Your training pathway guide for doctors in the UK 

Are you looking to become a doctor in the UK? The training pathway can differ in length and structure depending on your specialty. That’s why we’ve created a comprehensive guide to help you navigate the medical training pathway for doctors in the UK.  

Our guide offers a detailed breakdown of the medical training pathway to becoming a doctor, helping you to understand the stages involved in the process. With our help, you can feel prepared on your journey towards a rewarding career as a doctor.  

Medical training pathway  

There are many different stages in the training pathway, and you will only do the ones bespoke to your specialism and circumstances. We outline the stages and specialities below so that you can consider which combination would make up your training pathway.  

• Medical school
• Foundation training
• GP training
• Specialty training
  • Run-through training
  • Improving Surgical Training (IST)
• Uncoupled training
  • Core Training (CT), Core Surgical Training (CST) and Core Medical Training (CMT)
  • Internal Medicine Training (IMT)
  • ACCS (Acute Care Common Stem) 
  • Higher specialty training (HST) 
• Certificate of Completion of Training (CCT) 

Medical school (4-7 years)

If you are living in the UK, you will enter medical school after completing college or sixth form and most courses last for five years. Accelerated courses are available in certain medical schools for those who meet the prequalifying criteria. Accelerated graduate courses are four years long.  

Many medical schools offer intercalated degrees, which involves an additional year of study on top of your medicine degree programme and an opportunity to explore a new area in greater depth.  

There is also the possibility of studying a foundation medicine course for one year before starting a medical degree for students who don’t meet the entry requirements. This means you will be a medical student between four and seven years depending on your circumstances and training pathway. 

From September 2024, the UK government will also be piloting a Medical Doctor Degree Apprenticeship. The apprenticeship will last five years and apprentices will have to complete all academic elements of medical training, including a medical degree and the Medical Licensing Assessment. 

Foundation training (2 years)

After completing medical school (undergraduate medical degree), the next part of your training as a doctor is the two-year Foundation Training programme. You will need to apply through the national application process in autumn at medical school to start foundation training the following summer. During your foundation years, you will complete six different specialty rotations of four months at a time. The first year of foundation training is called F1 and the second is called F2. 

Key dates can be found on the UK Foundation Programme website. 

After completing the foundation programme, you can go on to train in a chosen specialty, or general practice (GP) training. There are around 60 different specialities to from and the area of medicine you select will determine the length and structure of your training. 

GP training (3 years)

To become an independent general practitioner in the UK, you must complete GP Specialty Training (GPST). This is usually three years and includes at least 18 months in an approved training practice, with the remaining time spent in an approved hospital or integrated training posts. You apply once after foundation training, and you are recruited for the duration of the specialty programme. 

Specialty training (3-8 years)

There are different types of training programmes for each specialty. Specialities will either offer run-through training or uncoupled training. As well as progressing through the training programme, you will need to pass the relevant Royal College assessments to gain your Certificate of Completion of Training (CCT). 

Run-through training

Some specialities offer a run-through training programme where you apply once after foundation training, and you are recruited for the duration of the specialty programme. The first year of run-through specialty training is called ST1, the second is called ST2 and so on. 

The list of run-through training specialities includes:  

• Cardiothoracic surgery 
• Clinical radiology 
• Community sexual and reproductive health 
• General practice 
• Histopathology 
• Neurosurgery 
• Obstetrics and Gynaecology 
• Ophthalmology 
• Oral and maxillofacial surgery 
• Paediatrics 
• Public health medicine 

The Royal College of Surgeons launched the Improving Surgical Training (IST) pilot in 2017, which introduced run-through training in several surgical specialities to trial improvements in surgical training. In 2022, Health Education England (HEE) paused the recruitment of all IST posts in England for 2022. The number of surgical training places was maintained as posts and added back into core surgical training. Wales and Scotland continue to recruit through the Improving Surgical Training (IST) program.

