Quick Facts — UK Training
- Regulator: General Medical Council (GMC)
- Foundation Training: 2 years (F1 + F2), managed by UKFPO
- Specialty Applications: Via NHS Oriel platform
- Working Hours: Governed by the New Deal / 2016 Junior Doctors' Contract
- Training Programmes: Run-through or uncoupled depending on specialty
The UK Training Structure
Medical training in the UK follows a structured pathway from graduation through to independent consultant practice. Since 2024, the term Resident Doctor has replaced "Junior Doctor" — applying to all trainees from Foundation Year 1 through to specialty registrar level.
Foundation Programme (F1 & F2) — 2 years
All UK graduates enter the 2-year Foundation Programme. F1 is required for full GMC registration. Applications via the UK Foundation Programme Office (UKFPO) during final year of medical school.
Core Training — 2–3 years
After foundation, most specialties require core training (e.g. Core Surgical Training, Core Medical Training, ACCS). Some specialties offer direct run-through training from FY2.
Specialty Training (ST3–ST8) — 4–6 years
Higher specialty training leading to Certificate of Completion of Training (CCT). Competition for specialty training posts occurs at ST3 level for most surgical and medical specialties.
Fellowship / Consultant
Post-CCT fellowships are increasingly common before substantive consultant posts. Consultant applications are via NHS Jobs or direct hospital advertisement.
Specialty Pathways
| Specialty | Entry Route | Duration After Foundation | Key Exam |
|---|---|---|---|
| General Surgery | CST (CT1–CT2) → ST3 | 8 years | MRCS, FRCS |
| Internal Medicine | IMT (CT1–CT3) → ST4 | 7–8 years | MRCP |
| Radiology | Direct ST1 | 5 years | FRCR |
| GP | Direct ST1 (run-through) | 3 years | MRCGP |
| Anaesthetics | ACCS/Direct ST1 | 7 years | FRCA |
| Emergency Medicine | ACCS → EM ST4 | 6–7 years | FRCEM |
| Psychiatry | Direct CT1 | 6 years | MRCPsych |
Foundation Programme Applications
UK medical graduates apply to the Foundation Programme through the UK Foundation Programme Office (UKFPO). The process uses a combination of:
- Educational Performance Measure (EPM) — derived from your medical school decile ranking and academic achievements
- Situational Judgement Test (SJT) — a 2.5-hour exam testing professional attributes
The EPM and SJT scores are combined to produce an application score, which determines foundation school preference allocation.
Specialty Applications via Oriel
Specialty training posts in the UK are advertised and applied for through the NHS Oriel system. Key points:
- Application windows typically open in November–January for August starts
- Longlisting, shortlisting and interview scores are weighted differently per specialty
- The MSRA (Multi-Specialty Recruitment Assessment) is used for many specialties as a longlisting tool
- IMGs must have GMC registration before applying
IMG Pathway — International Medical Graduates
International graduates seeking to work as a resident doctor in the UK must:
- Pass PLAB 1 & 2 (or hold a recognised primary medical qualification)
- Obtain GMC registration with a licence to practise
- Secure a sponsor (employer) for visa purposes (Skilled Worker visa)
- Apply for training posts via Oriel or service posts via NHS Jobs
UK Competition Ratios
Competition ratios vary significantly by specialty and year. The most competitive specialties for UK training historically include:
| Specialty | Approx. Ratio (applicants:post) | Competitiveness |
|---|---|---|
| Neurosurgery | 8–12 : 1 | Very High |
| Plastic Surgery | 6–10 : 1 | Very High |
| Radiology (ST1) | 3–5 : 1 | High |
| Cardiology (ST4) | 3–5 : 1 | High |
| GP | 1.5–2.5 : 1 | Moderate |
| Psychiatry | 1–2 : 1 | Lower |