Can anyone explain the hierarchy of NHS doctors to me?

[TheBlonde]

I can never work out how "qualified" the person I see is
Obv there are consultants but where do SHOs and Registrars fit in?

student dr's become house officers the senior house officers (sho's) the, registrars then senior registrars then finally consultants.

and they grow a bow tie

or, even worse, a comedy tie if they're paediatricians.

shos are usually on 6 monthly rotations around different depts to see what they want to do when they grow up.
they may, therefore have had approximately 2 days experience of the specialism they are talking to you about. always be nice to them, and then ask to speak to a senior reg or consultant

registrars have chosen their specialism and will have between 6 months and a few years experience at it.

senior regs are registrars who are looking for consultant posts, generally v up to date, have a good number of years experience (depends on the specialty) and are pretty much as good as a consultant for most purposes, and better than an old codger consultant who doesn't believe in newfangled notions (or is too lazy to keep up).

Drs can also train to be surgeons - I think usually at Registrar level/specialist level before going on to be a consultant.

and when they get the (virtual) bow tie they become Mr or Mrs or Miss

Are there things called "fellows" - or is that just a man?

a Q from me too - do they only get to be called Mr/Mrs once they're consultants?

I think fellowsips(?) having something tio do with teaching and universites

Normally, yes, BrandyTutter.

ooh bundle, great minds

ships not sips. Only consultant surgeons become miss, mr,ms or mrs.

Isn't it interesting how obviously the medical world expect us all to KNOW this?

To get a fellowship you have to have a specific type of grant paying your salary, but it doesn't mean you're a medic, it can apply to any kind of academic appointment at that level.

I have never ever seen a house officer, only SHOs what do HOs actually do?

As a female doc the heirachy and naming has always been quite irrelevant as despite numerous qualifications Im often referred to as nurse or asked to make tea,On the other hand in my experience people are often quite happy to undress and bare themselves to anyone with a Y chromosone as long as they have a white coat on even if they are only emptying the clinical waste bins ( this happened)

Before anyone leaps in nothing wrong with nurses.... some of my best friends are nurses... actually come to think of it they all are.

Doctors become Mr Mrs or Miss again once they have passed their fellowship exams and this is usually the sign of a senior surgical position. Don't worry if u dont see the consultant senior registrars and registrars are probably more up to date with their knowledeg and do more proceedures.

I agree comedy sox and ties are naf and as a rule of thumb avoid men with bow ties!

Foundation doctors are from newly qualified to 2 years experience since qualification but have moved between specialties every 4 months so may well have very little experience in paediatrics.

SHOs are the next step up and will probably be on a 2year rotation moving between jobs every 6 months but all within a particular specialty, eg paediatrics, unless they are training to be GPs when they do different types of jobs in order to give then a breadth of knowledge rather than a depth in any particular field. Some people do single SHO jobs to help decide if they like a particular area before trying to get a 2 year rotation.

To progress to a Specialist Registrar rotation you need to pass exams to become a member of a Royal College, eg Royal College of Paediatrics. You then train for a further 5 years, more if you want to do research or go part-time, to become a consultant. In this time you move around jobs every 6months or a year. You do 2 years of "core" training and then a further 3 years when you should try to pursue any particular interest that you have. If you want to do some particular subspecialties, eg Paediatric Cardiology, then you apply to the national grid for a training slot.

This tried and tested system is about to be replaced by something called Modernising Medical Careers which aims to get people to specialise almost from the day they leave med school and become consultants with less experience.

My friend is a Junior Dr (and I don't know what sort - I just know that she recently had to strike because she was a Junior Dr and it was a Junior Dr strike). She always introduces herself as Dr first name last name, or else she gets given the lunch order.

I've never seen a Dr in NZ in a white coat.

Our GP just rings up and says "it's first name". It's all very casual here you know. I make ds call him "Dr. firstname" though

you can get above a consultant as well

a senior consultant

my boss is a consultant and recently had her yearly 'test' thing' to see how she was teaching her stuff to the Drs below her etc.... i said well how does that work.... well senior consultants test her!

I work for 2 drs btw... 1GP and 1 consultant!

As said before only consultant surgeons go back to being Mr or Mrs!

I just realised- by fellow you probably mean Fellow of The Royal College of Physicians, don't you. so that's not the same as the fellows I was talking about. You do also get Clinical Fellowships where your salary comes from a grant awarding body.

Thanks all

If this helps, I was told on placement (am student nurse) that if they have a knife, they are a Mr/Mrs/Miss =) (so consultants)

That must cause confusion in the hospital canteen.

arf stg

not always, nutterlyUts! Obstetricians/ gynaecologists, wield knives, but are not considered surgeons! Some A+E consultants, though not surgeons, can be called Mr/Miss, as their Fellowship was obtained under the auspices of a surgical college.