Foundation House Officer

Medical career grades of the National Health Service

Year	Current (Modernising Medical Careers)		Previous
1	Foundation doctor (FY1 and FY2), 2 years		Pre-registration house officer (PRHO), 1 year
2			Senior house officer (SHO), minimum 2 years; often more
3	Specialty registrar, general practice (GPST), 3 years	Specialty registrar, hospital speciality (SpR), minimum 6 years
4			Specialist registrar, 4–6 years	GP registrar, 1 year
5				General practitioner, 4 years total time in training
6–8	General practitioner, 5 years total time in training
9		Consultant, minimum 8 years total time in training	Consultant, minimum 7–9 years total time in training
Optional	Training is competency based, times shown are a minimum. Training may be extended by obtaining an Academic Clinical Fellowship for research or by dual certification in another speciality.		Training may be extended by pursuing medical research (usually 2–3 years), usually with clinical duties as well

A Foundation doctor (FY1 or FY2 also known as a house officer) is a grade of medical practitioner in the United Kingdom undertaking the Foundation Programme – a two-year, general postgraduate medical training programme which forms the bridge between medical school and specialist/general practice training. Being a Foundation Doctor is compulsory for all newly qualified medical practitioners in the UK from 2005 onwards. The grade of Foundation Doctor has replaced the traditional grades of pre-registration house officer and senior house officer.

Foundation doctors have the opportunity to gain experience in a series of posts in a variety of specialties and healthcare settings. Learning objectives for each stage are specific and focused on demonstration of clinical competences. Emphasis was on the assessment and management of acutely ill patients, but changes in the curriculum have stressed that chronic conditions are also important. Training also encompasses the generic professional skills applicable to all areas of medicine – teamwork, time management, communication and IT skills.

This year replaces what was known as Pre-registration house officer. In the first year of Foundation Training, FY1s rotate through three or four jobs in different hospital specialties. The General Medical Council specify that every FY1 must complete at least three months of general medicine. Until 2007, it was also required for all FY1s to complete at least three months of general surgery, and therefore most programmes still include this. The rest of the year may be made up of further time spent in general medicine or general surgery, or time spent in other specialties (but not in general practice).

The first year of the posts in other specialties, such as general practice, emergency medicine, paediatrics, psychiatry, obstetrics or pathology. The training builds on what has been achieved during the previous year. FY2s will sometimes also refer to themselves as SHOs and will be in the SHO rota. Although some departments have separate rotas for GPVTS trainees and FY2s and a separate rota for specialist trainees.

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