Specialty training (UK)

Specialty training is the stage after the Foundation Programme in which a doctor trains in one specialty, such as general practice, paediatrics or surgery, on a curriculum approved by the GMC. Doctors in training are called specialty registrars and are graded by stage: CT1 to CT3 for core training and ST1 to ST8 for specialty training. Completing the programme leads to a CCT.

NHS England describes two types of programme:

• Run-through training: you apply once at the start and continue to the end without reapplying, subject to satisfactory progress. Examples are general practice, paediatrics and ophthalmology.
• Uncoupled training: you apply for core training first, then compete again for higher specialty training, usually at ST3 or ST4. Examples are anaesthetics and internal medicine training.

1. Get full GMC registration with a licence to practise, usually through PLAB for international graduates.
2. Show Foundation competence. For CT1 and ST1 posts, doctors who have not completed the UK Foundation Programme usually submit a Certificate of Readiness to Enter Specialty Training (CREST), signed by a consultant who supervised them for at least 3 months in the 3½ years before the post starts. NHS England also requires 12 months' experience after full registration, or equivalent, by the start date.
3. Apply on Oriel in the right recruitment round. For 2027 starts, Round 1 opened in October 2026 and Round 2 in November 2026.
4. Sit any required assessment, such as the Multi-Specialty Recruitment Assessment (MSRA) for the specialties that use it, then attend interview.
5. Accept an offer and arrange your visa with your employing trust.

The Medical Training (Prioritisation) Act 2026 gives preference in specialty recruitment to UK graduates and certain other groups. NHS Employers lists them as applicants with a primary medical qualification from the UK, Ireland, Iceland, Liechtenstein, Norway or Switzerland, applicants who have completed or are on a relevant UK training programme, and people with certain immigration statuses, including British and Irish citizens and those with indefinite leave. NHS England says that for most 2027 specialty recruitment, prioritisation applies both to offers of interview and to offers of a training place. International doctors can still apply but are considered after prioritised applicants.

From 1 April 2026, NHS Employers Pay and Conditions Circular (M&D) 1/2026 R2 sets these basic salaries in England:

• CT1 to CT2, ST1 to ST2: £55,355
• CT3, ST3: £67,325
• CT4, ST4 to ST5: £67,998
• ST6: £76,582
• ST7 to ST8: £77,348

Allowances for nights, weekends and on-call are paid on top. See our doctors in the UK guide for the full picture.

• A CREST signed by the wrong person or with competences still outstanding is rejected.
• Too little post-registration experience by the start date.
• Underestimating competition: NHS Employers notes specialty applications rose from 12,000 in 2019 to nearly 40,000.