Specialist registrar
Encyclopedia
A Specialist Registrar or SpR is a doctor
in the United Kingdom
and Republic of Ireland
who is receiving advanced training in a specialist field of medicine
in order eventually to become a consultant
. In surgery, also referred to as Higher Surgical Trainee or HST.
After graduation from medical school
, they will have undertaken several years of work and training as a pre-registration house officer
and senior house officer
, and will usually have taken examinations for membership of the Royal College
of their speciality. For example, medical registrars will take the MRCP
examinations to enable progression to become registrars.
Entry to the grade of SpR is now closed and thus information is largely historical. The entry into Specialist Registrar posts was regarded as highly competitive and so tough. Regional advertisements were placed by local deaneries, which controlled the number of places and the funding for posts. Open competition was afforded and, via shortlisting and interviews, successful applicants were given posts for 4–6 years depending on the speciality. A National Training Number was awarded concurrently and was attached to the post rather than the doctor, again historically. The number of posts available was strictly linked to the number of consultants required in a particular speciality, and therefore in the more popular specialities such as Cardiology, General Surgery and Sub-Specialties, Orthopaedics and Plastic Surgery it often took many attempts to get a post - leading to what is known as the "SHO bottleneck", whereby doctors are stuck at the grade of senior house officer
for a number of years. Changes in postgraduate medical training (Modernising Medical Careers
) are underway to alleviate this problem. Choice of final specialty is now limited by success in application, rather than time spent waiting for a post to be available and offered to you. This new method is more ruthless, but prevents stalling in career progression and should eliminate the number of doctors uselessly waiting in posts of dubious educational value. It does however hinge on a fair and robust selection process for the highly desirable posts, something that initially was a total and unmitigated disaster (MTAS).
Specialist Registrars generally stay in post for around five years (more or less depending on the speciality), gaining experience at first in a broad speciality (e.g. general medicine), later specialising in a subspeciality (e.g. cardiology
) after which they receive the Certificate of Completion of Training
(CCT). The CCT is awarded based on satisfactory yearly Record of In Training Assessments (RITA) and completion of an 'exit' exam or fellowship diploma in the specialty from one of the UK surgical colleges. After this a Certificate of Eligibility to the Specialist Register (CESR) is awarded. Listing on the Specialist Register permits application to consultant jobs. Specialist registrars are encouraged to undertake research in their field, and many choose to do this by means of a PhD
or MD
.
The SpR grade is set to disappear in 2007 with the full introduction of MMC. Instead, trainees will be referred by their ST level (e.g. ST3). ST3 roughly equates to the first year of SpR training, although standards of experience are now often far wide of this, secondary to the diminution of training at work and the effects of the European Working Time Directive
A note that the Republic of Ireland still employs the old system (i.e. prior to MMC) and therefore will continue to have posts graded as Senior House Officers and Specialist Registrars.
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...
in the United Kingdom
United Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...
and Republic of Ireland
Republic of Ireland
Ireland , described as the Republic of Ireland , is a sovereign state in Europe occupying approximately five-sixths of the island of the same name. Its capital is Dublin. Ireland, which had a population of 4.58 million in 2011, is a constitutional republic governed as a parliamentary democracy,...
who is receiving advanced training in a specialist field of medicine
Medicine
Medicine is the science and art of healing. It encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness....
in order eventually to become a consultant
Consultant (medicine)
In the United Kingdom, Republic of Ireland, and parts of the Commonwealth, consultant is the title of a senior doctor who has completed all of his or her specialist training and been placed on the specialist register in their chosen specialty...
. In surgery, also referred to as Higher Surgical Trainee or HST.
After graduation from medical school
Medical school
A medical school is a tertiary educational institution—or part of such an institution—that teaches medicine. Degree programs offered at medical schools often include Doctor of Osteopathic Medicine, Bachelor/Doctor of Medicine, Doctor of Philosophy, master's degree, or other post-secondary...
, they will have undertaken several years of work and training as a pre-registration house officer
Pre-registration house officer
Pre-registration house officer , often known as a houseman or house officer, was until 2005 the only job open to medical graduates in the United Kingdom who had just passed their final examinations at medical school and had received their medical degrees.Newly-qualified doctors are only allowed...
and senior house officer
Senior house officer
A senior house officer is a junior doctor undergoing training within a certain speciality in the British National Health Service or in the Republic of Ireland. SHOs are supervised by consultants and registrars, who oversee their training and are their designated clinical supervisors...
