Specialist registrar

A Specialist Registrar or SpR is a doctor in the Republic of Ireland and formerly 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 enable progression to become registrars.

Specialist Registrars generally stay in post for around five years (more or less depending on the speciality), gaining experience in a broad speciality (e.g. general medicine), and 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 Royal Colleges. 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.

Former UK usage

Medical career grades of the National Health Service
Year Current (Modernising Medical Careers) Previous
1 Foundation doctor (FY1 and FY2), 2 years Pre-registration house officer (PRHO), 1 year
2 Senior house officer (SHO),
minimum 2 years; often more
3 Specialty registrar,
general practice (GPST), 3 years
Specialty registrar,
hospital speciality (SpR), minimum 6 years
4 Specialist registrar,
4–6 years
GP registrar, 1 year
5 General practitioner,
4 years total time in training
6–8 General practitioner,
5 years total time in training
9 Consultant, minimum 8 years total time in training Consultant, minimum 7–9 years total time in training
Optional Training is competency based, times shown are a minimum. Training may be extended by obtaining an Academic Clinical Fellowship for research or by dual certification in another speciality. Training may be extended by pursuing medical research (usually 2–3 years), usually with clinical duties as well

Entry to the grade of SpR is now closed (replaced by Specialty Registrar) and thus information is largely historical. Some doctors who were appointed to this grade are still completing their training and when they do the grade will become obsolete.

The entry into Specialist Registrar posts was regarded as highly competitive and excessively 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 was known as the "SHO bottleneck", whereby doctors were 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.

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