UK Training

In the U.K. after leaving medical school you start work as a Foundation Trainee. This lasts 2 years: you are a FY1 (foundation year 1) for the first year, whilst you are provisionally registered with the GMC, then an FY2 (foundation year 2) for the 2nd year, when you will apply for full registration with the GMC. The vast majority of UK doctors have in recent years been appointed to Foundation training programmes after undergraduate training.

The following flow diagrams show basically how the current UK training schemes work. Different specialities offer core ST training then higher specialty training, whereas some specialities offer "run through" training.

Core With Subsequent Higher Speciality Training

Medical School (5-6 yrs) » Foundation Training (2 yrs) » Core Training (Medical / Surgical) ST1-2 » Higher Speciality Training ST3 - ST 6/7/8 » Consultant

Run Through Speciality Training

Medical School (5-6 yrs) » Foundation Training (2 yrs) » Run Through Speciality Training (ST1-6/7/8) » Consultant

Alternative Speciality Training

Medical School (5-6 yrs) » Foundation Training (2 yrs) » LAT/LAS Training » Staff Grade / Specialty Doctor Jobs » Consultant / Associate Specialist

Postgraduate Speciality Training

Throughout training, the different specialities require you to sit membership exams which you need to pass before you can become a GP or a consultant (e.g. MRCGP, MRCOG, MRCS). These exams often have high failure rates, they are expensive, you have to study whilst working and there may be different exams and formats. Have a look on the relevant college websites (see Careers available list) for more information. Sometimes these exams can be sat straight after medical school, others you may have to do more training before you can sit them. It is important to note that not everyone will want to become a consultant or GP, and there are still hospital-based service posts available, which do not necessarily require membership exams nor require a place on the structured run through or core & higher specialty training pathways, known as non-consultant career grade, staff grade, specialty doctor or associate specialist grade.

Part time training

Part time or flexible training is becoming more common, particularly as the number of female medical graduates has risen over previous years. For more information see:

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  • Additional Information

    To find out more about the foundation programmes available, have a look at the websites below. They have all the information that you need about the foundation programme and careers advice section gives you information about career fairs, too.


    You may feel academically inclined and there are foundation programmes which can lead you along an academic career pathway - have a look at these websites:

  • Postgraduate Foundation Training

    Some testimonials from current FY doctors

    Dr. Jade Force currently FY2 Doctor and is planning on working in New Zealand after FY2

    FY1: Respiratory, general medicine (renal) and general surgery – all in Raigmore Hospital

    Raigmore Hospital has been a great place to start work. As a district general it is a good size and people are helpful and welcoming. Things seem to run very efficiently and as you get to know who most of the staff it is easy to liaise with colleagues and get jobs done quickly. Inverness itself is fantastic – I love being based in the Highlands with great access to the , West coast, skiing... and the airport for visiting family! The river running through town is very pretty; there are also tons of tasty restaurants and a theatre. I definitely think it is a friendly place to work and despite having moved here from the opposite end of the UK Inverness feels like home now!

    Respiratory medicine was challenging as the patients are often very unwell and can deteriorate quickly. I gained lots of experience in assessing acutely breathless patients, venflons/ABG's and palliative care. You are part of a focused team on the ward (FY1/FY2 or ST/registrar) and an allocated consultant does a ward round twice a week. Occasionally I was expected to do the ward round by myself but more often an FY2 or registrar would be there to lead the round. There were weekly lung cancer MDT meetings which were interesting and also opportunities for small audit projects.

    I was attached to the renal team for 4 months. This was great as there were regular ward rounds and daily meetings in the renal unit to discuss all renal patients in the hospital. I felt well supported and the consultants were easy to reach when I had questions. The GI/renal medical ward is renowned for being busy and it deserves that reputation – however I really enjoyed working there; there's always lots happening and it is impossible to be bored! There were lots of opportunities for learning new procedures such as ascitic taps/drains.