Uncoupled training

All other specialties have uncoupled training. This means you will apply for core training and once completed, you will apply for entry into higher specialty training. Entry to higher specialty training is not guaranteed and entry to some specialties is very competitive. You can review the 2022 competition ratios to show the number of applications received against the posts available.   

Depending on which specialty you want to pursue, your program may be called Core Training (CT), Internal Medicine Training (IMT) or ACCS (Acute Care Common Stem). 

Core Training (CT)

Core training is between 2 and 3 years and forms the first stage of specialty training for doctors in some specialities. This is a paid training job in a hospital setting, with rotations covering a range of specialties. These may be themed towards one specialty or sub-specialty. Core training may be referred to as Core Surgical Training (CST) or Core Medical Training (CMT).  

The first year of uncoupled training is called CT1, the second is called CT2 and so on. Some specialities that start their training pathway with Core Training include: 

• Anaesthetics  
• General Surgery 
• Otolaryngology (ENT) 
• Paediatric Surgery 
• Plastic Surgery  
• Psychiatry  
• Trauma and Orthopaedic Surgery  
• Urology 
• Vascular Surgery 
• Academic Surgery  

Internal Medicine Training (IMT)

The Internal Medicine Training (IMT) programme replaced Core Medical Training (CMT) in August 2019. Doctors wanting to pursue a medical specialty will start their uncoupled training pathway via the IMT route. If you want to pursue a medical specialty in Group 1, your programme will be 3 years and for Group 2, it will be 2 years.  

Group 1 specialties: Acute Internal Medicine, Cardiology, Clinical Pharmacology and therapeutics, Endocrinology & Diabetes Mellitus, Gastroenterology, Genitourinary Medicine, Geriatric Medicine, Infectious Diseases (except when dual with Medical Microbiology or Virology), Neurology, Palliative Medicine, Renal Medicine, Respiratory Medicine, Rheumatology and Tropical Medicine (except when dual with Medical Microbiology or Virology). 

Group 2 specialties: Allergy, Audiovestibular Medicine, Aviation & Space Medicine, Clinical Genetics, Clinical Neurophysiology, Dermatology, Haematology, Immunology, Infectious Diseases (when dual with Medical Microbiology or Virology), Medical Oncology, Medical Ophthalmology, Nuclear Medicine, Paediatric Cardiology, Pharmaceutical Medicine, Rehabilitation Medicine, Sport and Exercise Medicine, Tropical Medicine (when dual with Medical Microbiology or Virology). 

ACCS (Acute Care Common Stem)

Acute Care Common Stem is a four year uncoupled core training programme.  The first two years are spent rotating through six month placements in: 

• Emergency Medicine (EM) 
• Internal Medicine (IM) 
• Anaesthetics 
• Intensive Care Medicine (ICM) 

The third and fourth years are spent training in your chosen specialty for entry into Higher Specialty Training. It is the only core training programme for those wanting to enter Higher Specialty Training in Emergency Medicine and is an alternative core training programme if you want to enter Higher Specialty Training in Anaesthetics. 

Higher specialty training (HST)

The final part of uncoupled training in the progression from trainee to consultant is Higher Specialty Training (HST). Upon completion of Core Training, IMT or ACCS and the relevant Royal College assessments, you will need to complete higher specialty training (ST3/ST4+). Recruitment into higher specialty training is organised nationally by a lead NHS England local office or Deanery on behalf of all local offices and deaneries. This means that you complete one online application and state your preferred location rather than submitting multiple applications. 

Upon selection to an HST programme, you will then progress through several further years of training (typically between four and five) in your chosen specialty. A full overview of specialty recruitment can be found on the Health Education England (HEE) website.  

Some specialities have programmes that offer subspecialty training or Advanced Training Skills Modules (ATSMs) after five years of general training. These are optional depending on your career goals, abilities, and interests. 

Certificate of Completion of Training (CCT)

On completion of a run-through or higher specialty training programme, you are awarded a Certificate of Completion of Training (CCT) that allows you entry into the GMC specialist or general practice register. 

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