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Annijo
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#1
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Hi everyone,
This might be a silly question but I am sorry I am completely unsure of all these new training posts.
I have been out of practice for more than 7 years and I am completely unsure of the new system of recruitment in medical training. Before I left medical career I was working as SHO year 2 in Paediatrics (I want to be a paediatrician) but then I left career to raise kids. Now I want to come back to medicine again but completely confused of all the st1 / ct1 . What is the difference between st1 and ct1? Please can somebody explain. Thank you
I want to specialise in Paediatrucs only, so what's the best route.
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seaholme
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CT is core training and ST is specialty training. So if you go down a route that is immediately specialty e.g. Obs and Gynae which has a run-through training (as does, to my knowledge, Paeds) then you become ST1. If you go down a route that requires core training to specialise later e.g. Haematology then you become a CT1.

That's my understanding of it anyway. If you've done 2 years of pure Paediatrics already then technically you'd be ST2 Paediatrics, about to become ST3. ST3 and above generally = registrar.

Somebody please correct me if I'm wrong, as the whole system is very hard to google accurately, this is based on my own general knowledge understanding!
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MonteCristo
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Seaholme is correct. Specialties with uncoupled training might have a "core training" (CT) period followed by "specialty training" (ST). If you wanted to pursue a career in T&O surgery, you would usually need to complete core surgical training (CT1+CT2) followed by an application to join T&O specialty training (ST3-ST8). Other specialties (e.g. neurosurgery, radiology, and paediatrics) begin specialty training at ST1 and so trainees don't need to competitively apply for access to a higher training programme (you are a "run-through" trainee).

For contrast, cardiothoracic surgery has a run-through route (ST1-ST8) but will also accept a small number of trainees that completed core surgical training (CT1+CT2) directly into cardiothoracic specialty training (ST3).

If you've completed the foundation programme (or equivalent) and want to enter paeds training, you are applying as an ST1 (I don't believe there is any kind of "CT" in paeds). Whether your training programme will "count" any of your previous experience (e.g. let you enter at ST2) would depend on what/when it was and their willingness to be creative in your favour. This is what you should be applying for: http://www.rcpch.ac.uk/training-exam...and-st2/applic

Most specialties consider ST3 to be the beginning of old-style "registrar" training, except for emergency medicine where this begins at ST4.
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Helenia
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(Original post by MonteCristo)
Most specialties consider ST3 to be the beginning of old-style "registrar" training, except for emergency medicine where this begins at ST4.
I believe that paeds trainees actually become registrars at ST4 as well, though there seems to be some flexibility around ST3s.

Good luck OP!
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Annijo
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Thank you so much for responses, although I still don't understand the importance of introducing core medical training, ct1 and ct2. I mean what's the point of it in the medical training as a whole when you are spending 2 years of foundation training already and getting the idea of different specialities before making up your mind of your final chosen speciality.
Before it used to be very straightforward as after working as a house officer you start your training as a SHO in your chosen speciality.
I am still very confused.
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Helenia
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(Original post by Annijo)
Thank you so much for responses, although I still don't understand the importance of introducing core medical training, ct1 and ct2. I mean what's the point of it in the medical training as a whole when you are spending 2 years of foundation training already and getting the idea of different specialities before making up your mind of your final chosen speciality.
Before it used to be very straightforward as after working as a house officer you start your training as a SHO in your chosen speciality.
I am still very confused.
The idea of core medical/surgical training is to give people a rounded experience of lots of different medical/surgical specialties, so they're able to choose registrar posts with more insight. People always did a variety of SHO posts before choosing a subspecialty, this is just formalising it.

If you want to stay in paeds it's very straightforward, you just need to get in touch with RCPCH (I guess?) to find out your options regarding getting back into training. There are probably also non-training SHO/SpR posts around which might be a good place to start?
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Annijo
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(Original post by Helenia)
The idea of core medical/surgical training is to give people a rounded experience of lots of different medical/surgical specialties, so they're able to choose registrar posts with more insight. People always did a variety of SHO posts before choosing a subspecialty, this is just formalising it.

If you want to stay in paeds it's very straightforward, you just need to get in touch with RCPCH (I guess?) to find out your options regarding getting back into training. There are probably also non-training SHO/SpR posts around which might be a good place to start?
Thank you so much Helenia, that make quite a lot of sense, thanks for easy explanation, much appreciated.
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fishfacesimpson
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(Original post by Annijo)
Thank you so much for responses, although I still don't understand the importance of introducing core medical training, ct1 and ct2. I mean what's the point of it in the medical training as a whole when you are spending 2 years of foundation training already and getting the idea of different specialities before making up your mind of your final chosen speciality.
Before it used to be very straightforward as after working as a house officer you start your training as a SHO in your chosen speciality.
I am still very confused.
It hasn't really changed things significantly in medicine. Most people in the bygone era would've done their PRHO (fy1) then done Sho jobs for anywhere between 1-3 years (let's say fy2-ct2) depending on when they got their membership. What has changed is that people rarely jump from medical specialty to specialty. It's not uncommon to hear experienced consultants now talking about how they may have been a cardio spr for one year then respiratory for a year before settling into neurology, for example. It's harder to do that now and the system can be perceived as favouring those who know exactly which path they want to follow
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MonteCristo
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I'm currently in the US where medical students typically go directly into their chosen specialty and don't spend/waste time rotating through different jobs before beginning their core business of training to become a consultant/attending. As a consequence, training in surgery is finished five years after qualifying from medical school and emergency medicine after only three years. I can see the pros and cons of both systems but I am really not sold on four years post-qualification generic training before doctors can become dedicated to their specialty.
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junior.doctor
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I think everyone above has covered most aspects of paeds specialty training. It is run-through training, which means that once you're accepted at ST1, you have a national traning number, and subject to you completing each year of training satisfactorily, you progress through from ST1 to ST8 without having to reapply for a new training programme.

ST3 is an odd, sort of transition year in paeds. If you work in a tertiary centre / large centre, ST3 still counts as SHO. If you work in a small DGH, then ST3s are all on the SpR rota. Which means that you can effectively spend 6 months being an SpR and then go back to being an SHO again for the next 6 months.

RCPCH will be able to advise about how much your previous experience will count for different things. You can only apply for ST1 if you have less than 18 months post-FY2 experience in paeds, otherwise you have to apply for ST2 and beyond. Obviously if you didn't do a foundation programme then this'll be harder for you to quantify and you'll have to get advice from them. The national recruitment happens every autumn for Aug/Sep posts the following year - application for 2016 recruitment has already closed. There are plenty of staff grade / non-training posts out there in paeds, tho, in the meantime.
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