    General surgery was the most enjoyable job in FY1 for me! I was attached to the vascular team which is busy; the consultant and registrar are away in theatre most of the time and the FY1 is left to look after the 25-30 vascular patients throughout the day. You have to clerk elective admissions to the ward and you can help in theatre (if the wards aren't too busy). During the 4 month rotation you have a whole week allocated as 'theatre week' – this is a flexible 5 day block that you can mould to suit your own interests – help/observe in whichever theatre cases you think are most interesting. I particularly enjoyed the strong sense of team work in the surgical rotation (helped by twice daily ward rounds). I also found that it was very sociable during the day, as all the junior staff worked together, effectively 'managing' the surgical wards responsibly whilst the seniors were in theatre.

    FY2: General practice (Inverness), rural hospital medicine (Fort William) and teaching fellow (Centre for Health Science, Inverness)

    I think the best thing about my N13 programme I had from the North deanery is being based in Inverness for 20/24 months and having such varied FY2 rotations (after a good grounding of general medicine and general surgery in FY1).

    My favourite rotation has been GP – I was attached to Kinmylies Medical Practice in Inverness. This is a tiny practice with only 2 GP's but they are really welcoming and I soon felt part of their team. I had my own consulting room and ran 7 surgeries a week (each filled with 15 minute appointments). The other 3 sessions in the week were for either shadowing one of the GP's, a teaching session or private study. Although I took a pay cut during this block the 08.30-5 hours were great and I loved having every weekend off! It was so different to hospital medicine that I learnt about a whole new range of conditions and really practiced my communication skills. I also had the opportunity to do a few home visits and visit patients in the community hospital.

    Working at the Belford Hospital in Fort William was a steep learning curve in terms of responsibility. The hospital is small with only 2 wards (one for acute admissions and one rehab ward) and an A&E. As an FY2 you are the 'senior' to FY1's and there are no registrars. This means that you have to work closely with the consultants and make lots of independent decisions. As the hospital is small when you are on call (half the time) you cover A&E and the wards after 4.30pm or at weekends. Working in A&E next to the Nevis Range is great as you are exposed to lots of big trauma cases and as there are no middle grades you are the first port of call and often the only Dr on site. I was pushed out of my comfort zone on numerous occasions which is scary at the time but in retrospect great for my learning! As well as lots of A&E exposure you also do some 08.30-16.30 shifts on the ward – this can be quite quiet and as junior staff live upstairs in the hospital accommodation you often get the chance to go upstairs to your own flat and study or rest. Living in the hospital is also useful on night shifts as if A&E is quiet for a few hours you can sleep in your own bed!

    My final rotation has been working as a clinical teaching fellow in the Highland Medical Education Centre (HMEC). This is entirely different to the usual FY1/FY2 jobs. I work 9-5 and it is primarily a desk job. My timetable is very flexible and although there are a few set commitments most of the timetable is arranged myself (through liaising with other teaching staff or students). My duties include supporting the 4th and 5th year medical students with bedside teaching, scenario based teaching and revision tutorials; helping the senior teaching fellows with seminars, writing OSCE questions for the question bank, organising OSCE'S and examining in formative exams. There is also some time to work on personal research projects and help with established projects. I have enjoyed the flexibility of this job and the opportunity to develop my CV and teaching skills. I have done a few locum shifts in the hospital at weekends to top up my un-banded salary and keep developing my clinical skills.

    The FY1 experience!

    Dr. Anne-marie Shanks currently an FY1 doctor

    If you asked me a year ago how I felt about the prospect of starting FY1 I would have probably said something along the lines of "looking forward to the challenge of the next phase of training", "A little scared of the responsibility, maybe even terrified"

    What I remember of the first day... inductions, passwords, logins and basically information overload. I don't really remember much else. Much of the first month felt like a blur that is probably because that was when the most information was being processed; the transition between medical school and doctor was perhaps occurring. My first job was Department of Medicine for the elderly and I had no expectations, being general it gave me lots of ward experience, of sick patients not just with one problem but with many including social issues as well. So having started out feeling terrified that I was not ready – actually I was absolutely terrified in retrospect – I can honestly say the first day was not so bad!!!

