Not sure if it's just me

Philippa* · 13-05-2009, 07:34 PM

But I find this whole F1/F2, ST, academic/clinical/ACCS - basically the whole shabang, rather confusing.

**Bishop** · 13-05-2009, 07:47 PM

hey your not the only one, apart of me thinks they're doing it on purpose to confuse the medical community ha!

**art-of-the-table** · 18-07-2009, 10:00 AM

The whole thing is actually rather simple but unfortunately there is no official source that explains things, hence the confusion.

Roughly speaking the system is as follows:

1 - Special academic posts have been created for those who are interested in an academic career. At the same time there are less pressures on those who don't want to do research to do any. Academic posts exist straight after medical school.

2 - After medical school, everyone must do two years of Foundation Programme (called F1 and F2). These are designed to ease you into hospital life and teach you to work independently as a doctor, with help from seniors obviously.

3 - After those two years, you have several options:

* Join a GP training scheme. Currently, this is 3 years.
* Join a core training scheme. At present there are three of them:
- Core Medical Training, if you want to work in a medical specialty
- Basic Surgical Training (Also called Surgery in General) if you want to work in a surgical specialty
- Acute Care Common Stem (ACCS) if you want to do A&E, acute medicine or anaesthesia.
* Some specialties such as paediatrics, O&G, Psychiatry have their own junior training schemes

These posts are known as CT1 & CT2 for core training schemes. Those in Paeds, O&G, Psych are called ST1, ST2

4 - Once you have done the core training, you can join specialist training at ST3 level (or ST4 for paeds/psych). You basically have to apply for it.

5 - Once you are in a specialist training scheme, you are assessed every year for competencies and if you pass these then you get your Certificate of Completion of Training (CCT). This is you entry gate to the consultant grade.

Note that all of this is a competitive process. Although everyone is guaranteed an F1 post, after that there aren't enough training posts for everyone. So some people have to take staff grade posts. They have another route to become consultants which is to continue to work as staff grades until they get enough experience (typically 15 years) and then apply to the PMETB to be included on the specialist register.

Hope this helps. It is obviously a simplified summary. Happy to answer any questions.

**smile88egc** · 18-07-2009, 07:59 PM

Oooh thanks, thats uber helpful!

Quick question- i really like general medicine and also paeds, not sure which one i want to specialise in, and not sure foundation years will help much in my decision. Is it possible to do 2 years core medicine after foundations years then swap to paeds if i wanted to after?

I want to leave specialising till as late as I possible can!

Thanks again

**Spencer Wells** · 18-07-2009, 08:54 PM

Originally Posted by smile88egc

Is it possible to do 2 years core medicine after foundations years then swap to paeds if i wanted to after?

No. (That's the short answer)

The long answer is:

No(t easily).

**yazoo** · 18-07-2009, 09:45 PM

Originally Posted by Spencer Wells

No. (That's the short answer)

The long answer is:

No(t easily).

If you can get a good short-listing score (which all good applicants will), and you can spin your story well at interview (this would require hard evidence as a foundation for the spin, though!) I don't think it would be any harder than FY2 to ST1. In fact, if your reasoning was compelling, you could argue it might be easier.

**Spencer Wells** · 18-07-2009, 09:53 PM

You have greater experience of it then me so I'll happily accept your points. However, I think it would be quite difficult to show commitment to a specialty without experience in it at ST1/2 level. Say I did core medical training and then decided I wanted to apply to a surgical ST3. Without MRCS I'd be screwed.

**yazoo** · 18-07-2009, 10:19 PM

Absolutely. You couldn't do it without completing the core training. You can't do a direct sideways transfer, but you can change specialty.

**smile88egc** · 19-07-2009, 02:52 AM

So if you can't directly transfer then how do you change specialty?

Would I have to do 2 years core medicine, then another 2 years core paeds?

TBH i wouldn't mind this too much as i'd love to gain loads of experience and progressing quickly up the ladder isn't much of an issue when you graduate at 22, for me anyway.

Would i even be allowed to do 2 lots of core training?

**yazoo** · 20-07-2009, 10:05 PM

You change specialty by applying for a different training job. In open competition, you would apply with FY2s for ST1 training posts (occaisionally ST2 if you could demonstrate appropriate competences). So in theory, anyone from FY2 to consultant can apply for an ST1 job (if they can demonstrate Foundation Competencies and that is quite easy for an experienced Dr).

People have always changed specialty. MMC hasn't made that much difference to changing specialty. But obviously you need to be properly trained, and that means doing ST1-X jobs again (for most people).