Specialist registrar

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NHS Medical Career Grades
Old System New System (Modernising Medical Careers)
Year 1: Pre-registration House Officer (PRHO) - one year Foundation House Officer - 2 years
Year 2: Senior House Officer (SHO)
a minimum of two years, although often more
Year 3: Specialty Registrar (StR)
in a hospital speciality:
six years
Specialty Registrar (StR)
in general practice:
three years
Year 4: Specialist Registrar
four to six years
GP Registrar- one year
Year 5: General Practitioner
total time in training: 4 years
Years 6-8: General Practitioner
total time in training:
5 years
Year 9: Consultant
total time in training:
minimum 7-9 years
Consultant
total time in training:
8 years
Optional Training may be extended by pursuing
medical research (usually two-three years),
usually with clinical duties as well
Training may be extended by obtaining
an Academic Clinical Fellowship for research.


A specialist registrar is a doctor in the United Kingdom who is receiving advanced training in a specialist field of medicine in order eventually to become a consultant.

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 qualify them to become registrars.

Competition for specialist registrar posts is regarded as tough. The applicant must first get a National Training Number which allows them to enter specialist training, and then secure a post. The number of posts available is strictly proportional to the number of consultants required in a particular speciality, and therefore in the more popular specialities it can often take 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.

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), and are eligible for promotion to consultant. 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/registrar 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).

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