    The transition between one job and next was more difficult than I had first thought. Comparing it to my first day I had no "real" expectations as I had no experience on what to expect, however at changeover you have expectations for the next job. You have developed working relationships with colleagues and you are used to your environment and then you change and you have to start working on all those again. I would have cringed if a year ago I had said this….Team work is one of the most important aspects of FY1 and being part of that team and being valued makes the transition all the more comfortable.

    Eight months on and looking back, it may be fair to say that I was theoretically prepared for FY1 in medical school terms but was not prepared for the practicalities of working: get your passwords/logins early, prepare for the rota- buy food in advance, and books holidays and remember ABCDE!

    Dr. Andrea Woolner currently an FY2 Doctor and is about to begin ST training in Obstetrics & Gynaecology

    I remember not knowing what to expect of my first day as a "real" doctor. I was certainly anxious at the prospect, but the first day was surprisingly OK. There were lots of people around to ask questions and it was nice that the shadowing period (which everyone has to undertake before starting their first job – shadowing the FY1 doing the job that you will start in) had introduced me to the new hospital and the staff. There was quite a lot happening all at once – I had moved cities, suddenly become a working professional and was in a position of responsibility - almost all overnight!

    It was hard, it is certainly stressful and the hours are long, but I can honestly say from the first few days I knew I was going to enjoy my job. I started in general surgery in Raigmore Hospital Inverness. The rotation included a chance to work in all of the surgical specialities, including gaining experience in surgical HDU and on call receiving. We (FY1s) held the receiving bleep so accepted all GP referrals – daunting at first, but this was a great experience and allowed you to learn about the difficulties from both sides of acute referrals and about bed management. I had the chance to attend theatre a few times as an assistant and was inspired by the consultants and registrars undertaking sometimes emergency procedures. The patients were often very unwell when they arrived, and it was great to be involved in their acute management, providing adequate pain relief and then seeing their progress following treatment –whether surgical or not. It was great then to be arranging discharge for a patient who you had seen at first with life-threatening conditions. It was also very interesting to meet patients attending electively – and empathising with their concerns and hopes pre-theatre. I then moved jobs (this is probably the worst part of FY jobs, moving every 4 months when you have just become part of the team when feel like you have just adjusted – but it has to be done so you gain a range of experience) and I spent the next 8 months of FY1 in medicine, moving through respiratory and gastrointestinal wards with acute medicine on call shifts. This was again a fascinating experience. Both busy wards and acute medicine was always busy, so you had to be organised – a successful FY doctor always has a jobs list never far from their sight! Again it was inspiring to learn from your seniors in medicine and see patients come in with an array of medical problems and develop confidence in initially managing various clinical presentations on your own. Obviously in all areas of medicine it is not always a curative outcome, and it is hard when you are dealing with breaking bad news, dealing with death and speaking to grieving families. But, I found that by communicating effectively in these situations, despite it being the worst news in the world, you can still help people and provide much needed support. I always found lots of support from seniors and also from the FY peer group – it is a good idea to get to know the other FYs, as you are all going through the same things and you are a great source of support to one another. FY2 was strange, as it was more of a step up than I had realised, you are no longer the most junior! I again found the environments very supportive, and enjoyed the more specialised areas I had the chance to experience. I really felt medical school had prepared me well for the good and the bad parts, but some of the things medical school simply cannot prepare you for but you learn very quickly as an FY doctor with lots of support, and now it seems like this is all I have ever done. You need to be organised – not only at work but in life, you need to buy food in advance, know the rota well, and arrange any necessary swops well in advance. You need to appreciate how much you can learn from seniors and other health professionals and take every opportunity to learn during FY. It is a privilege to qualify and work in this profession – enjoy the junior stage, but be prepared for it too.