If you’re new to the UK medical system, the different titles — F1, F2, SHO, registrar, consultant — can be confusing. Here’s a straightforward guide to what each level means and what role these doctors play in the NHS.
NHS Doctor Career Levels
| Level | Other Names / Titles | Main Responsibilities |
|---|---|---|
| F1 | Foundation Year 1, Junior Doctor | First year after med school; ward jobs, clerking, prescribing under supervision |
| F2 | Foundation Year 2 | More independent than F1; rotations; A&E shifts; preparing for specialty training |
| CT1–CT3 | Core Training, sometimes still called SHO (Senior House Officer) | Early specialty training; covers a range of rotations; first line in emergencies |
| ST3–ST7+ | Registrar | Senior trainee; leads ward rounds, supervises juniors, performs specialist procedures |
| Consultant | Specialist, Attending (similar in US) | Fully qualified specialist; final responsibility for patient care; team leader and trainer |
Foundation Year 1 (F1)
- Who they are: Freshly graduated doctors in their very first year of practice after medical school.
- What they do: F1s are supervised closely. They handle day-to-day ward jobs like taking bloods, writing notes, prescribing (with sign-off if needed), and clerking new patients. They’re learning how to work safely and professionally while building confidence.
- Role in the system: They’re the first port of call for many ward issues and form the backbone of routine ward work.
Foundation Year 2 (F2)
- Who they are: Doctors in their second year after graduation.
- What they do: F2s take on more responsibility. They see patients in acute settings (like A&E), request investigations, and make more independent clinical decisions, but still under supervision.
- Role in the system: F2s bridge the gap between junior and more senior doctors. They start to rotate into specialties and build skills that will help them apply for core or specialty training.
Senior House Officer (SHO)
- Who they are: This is an older term, but many people still use “SHO” to mean doctors around the F2 to early specialty training level (CT1–CT2).
- What they do: SHOs do more independent ward rounds, assess patients in A&E, and manage unwell patients with guidance from registrars or consultants.
- Role in the system: SHOs are often the first doctor to review a patient when something urgent happens, especially at night.
Specialty Training (Core Training CT1–CT2, then ST3+)
- Who they are: After completing Foundation training, doctors apply for specialty training. Core training (CT) covers the first couple of years, then higher specialty training (ST3 onward) takes them closer to consultant level.
- What they do:
- CT1–CT3: Rotate through different specialties (surgery, medicine, etc.) to build broad experience.
- ST3+ (registrars): They are the middle/senior doctors on the team. They lead ward rounds, supervise juniors, perform procedures, and handle complex cases.
- Role in the system: Registrars are key decision-makers on the wards. They balance hands-on patient care with teaching juniors and keeping the team running smoothly.
Consultant
- Who they are: Fully trained specialists who have completed all their training and are on the GMC’s specialist register.
- What they do: Consultants are responsible for leading a team and making the final decisions about patient care. They manage clinics, perform major surgeries or procedures, and oversee the training of junior doctors. They also have leadership roles within hospitals.
- Role in the system: Consultants carry the ultimate responsibility for patient outcomes in their specialty. They’re both clinical leaders and mentors.
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