Blog / Job titles and where to look
NHS job titles for overseas doctors (IMGs), explained
If you're an international medical graduate (IMG) scrolling through NHS adverts, the job titles can feel like a code. Trust doctor. Clinical fellow. SHO. Trust grade. Two adverts with the same title can describe quite different jobs.
The first thing to know is that most of these titles aren't official grades. The BMA calls this group locally employed doctors: they aren't on nationally agreed contracts, but on local versions of them. So the title is the hospital's choice. What the job really involves sits in the job description and the person specification.
NHS doctor job titles: SHO, trust grade, clinical fellow and more
| Title | What it usually means |
|---|---|
| Foundation doctor (FY1, FY2) | A national training programme for newly qualified doctors. |
| Core and specialty training (CT1, ST1 and above) | National training posts, recruited on a fixed yearly timetable through Oriel. |
| SHO | The old name for the grade between house officer and registrar. The Foundation Programme replaced it from 2005, but you may still see it in adverts, usually for non-training posts. |
| Trust doctor, trust grade, trust junior doctor | A post employed by the hospital trust itself (the BMA calls these locally employed doctors), not part of a national training programme. |
| Fellow posts (clinical, teaching or academic) | Also trust-employed. The name hints at the focus (service, teaching or research), but the mix of duties varies a lot. |
| LAS and LAT | Fixed-term locum posts at registrar grade. A locum appointment for service (LAS) covers only the service side of a training post, lasts up to three months and isn't approved for training. A locum appointment for training (LAT) is given training recognition in advance and can count towards completing training. |
| Specialty doctor | A national grade with its own nationally agreed contract. There is no single national figure for years of experience, so read the person specification: some adverts ask for many years of postgraduate experience. |
| Consultant | The senior grade. |
Training post or non-training post? Locally employed doctors
This is the question that matters most, and the title won't always tell you. The BMA is clear that a post outside a recognised NHS training grade, such as a clinical fellow or locally employed role, can't be treated as a recognised training placement. Don't assume the time will count towards specialty training later. If a future training application matters to you, ask the employer before you accept. If you hold full registration after PLAB, our guide to jobs after PLAB explains which of these posts you can apply for.
How to read an NHS doctor job advert and person specification
Skip the title at first. Open the job description and the person specification and look at:
- the essential criteria, because that's what shortlisting is based on
- whether the post is a training post or a trust-employed one
- the contract: is it a national contract or a local one? The BMA has a checklist for doctors weighing up trust grade, clinical fellow and similar offers
- the on-call rota, supervision and any teaching or research time
Where the jobs are advertised
NHS Jobs, run by the NHS Business Services Authority, covers England and Wales. Scotland and Northern Ireland have their own sites. Training posts go through Oriel. Many trusts also send you into a system called Trac to finish the application form, even though the advert started on NHS Jobs.
Common questions
What is the difference between a trust grade doctor and a clinical fellow?
Both are usually employed by the trust itself, not through a national training programme. The title hints at the focus, such as service, teaching or research, but the duties vary, so read the job description.
Does a clinical fellow post count towards specialty training?
Not automatically. The BMA says a post outside a recognised training grade can't be treated as a training placement, so ask the employer before you accept.
Is SHO still used as a job title?
You may still see it in some adverts, usually for non-training posts. The Foundation Programme replaced the old SHO grade from 2005, so the title no longer describes a national grade.
What do LAS and LAT mean?
Locum appointment for service and locum appointment for training. Both are fixed-term registrar-grade posts. Only a LAT is given training recognition in advance.
Sources
- BMA, locally employed doctors: https://www.bma.org.uk/pay-and-contracts/pay/other-doctors-pay/locally-employed-doctors-leds
- BMA, checklist for locally employed doctors: https://www.bma.org.uk/checklist-for-locally-employed-doctors
- NHS Employers, pay scales and circulars: https://www.nhsemployers.org/articles/pay-scales-202627
- NHS Business Services Authority, NHS Jobs: https://www.jobs.nhs.uk/employer/terms-and-conditions
- Oriel: https://www.oriel.nhs.uk/Web/
- BMA, locum work for resident doctors (LAS and LAT): https://www.bma.org.uk/pay-and-contracts/working-hours/work-schedule/locum-work-for-resident-doctors
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