Specialist registrar

A specialist registrar (SpR) is a doctor in the United Kingdom or the Republic of Ireland who is receiving advanced training in a specialist field of medicine in order to become a consultant in that specialty. After graduation from medical school, a specialist registrar will undertake several years of work and training as an intern or pre-registration house officer, and as a senior house officer. They may be required to take diploma examinations in order to enter registrar training. These are administered by the medical royal college or in some cases a separate postgraduate training body responsible for that specialty and are usually termed "memberships". This means membership to the Royal College of their specialty. For example, those wishing to specialise in general medicine must take the examination for Membership of the Royal College of Physicians. Doctors will work in specialist registrar posts for around four to six years, depending on their speciality. They gain experience in a broad speciality (for example, general medicine), and often also a subspecialty (such as cardiology). After this they receive a certificate termed a Certificate of Completion of Training (CCT) in the UK, or Certificate of Completion of Specialist Training in Ireland. The certificate is awarded based on satisfactory regular completion of assessments and milestones (known in the UK as the Record of In-Training Assessments, or RITA). In many specialties, doctors must also complete an 'exit' exam or diploma in their specialty, often termed a "fellowship" exam. Doctors with a CCT or CCST are transferred to the specialist register administered by the Medical Council, permitting application to consultant jobs. Specialist registrars are encouraged to undertake research in their field, and many choose to do this by means of a Ph.D. or MD. The entry into Specialty Registrar posts is competitive. Published competition ratios by the NHS report that most specialties receive many multiples more applicants than available posts.