If you are keen to pursue a career as a doctor and have an interest in following a particular specialism, you need to know how to go about embarking on that career path. While everyone is aware that the first step is to go to university to study medicine, there is a lot more to it than that, and many more years of further study are required to become fully qualified in a specific area of medicine.

Although being a specialist doctor is not an easy or quick-fix career path, it is certainly a lucrative and rewarding one, but anyone embarking on it needs to be aware of what precisely is involved before making their application to medical school.

Applying To University

The very first step to becoming a doctor of any kind is to make an application to medical school. The grades required are usually very high, so it is important to achieve good grades in sciences at A level in order to be accepted onto a course.

A medical degree will take between 4 and 6 years of study depending on the pathway taken. The degree will involve both classroom study and placements in healthcare settings like training hospitals, GP surgeries or clinics. During the medical degree, students will develop a basic grounding in the principles of all areas of medicine and will form the basis of their future medical career.

The Foundation Programme

After graduating, students then go on to do postgraduate training by applying for a foundation programme. The foundation programme is a prerequisite for anyone who wants to be a doctor in the UK and nobody can take a job as a doctor of any kind in the UK without having followed a foundation course of study. This programme lasts for two years and is a bridge between training in medicine as an undergraduate and training in a speciality.

The foundation year provides trainees with defined competencies and practical skills, teaching the basics about how to deal with patients who are acutely ill and ensuring that the junior doctor has a full understanding of the basics of medical practice. During the foundation year, doctors are able to undertake tasters which are periods of up to 5 days spent shadowing a practitioner in a particular speciality to give an insight into it and to decide which of the specialisms they would like to follow later in their career.

The Foundation Programme represents the first opportunity that the trainee doctor has to be paid for their work. During this period of their education they will be referred to as a Junior Doctor within their medical setting and will earn a salary.

Speciality Training

Doctors who want to go into general practice then go on to study for another three years to become a fully qualified GP. Those who want to work in a specialist area must also spend a further period of time training in their specific chosen area. There are around 60 specialities which trainee doctors can choose from, and the area chosen determines the length of time spent training before finally becoming fully qualified. For example, paediatrics is one of the longest periods of speciality training, lasting for around 10 years.

Those who follow a speciality training programme are called speciality trainees or speciality registrars. Speciality training is run in several ways including:

• Run through training programmes – these last around 3 years for GPs and 5-7 years for the other specialities. The purpose of the programme is to give trainees an overview of their speciality becoming increasingly specialised with time.
• Higher and Core Speciality Training Programmes – these involve 2-3 years of core training followed by open competition in order to enter a post for higher speciality training. This is a very competitive pathway.
• ACCS (Acute Care Common Step) – this 3 year programme is suited to those who want to specialise in emergency medicine, anaesthesia, acute internal medicine or general internal medicine. In the third year of this programme, there is highly specialised training to allow for entry into a higher speciality training programme
• Stand alone approved posts – these are equivalent training posts that do not form part of a run through programme. They are educationally approved and could contribute to a CCT. Some of these posts including LATs and FTSTAs.

To become a speciality doctor, doctors must have already undertaken a minimum of four years of postgraduate full time training, with two of which being in a speciality training programme. Any doctor who has not already completed a UK approved training programme for entry to the specialist register may have their experience and training assessed for its suitability for entry.

Entry to the specialist register depends on a CESR being awarded (a certificate of eligible for specialist registration).