Postgraduate training

[Felix64]

I am a first year medical student. Just been looking over the MMC website to try and get an idea of how postgraduate training works and have been left quite confused. I understand everything up to and including the foundation program but what happens next?

1) I know you have to compete for speciality training, but what do you do if you don’t get a place?
2) If you don’t get a place on run through training or core training, is it still possible to become a consultant, if so how?
3) I was under the impression that for run through training, if you got a place you no longer had to compete and as long as you progress to a decent standard you get your CCT. If this is the case then how come it is possible to apply for jobs at ST2, ST3 etc? Surely you would just get a place at ST1 and then work your way up?
4) If you get a place at say ST2, are you then on the run through system and no longer have to compete?
5) On the website how come everything is only listed up to ST4, when speciality training is supposed to take 7 years? What about the other three years?

If anybody could give me an overview of how this all works, or just answer some of the questions it would be much appreciated

[James]

1: You can apply again in the second round (like clearing through UCAS); Go for an FTSTA (a stand alone 1 year training post); Emmigrate (no joke, lots do); Or apply for a less competitive speciality and/or location

2: Essentially No. You need to complete core & specialist training to be a consultant. A very small number of people have gone through a non-training route and 'article 14' - but they are trying to get rid of this.

3: It all depends on the speciality, it is all in flux at the moment with some specialities retaining run-through and some making you reapply at the 'old' registrar level (ST3 or 4 depending on speciality). Even if you get a run through post there will still be competition for sub-specialisation - eg. which of the medical ST2's will get a job in cardiology and which will get one in GU medicine.

As for the jobs being advertised at ST2 level, there is always a level of dropping out & swapping specialities which will leave gaps to be filled (usually by people from question 1)

4: Depends on the specialty

5: From ST4 (paeds, O&G, A&E, Psych) or ST3 (rest) you will have guaranteed run-through to ST7-9 when you become a consultant.

I think you also need to bear a couple of things in mind. Firstly the post-graduate exams (eg. MRCP/MRCS) which are very difficult and you need to pass before certain defined stages in your training. Also there is a significant oversupply of consultants in many specialities and you will need to be building your CV throughout your training to get that elusive consultant post.

[Felix64]

So essentially they are choosing the consultants of the future two years after they graduate from medical school, and everyone else is left stuck in a service post or whatever it is they call it? Seems a little ridiculous.. Is competition at the moment still really high due to an aftermath of the changing of systems? Is the situation expected to get any better? Thanks for your response by the way it was really helpful.

[ben_]

As I understand it the situation is actually expected to get worse - if you are a doctor, that is. If you are allocating the NHS budget unemployment among the medical workforce driving wages down works out very nicely for you.

[Felix64]

Great..

Oh well, thanks for answering the questions guys.