In the UK, becoming a consultant marks the peak of clinical responsibility and leadership. Consultants are expert senior doctors who guide junior doctors, make complex decisions, and influence the direction of patient care, education, and research. For junior doctors in the NHS, reaching this level is both a prestigious and fulfilling career milestone.
This guide outlines the NHS medical training pathway specifically for UK-trained junior doctors from the Foundation Programme through to becoming a consultant, offering clarity and practical steps for each stage.
The UK’s NHS medical training pathway, overseen by the General Medical Council (GMC), is designed to equip junior doctors with clinical expertise, leadership skills, and academic proficiency. The structured training system supports junior doctors as they progress toward roles in General Practice or consultant-level positions across more than 60 medical specialities.
To start this journey, you must graduate from a UK medical school with an approved medical degree and obtain provisional registration with the GMC.
This 2-year foundation training provides a structured introduction to clinical work:
This stage is critical for building core skills and deciding your future speciality.
Read also: Obtaining Full GMC Registration
After the Foundation Programme, doctors select one of two training routes:
Uncoupled Route: Core Training + Higher Speciality Training
This two-part approach allows flexibility in speciality choice.
1. Core Training (CT1–CT2 / ST1–ST2): 2 years of broad clinical training tailored to your intended speciality. Common options include:
2. Higher Speciality Training (ST3–ST6/ST8): 4 to 6 years of advanced, focused training within a chosen speciality. You gain deeper clinical knowledge, leadership experience, and teaching skills during this period. You must also pass the relevant Royal College Exams.
Coupled Route: Run-Through Training
Doctors progress from ST1 to ST6 or ST8 in run-through training without reapplying for higher speciality training. Lasting 6–8 years, this route offers continuity and is common in specialities like General Practice, Paediatrics, Obstetrics and Gynaecology, and Clinical Radiology. Completion leads to a Certificate of Completion of Training (CCT), provided all competencies and exams in the speciality training are fulfilled.
To progress through higher levels of training, doctors must pass speciality-specific exams set by their Royal College. These exams assess clinical competence, decision-making, and readiness for independent practice.
Examples include:
These exams are essential for obtaining a Certificate of Completion of Training (CCT).
Once speciality training and exams are complete, you can apply for the CCT via your Royal College. With this, you are eligible to join the GMC Specialist Register, a requirement for working as a consultant in the UK.
Although this guide focuses on UK junior doctors, the NHS also offers flexibility within the traditional speciality training pathway:
These options allow junior doctors to shape their career around life circumstances without derailing long-term goals.
1. How long does it take to become a consultant in the UK?
2. What are my options if I don’t want to become a consultant?
The NHS medical training pathway is a well-structured, supportive journey that empowers junior doctors to advance into consultant-level roles. By staying focused, organised, and open to opportunities, you can progress with confidence and clarity.
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