After the Foundation Programme you apply for a specialty training programme. Each is set by a Royal College curriculum approved by the GMC. There are two broad structures.
| Structure | How it works | Examples |
|---|---|---|
| Uncoupled (core, then higher) | You complete a 2–3 year core programme and Royal College exams, then apply again for higher training (ST3 or ST4) | Internal Medicine Training, Core Surgical Training, Core Psychiatry Training, Acute Care Common Stem |
| Run-through | One application at the start; progression depends on annual ARCP outcomes and exams | Paediatrics, Obstetrics and Gynaecology, Clinical Radiology, Ophthalmology, Neurosurgery, General Practice (ST1–3) |
- Each year, an ARCP panel reviews your portfolio, supervisor reports and exam progress.
- You rotate between hospitals and regions during training.
- At the end you receive a CCT and can join the GMC Specialist Register (or the GP Register).
- Training can be done less than full time and you can take approved time out of programme for research, training or experience.
This page is general education, reviewed 24 October 2026. Rules, fees and dates change: always confirm with the official sources below. It is not medical, legal or immigration advice.