Hospital doctor
Hospital doctors apply medical knowledge and skills to the diagnosis, prevention and management of disease. They work in wards and out-patient clinics, predominantly in the public sector (National Health Service), but also in the private sector. As well as treating patients, they refer them to a wide range of other health care professionals, including nurses, radiographers, pharmacists and physiotherapists. Hospital doctors work within a number of specialties, of which the most common are:
Specific tasks depend on the specialty; a surgeon's daily tasks are significantly different from those of a doctor working in accident and emergency (A&E) or a general physician. However, the following responsibilities are likely to be carried out, regardless of the doctor's specialty, on a daily or weekly basis:
To become a hospital doctor, you must hold a degree in medicine recognised by the General Medical Council (GMC) . Entry with only an HND or foundation degree is not possible.
Entry to medical school with a previous unrelated degree is possible and medical schools may give credit for your prior learning. Most schools prefer science graduates with a 2:1 or above, but some will consider graduates of other disciplines. For further information on graduate entry see the ‘becoming a doctor’ section on the British Medical Association (BMA) website or search and apply for courses on the Universities and Colleges Admissions Service (UCAS) website.
Competition for entry to a first degree course in medicine is fierce. Very high A-level grades (in relevant subjects such as sciences and maths) are required and relevant pre-entry work experience is usually needed. A limited number of medical schools offer foundation courses for those with non-science qualifications.
Requirements vary between medical schools, but candidates usually need to show evidence of the following:
Financing a course is a growing problem. The length of the course and the long hours of study, which usually prevent part-time employment, can place a strain on finances.
Check directly with medical schools to establish the current rate of fees, and with funding bodies to confirm your eligibility. Graduate students who have previously taken a higher education course lasting more than two years will not normally be entitled to funding from local authorities (or equivalent bodies in Scotland and Wales). From year five The National Health Service (NHS) pays tuition fees and means-tested bursaries for eligible students.
Some students on accelerated courses are eligible to receive NHS support in the second, third and fourth year. See NHS Careers for a useful summary of financial support for medical students and NHS Student Bursaries for further details.
Other sources of funding include:
BMA Charities can provide details of other organisations that may fund individuals studying medicine as a second degree. The Money4MedStudents website provides more information on charitable trusts, scholarships, bursaries, and how to apply for financial support.
For more information, see work experience and internships and search courses and research.
All medical students graduating from medical school embark on a two-year Foundation Programme , undertaking a series of placements in different specialties and healthcare settings. The first year (F1) builds upon the knowledge, skills and competences acquired in undergraduate training and generally offers three placements in different areas of work, ideally medicine, surgery and another specialty.
The second year of foundation training (F2) builds on F1 but offers the opportunity to diversify more, with the main focus being on the assessment of key competencies and management of the acutely ill patient in different settings. It is again usually made up of three four-month placements, frequently including one placement in a less common specialty (e.g. psychiatry, cardiology), academic medicine or general practice, helping the trainee to make a decision about which specialty training programme to pursue.
Doctors qualify for full registration with the General Medical Council (GMC) when they have successfully completed foundation year one (F1), having gained provisional registration following medical school. When F2 is completed a Foundation Achievement Competency Document (FACD) is received.
During the foundation years increasing responsibility for patient care is given. Initially, work will be closely supervised by more senior doctors, but more responsibility will be taken on as experience is gained.
Doctors coming out of foundation training will need to apply for specialty training programmes to become Specialty Trainees (STs) or Speciality Registrars (StRs). Person specifications for specialty training are available on the Medical Specialty Training website.
After completion of the Foundation Programme (FP), entry directly into specialist training (ST) can be applied for. Doctors follow a competency-based rotational programme, which focuses on their chosen medical specialty. Typical specialties include surgery, medicine and acute care (which divide into further specialties), psychiatry and paediatrics. The training programmes vary considerably according to the specialty and details of the different programmes are on the Medical Specialty Training website.
Successful completion of this training, i.e. passing the necessary examinations, appraisals and assessments, leads to the award of the Certificate of Completion of Training (CCT). The time it takes to train depends on the specialty. On receiving CCT, entry to the specialist register held by the General Medical Council (GMC) is then possible and applications for higher specialist training and a post as a consultant can be made.
Consultant is the career grade that most hospital doctors aspire to. A consultant is responsible for their own work and for supervising the work and training of all doctors in their team.
Under the current training structure it is possible for doctors to become consultants eight years after graduating from medical school. Currently, most consultants train for longer than this as extra experience and research is often advantageous for competitive posts.
Progression through all the different grades will involve study and continuous professional development (CPD) in the form of assessment and exams. The number of jobs at all levels of service is determined by current and future service need.
The role of hospital doctor is increasingly oriented towards management, training, education and mentoring functions, as well as liaising with other specialists. Health service modernisation and the increasing emphasis on patient choice and patient safety, mean that there is an increase in accountability and paperwork in all promoted posts. Ethical issues (e.g. euthanasia) and the threat of litigation are key themes that doctors need to be aware of as their career advances.
The vast majority of hospital doctors work in NHS hospitals (see NHS Careers ), but there are also an increasing number of doctors in private hospitals.
There are opportunities for private work, particularly at consultant grade, which can be combined with working for the NHS. These opportunities may increase as government policy attempts to address the costs of caring for an ageing population and expensive new treatments. It is predicted that an increasing proportion of NHS work will be contracted out to the private sector. As a result of proposed changes to health care provision there may also be some merging of the traditional roles of hospital doctors and general practitioners (GPs). For information on the latest developments see the The National Health Service (NHS) website.
There are limited opportunities within the armed forces, with some possibility of working overseas. There are also some opportunities to work within the prison service.
Voluntary and charitable organisations employ small numbers of doctors to work in developing countries. Médecins Sans Frontières (MSF) is one of the best known. These posts are often very poorly paid, but competitive and often hugely rewarding.
Specialist recruitment agencies may also hold jobs. See the Recruitment and Employment Confederation (REC) website for details.
Individual trusts and hospitals advertise vacancies on their websites, and sometimes in printed bulletins.
Get tips on job hunting, CVs and covering letters and interviews.
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