sources of career advice available
- Think about options that will suit your lifestyle
- Don't rush into making a decision
- When considering posts ensure that the contract and the conditions of service are fully understood
- 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
When to choose and apply for specialty training
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).
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.
With the exception of the GP programme, 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.
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.
For example, doctors wishing to commence training in August 2022 must submit their applications by October or November 2021.
Some specialties may also have further rounds of recruitment throughout the year, with different start dates.
An indication of key recruitment dates for each year can be found in the Medical Specialty Recruitment Applicant Handbook.
Health Education England - Specialty Training
How to apply
In the main recruitment round, applicants complete an online application form around October or November and are usually invited to interview between December and March.
Interviews may be in person or online. For a number of specialties, you may be asked to provide an application portfolio (sometimes called an 'evidence folder') which demonstrates your suitability for that specialty or training programme.
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). It will also be important to have an up-to-date CV detailing your experience, skills and achievements to date.
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 and you may find it hard to convince an interview panel of your commitment to a specialty if you apply for too many.
In 2017, around 50% of applicants applied to only one specialty or training programme, 25% applied to two specialties or programmes and 11% applied to three specialties.
A small number of applicants each year apply to more than three specialties with a very small number of applicants applying to 16 to 18 specialties or programmes.
Find out more on the Specialty Training website.
Completing Specialty Training overseas
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
Doctors from European Economic Area (EEA) countries are entitled to registration in other EEA countries as long as they satisfy certain standard criteria.
Other countries outside of the EEA recognise UK training and take UK trained doctors onto their specialty training programmes.
For example, in Australia and New Zealand if you hold a primary medical qualification from the UK, you are eligible for registration without sitting any exams. 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.
Some doctors may also apply to take time out of their training, which may or may not ‘count’ towards the total training time in that specialty. Details about these kinds of opportunities can be found on the Health Careers website and in the Gold Guide (Reference Guide for Postgraduate Specialty Training in the UK).
BMA advice - Working and training abroad
Medical experience outside the EEA
Medical experience within the EEA
Medical experience in the Republic of Ireland
Tips on planning your return to the UK