, and will usually have taken examinations for membership of the Royal College
Royal College
A Royal College in some Commonwealth countries is technically a college which has received permission to use the prefix Royal. Permission is usually granted through a Royal Charter. The charter normally confers a constitution with perpetual succession and the right to sue or be sued independently...
of their speciality. For example, medical registrars will take the MRCP
Membership of the Royal College of Physicians
Membership of the Royal Colleges of Physicians is a postgraduate medical diploma. The examinations are run by the Federation of the Medical Royal Colleges of the United Kingdom – the Royal College of Physicians of London, the Royal College of Physicians of Edinburgh, and the Royal College...
examinations to enable progression to become registrars.
Entry to the grade of SpR is now closed and thus information is largely historical. The entry into Specialist Registrar posts was regarded as highly competitive and so tough. Regional advertisements were placed by local deaneries, which controlled the number of places and the funding for posts. Open competition was afforded and, via shortlisting and interviews, successful applicants were given posts for 4–6 years depending on the speciality. A National Training Number was awarded concurrently and was attached to the post rather than the doctor, again historically. The number of posts available was strictly linked to the number of consultants required in a particular speciality, and therefore in the more popular specialities such as Cardiology, General Surgery and Sub-Specialties, Orthopaedics and Plastic Surgery it often took many attempts to get a post - leading to what is known as the "SHO bottleneck", whereby doctors are stuck at the grade of senior house officer
Senior house officer
A senior house officer is a junior doctor undergoing training within a certain speciality in the British National Health Service or in the Republic of Ireland. SHOs are supervised by consultants and registrars, who oversee their training and are their designated clinical supervisors...
for a number of years. Changes in postgraduate medical training (Modernising Medical Careers
Modernising Medical Careers
Modernising Medical Careers is a programme for postgraduate medical training introduced in the UK from 2005 onwards. The programme replaced the traditional grades of medical career before the level of Consultant. The different stages of the programme contribute towards a "Certificate of...
) are underway to alleviate this problem. Choice of final specialty is now limited by success in application, rather than time spent waiting for a post to be available and offered to you. This new method is more ruthless, but prevents stalling in career progression and should eliminate the number of doctors uselessly waiting in posts of dubious educational value. It does however hinge on a fair and robust selection process for the highly desirable posts, something that initially was a total and unmitigated disaster (MTAS).
Specialist Registrars generally stay in post for around five years (more or less depending on the speciality), gaining experience at first in a broad speciality (e.g. general medicine), later specialising in a subspeciality (e.g. cardiology
Cardiology
Cardiology is a medical specialty dealing with disorders of the heart . The field includes diagnosis and treatment of congenital heart defects, coronary artery disease, heart failure, valvular heart disease and electrophysiology...
) after which they receive the Certificate of Completion of Training
Certificate of Completion of Training
CCT or Certificate of Completion of Training is the certificate that physicians in the United Kingdom receive to indicate that they have completed training in their chosen specialty and are eligible to apply for a post as a consultant or a general practitioner .This certificate is awarded by the...
(CCT). The CCT is awarded based on satisfactory yearly Record of In Training Assessments (RITA) and completion of an 'exit' exam or fellowship diploma in the specialty from one of the UK surgical colleges. After this a Certificate of Eligibility to the Specialist Register (CESR) is awarded. Listing on the Specialist Register permits application to consultant jobs. Specialist registrars are encouraged to undertake research in their field, and many choose to do this by means of a PhD
PHD
PHD may refer to:*Ph.D., a doctorate of philosophy*Ph.D. , a 1980s British group*PHD finger, a protein sequence*PHD Mountain Software, an outdoor clothing and equipment company*PhD Docbook renderer, an XML renderer...
or MD
Doctor of Medicine
Doctor of Medicine is a doctoral degree for physicians. The degree is granted by medical schools...
.
The SpR grade is set to disappear in 2007 with the full introduction of MMC. Instead, trainees will be referred by their ST level (e.g. ST3). ST3 roughly equates to the first year of SpR training, although standards of experience are now often far wide of this, secondary to the diminution of training at work and the effects of the European Working Time Directive
A note that the Republic of Ireland still employs the old system (i.e. prior to MMC) and therefore will continue to have posts graded as Senior House Officers and Specialist Registrars.