SHO, STR, FY1- what does it all mean?? Watch

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abixx
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Please can someone explain the entire process, with all the different titles and labels involved in medicine.

So far I know that there are 6 yrs of medical school, the last three of which are done in a hospital- clinical.

then there is FY1 and FY2 - which I understand to be a junior doctor

then there are words like registrar, clinical fellow, physician, consultant, professor, house officer, senior house officer.... i just dont get the difference or where they come in the hierarchy

thanks!
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meowcat95
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(Original post by abixx)
Please can someone explain the entire process, with all the different titles and labels involved in medicine.

So far I know that there are 6 yrs of medical school, the last three of which are done in a hospital- clinical.

then there is FY1 and FY2 - which I understand to be a junior doctor

then there are words like registrar, clinical fellow, physician, consultant, professor, house officer, senior house officer.... i just dont get the difference or where they come in the hierarchy

thanks!
House officer and Senior house officer are the old names for F1 and 2. Once you've done your first two years as a junior doctor you enter speciality training as a registrar - this can be GP, general medical, general surgical, and possibly psychiatric. You do this for different numbers of years depending on which route you choose - you can be a GP 5 years after medical school and are trained enough to be a consultant after 8 years. A consultant generally works in or is associated with a hospital. There are however too few posts to allow every 32 year old who's ready to be a consultant to take a job so realistically most registrars are promoted after 10 years or more from medical school. A physician is another term for a doctor. I think clinical fellows and professors are terms for those who are heavily involved in education, possibly associated with a university, but I'm not sure about that!
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Helenia
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This confusion mostly stems from the change from the old system to the new (MMC) one a few years ago.

Previously, hospital doctors (GP trainees are slightly different) worked in a 4-tier hierarchy: -
  • House Officer/PRHO (1 year)
  • SHO (2-3 years)
  • Registrar - this was sometimes subdivided into registrar/senior registrar (~5 years)
  • Consultant


It was possible to work in SHO-level posts in different specialties for several years until you found one you really liked, then started to build up experience in that specialty until you were ready to apply for registrar jobs.

Nowadays, after medical school, you do FY1 and FY2, which are both general, non-specialised rotation years. You then go into training for your chosen specialty. Some specialties, like Paeds and Obs & Gynae have "run through" training so once you have got onto a programme you stay on it until you are a consultant; in these you start as an ST (specialty trainee)1, and progress up to ST8 or more. In other specialties like medicine, surgery, anaesthetics, you do 2 or 3 years as a "core trainee" and then reapply for further subspecialty training; you are known as a CT1/2 for the core training years, and then an ST3 (or higher) in the later years.

Technically all these numerical codes should replace the old grading but in reality, the way that rotas work mean that there is still an "SHO" and "registrar" grade. The SHO level includes FY2s, CT/ST1/2s and sometimes CT/ST3s, depending on specialty. Some GP trainees will also do in-hospital jobs at SHO level as part of their training. The registrar grade is then ST3/4 and above. There are also jobs which do not count towards specialist training but are just there to fill up numbers within rotas - these are often called staff grade/trust grade/clinical fellows. A consultant is someone who has completed their specialist training; the amount of time this takes varies between specialties, but is usually 6-8 years not including medical school or foundation years.

A physician can be simply an alternative name for any doctor, or it can specifically mean a doctor specialising in internal medicine.

A professor is someone who has been appointed to a professorial teaching position within a university. They are usually also a consultant but will spend some of their time on teaching/research rather than clinical work.

A clinical fellow is a rather vague term. It usually means a doctor who is not in an official training position, but they may be at SHO or registrar level and may also have teaching/research responsibilities.

It's a pretty confusing system, but I hope that helps.
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abixx
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THANK YOU!!!

its still quite confusing but at least I can understand the labels on people's badges at work experience!
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shyamvachhani9
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what is starting salary of sho after 2 years of international experience which is valid as fy1 and 2. and what post will i be holding if i am not entering core training??
i will be in pay scale of fy2 or ct1 or st1??
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ForestCat
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(Original post by shyamvachhani9)
what is starting salary of sho after 2 years of international experience which is valid as fy1 and 2. and what post will i be holding if i am not entering core training??
i will be in pay scale of fy2 or ct1 or st1??
CT1=ST1. They are the same level of training, CT means core training (a broad overview in either medicine or surgery) and ST means speciality training (some specialities are run through, meaning you go straight into them after foundation years).

It will honestly depend on what stage you go into. Yes you hold valid experience, but have you applied for a training post?

The BMA does publish the pale scales for junior doctors under the new contract. But your actual pay will vary depending on what you rota is for each placement.
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ForestCat
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(Original post by shyamvachhani9)
what is starting salary of sho after 2 years of international experience which is valid as fy1 and 2. and what post will i be holding if i am not entering core training??
i will be in pay scale of fy2 or ct1 or st1??
Also this thread is very old, best to start a new thread with any further questions.
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