One of the most important questions that we get asked about from international doctors is about where they fit in to the UK system and what grade they can expect to work at. The terminology is different from country to country, so hopefully this brief guide will get you used to the UK system and give you a better idea of where you might fit in. As always, email over to info@BDIresourcing or use the links on our website to submit any questions or queries that you have and we will be happy to help.
Foundation Year 1 (FY1 or Trust grade equivalent)
After completing 4-6 years of university studying for a medical degree, UK graduates first gain provisional GMC registration and enter in to their FY1 year. This is almost an orientation year building on knowledge and skills gained at medical school. Since most international doctors come to us after they have completed their internship year, it is rare that we use this grade.
Foundation Year 2 (FY2 or Trust grade equivalent)
The second year of the Foundation Training involves slightly longer rotation and more of an in depth exposure to the hospital environment. A big part of this year is determining your chosen specialist interest area upon completion. Most of the posts that we recruit to for this level are for doctors who have completed their internship year overseas and ideally have a few month of additional second year experience. Trust Grade posts are not training posts, however many departments will sign off equivalent competency certificates to ensure that you can still apply to the next stage in their medical career.
Junior Middle Grade (CMT1/2 and ST1/2 or Junior Clinical Fellow and SHO equivalent)
At this stage, doctors have usually started to get an idea of the area that they will eventually go on to specialise in. This phase of a doctors career is about expanding on foundation training and moving towards specialist training. As an example, a medicine doctor will spend these two years of their career usually in longer rotations between several medicine specialisms whilst studying towards their MRCP exam. Once complete they will usually elect to continue with one particular specialist interest all the way through to Consultant level. At this stage some doctors will choose a career in General Practice and may opt to work in a primary care setting. Junior Clinical Fellow and SHO equivalent positions are an excellent starting place for international doctors with a small amount of specialist training who are perhaps looking to study towards a Royal College qualification.
Senior Middle Grade (ST3-8 and GP trainee or Senior Clinical Fellow and Staff Grade equivalent)
Once a doctor has made it to this stage in their career they should have developed all of the skills necessary to be ready to fully immerse themselves in specialist training for the next 4-6 years (depending on the length of training for the chosen specialism). Each year of progression will involve more advanced practice and autonomous working, with the emphasis moving away from training and towards becoming fully independent – eventually becoming a trainer of the next generation. Those who choose a career in General Practice will go through slightly less years of training (usually three). Once the training years are complete, doctors receive a Certificate of Completion of Training (CCT) and gain entry to either the GMC Specialist Register or GP Register. Equivalent Senior Clinical Fellow and Staff Grade vacancies are often the best starting point for international doctors who are looking to join at this level.
Consultant or GP
Once the years of specialist training are complete doctors are free to work independently as Consultants or General Practitioners. For international candidates, it is worth noting that the CESR route recognises equivalent specialist training and without this it will be impossible to enter the UK system as a permanent Consultant straight away. That said, many international doctors who don’t already hold CESR or CCT choose to either act down to a senior middle grade whilst they work towards specialist registration or alternatively take up temporary posts which will allow Consultants to work for a fixed terms without their CESR or CCT.
As ever, the NHS has many different variations and can seem quite complicated for those who aren’t part of it every day. We have tried to simplify things in this article, however if you have specific questions relating to your circumstances or any of the things that we haven’t covered then please email us on info@BDIresourcing.com or use the forms on our website.