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Overview of post-graduate training in medicine

Looking at the training involved and career pathway after medical school.

Life after medical school

Once you have completed your degree, you will move into postgraduate training. All graduates start with the foundation programme, but what comes next depends on the field you want to work in. Below is a downloadable diagram showing a generic career pathway for physicians:

Run-through and uncoupled training

Specialty training programmes fall into two different categories: run-through training and uncoupled training. With run-through training, progression is uninterrupted; you start in specialty training year 1 (ST1), and progress through ST2, ST3 etc automatically, provided competency requirements are satisfied.

Uncoupled training, however, is split into either 2 or 3 years of core training (CT1, CT2 etc), before entering higher specialty training at ST3 level. With this path, entry to ST3 is a competitive process, which involves applying for a post, much as you would at the start of training.

Whether you undertake run-through or uncoupled training depends on your chosen specialty. The vast majority of hospital physician specialties are uncoupled, involving core medical training (CMT) or acute care common stem (acute medicine), followed by higher specialty training, which starts at ST3.

Training bodies

Training programmes are usually delivered by training schools, and the schools are overseen by local education and training boards, or LETBs (formerly known as deaneries). The LETBs share the ultimate responsibility for training and recruitment at specialty level with the UK’s medical royal colleges. Curricula are set by specialist advisory committees (SACs), which are made up of representatives from colleges, deaneries and specialist societies.