What are the titles and ranks of doctors in the NHS?

What are the titles and ranks of doctors in the NHS?

In the United Kingdom, the titles and ranks used for doctors vary depending on their level of training, and experience.

Here are some of the common doctor titles used in the UK.

Community based doctor

1. General Practitioner (GP)

GP is a primary care doctor who provides medical care to patients in the community. They diagnose and treat a wide range of health conditions, and can refer patients to specialists if needed. In an average clinic of 20 patients, one will be referred to hospital. As well as a medical degree, they also have additional postgraduate qualifications.

Hospital-based doctors

2.  Hospital Consultant

A consultant is (usually) a specialist doctor who has completed extensive training and has expertise in a particular area of medicine, such as cardiology or gastroenterology, or vascular or colorectal surgery. Consultants are employed by hospitals and provide specialised care to patients referred to them by GPs or other healthcare professionals. They hold higher postgraduate qualifications, such as a Membership of the Royal College of Physicians (MRCP) or Membership of the Royal College of Surgeons (MRCS).

Strangely surgeons are referred to as ‘Mr’ or ‘Miss’ in the UK (see below).

The following posts are sometimes called ‘junior doctors’. CKDEx prefers not to use that phrase as many are senior and highly skilled doctors that save lives every day.

3. Registrar

A registrar (or specialty trainee, ST) is a senior doctor who is in the middle of their training, between a junior doctor and consultant (or GP); undergoing specialty training in a hospital. They work under the supervision of consultants and are responsible for managing patients and providing care within their chosen specialty. Registrars typically hold a postgraduate qualification, such as a Membership of the Royal College of Physicians (MRCP) or Membership of the Royal College of Surgeons (MRCS). Doctors are registrars for about five years before they become a consultant.

4. Specialist (SAS; specialist, associate specialist and specialty) doctors

They are experienced and senior doctors in permanent posts. They have at least four years of full-time postgraduate training, two of which have been in their relevant specialty. SAS doctors work in hospitals and have a very ‘hands on’ role with a lot of patient contact. They are often called ‘associate specialists’ or ‘trust grade doctors’.

Many SAS doctors have made a positive choice to step into a SAS position from a traditional consultant training pathway – e.g chosen not to be a registrar then a consultant.

The next two stages of training are often called ‘junior doctors’.

5. Senior House Officer (SHO)

An SHO is a junior doctor who has completed their foundation training and is gaining more experience in a hospital setting. They work under the supervision of registrars and consultants, and rotate through different specialties as part of their training. Doctors are SHOs for 2-3 years.

There are many times when I am the most senior doctor on the ward in my specialty, responsible for many lives, but I am still called a ‘junior doctor’ – and still ‘in training’, and will be for several years.

6. Foundation Doctor

A foundation doctor is a junior doctor who is the start of their medical training after graduating from medical school. They work in hospitals under the supervision of consultants, registrars and SHOs.

They gain experience in various specialties. It is a two year position, with doctors rotating speciality every 4 months. They are called FY1s (or F1s) in the first year, and FY2s (or F2s) in the second year. All foundation doctors have a medical degree.

7. Medical student

To become a doctor, medical students typically undertake a five-year university (called a medical school) undergraduate course, or a four-year postgraduate course. This usually includes two years studying basic medical science, followed by three years of more clinical training; during which they work in hospital wards under the supervision of consultants.

Other terminology

It is important to note that the titles used for doctors vary depending on the nation within the UK, as healthcare is a devolved; with different arrangements in England, Scotland, Wales, and Northern Ireland. Additionally, there may be other specialised titles used for doctors in specific roles, such as surgical trainees, public health, locum (temporary) or academic (see below) doctors.

Academic doctors
Academic (or ‘clinical academic’) doctors often work in a combination of teaching, research, and specialist clinical care. They undertake research in order to develop the science of medicine, and can be any grade of doctor from a foundation year junior doctor to a consultant or GP.

Common job titles for academic doctors are (from senior to junior):

• Professor – consultant
• Reader/associate professor – consultant
• Senior lecturer (SL) – consultant
• Lecturer – registrar
• Clinical research fellow – registrar
• Academic clinical fellow (ACF) – equivalent to SHO.

Summary

What are the titles and ranks of doctors in the NHS. We hope you understand them better now.