Not every doctor follows a training programme. Many doctors work in non-training posts, which carry substantial responsibility and can be rewarding.
- Locally employed doctors (LED) / Trust grade: employed by a trust for one-year or longer posts; often a first job for IMGs.
- Staff grade, associate specialist and specialist (SAS) doctors: experienced non-training doctors with a recognised pay scale.
- Clinical fellows: posts that include teaching, research or service experience, sometimes with a funded course.
- Specialist registration without training: the CESR route (see the Super-specialising stage) lets experienced doctors reach the Specialist Register.
Making these posts count
- Ask for a named educational supervisor and protected teaching.
- Keep an e-portfolio of workplace assessments, audits and teaching.
- Use the Prioritisation Act context: plan multiple years if you aim for training later.
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.