As a doctor, you have a large variety of options when it comes to your career. All medical careers have their own pros and cons, and it is often difficult to choose which specialty is for you. However, throughout the course of your studies and training there will be many opportunities to experience different specialties and to learn what you enjoy doing and what career suits you the most.
Becoming a Doctor and Foundation Training
A medical degree can take between 4 years (postgraduate accelerated degree) to 7 years (regular length degree including intercalated year) to complete. A standard-length undergraduate medical degree in the UK takes 5 years to complete, 6 if you choose to intercalate. You can explore all available medical degrees on websites like UCAS, which offers a list of all medical degrees and allied subjects available in the UK.
Following your medical degree, you will be required to complete 2 years of foundation training followed by 3 to 8 years of specialist training. After your foundation years is the time when you will decide what specialty you are interested in, and you will develop skills in this specialty over the course of specialist training.
At this point, you will have had experience with many different types of doctors in different medical disciplines throughout the clinical part of medical school and your foundation training, therefore it will be easier to choose a medical branch to focus on.
Foundation training is designed to facilitate the transition from medical school to specialty training, and it is organised through Foundation Schools. Foundation Schools are essentially groups of institutions that consist of medical schools, local deaneries, trusts, and other organisations (eg, hospices) which offer comprehensive foundation training in a variety of different clinical settings.
Tips for choosing your Foundation School:
Consider which part of the UK you prefer
Look up competition ratios (applicants to available places) of your preferred Schools. Competitive ratios may be listed on the website of the deanery to which a Foundation School belongs, and other websites feature graphs summarising the competition ratios of Schools across the UK.
After you decide which Schools you prefer, you will be required to rank all Foundation Schools from most to least preferred on the application. Allocation to a School will depend on an academic score called the Educational Performance Measure provided by your medical school, and the score of your completed Situational Judgement Test.
Once you are allocated to a School, you will be asked to indicate your preferred programmes. Even if you do not get your desired specialty, you may be able to do a ‘taster’ a few days in the specialty during your training.
Specialties and salary ranges
When choosing which specialty to work in, it is good to be aware of all currently approved medical specialties to ensure you know your options. You may also wish to consider how your favourite specialties compare in terms of earning potential.
Currently, there are 338,327 doctors registered in the UK, 23 medical Royal Colleges and Faculties across the UK and Ireland, each responsible for development of and training in one or more specialties. In the UK, there are 65 approved medical specialties and 31 subspecialties (you can find a list of all medical specialties here).
Out of all registered doctors in the UK, approximately 26.4% of doctors specialise in general internal medicine (which includes acute medicine, geriatrics, gastroenterology, cardiology, and more) and general practice, 17.8% specialise in surgery, 10.2% in psychiatry, followed by other, smaller specialties such as emergency medicine, pathology, and more.
Generally, a doctor’s salary depends on the hours they work, how much time they dedicate to out-of-hours, on-call, holiday, and weekend work, and how many additional responsibilities they undertake. Doctors are paid extra if they work extra hours above the 40-hour work week, and on-call commitment, weekend and holiday work will have additional bonuses on top of that.
Some specialties will require more time on-call than others, for example in surgery or acute internal medicine you are much more likely to be on-call during both the week and the weekend than geriatric medicine or general practice.
Additionally, your pay will reflect your experience in the working field. The salary for specialty doctors* and consultants increase the longer you work in the position. The average salary for a full-time consultant being ~£120k (including bonuses), while the salary for specialty trainees is slightly more fixed, between £38,694-£49,036. Some doctors enhance their pay via private work.
Generally, specialties requiring more on-call, weekend, and holiday commitment and more out of hours work will come with higher pay. For example, surgery is one of the highest paid medical specialties, followed by cardiology. Surgery requires more time commitment than most specialties, and surgical training alone lasts longer than most other specialties, requiring a minimum of 8 years (including core and specialty training).
Consultancy is the most senior position to achieve as a hospital doctor. Consultants are responsible for their own clinical work, and additionally for managing different teams of junior and specialty doctors. Specialty or SAS doctors are also experienced doctors in permanent posts but tend to work more regular hours than consultants and have fewer management responsibilities. They may work in hospitals and the community simultaneously. Working as a SAS doctor may provide a better work-life balance.
Other things to consider when choosing your specialty
It is important that you pick your specialty carefully, and do not rush into a decision. A good thing to consider when choosing your area of work is whether it will suit your lifestyle. Here are some questions to ask yourself before committing to a specialty:
What is the on-call commitment like?
How flexible are the training and working options for this specialty?
How feasible it is to maintain a good work-life balance?
Besides hospital work, what else can I do in this specialty?
Some specialties, for example general practice, will have alternative career options such as teaching, working as medical writers, working in local or national sports clubs or concerts, participating as a supporting medical practitioner on expeditions, and more. In some specialties you may be able to develop a special interest, and most specialties will allow work in education.
Where to find further information?
Before choosing a specialty, it is best that you have as much information about it as possible. To obtain this information, you may speak to a medical practitioner in the field and try gaining some work experience in the field (for example through taster days), contact postgraduate deaneries or the appropriate royal college, or contact the British Medical Association (BMA).
There are a variety of resources available online that may be helpful, such as the BMA website, websites of royal colleges, or different podcasts specific to a specialty, for example the Heart podcast from the British Medical Journal group, focused on cardiology.