The NHS and it's international workforce
The National Health Service (NHS) is the world’s largest publicly funded healthcare system, established in 1948. It provides care to millions of people, with over 1 million patient interactions every 15 hours!
It is also one of the largest employers in the world, but despite this, the UK has fewer doctors per 1,000 people than many European countries. This means NHS staff often face a high workload.
The NHS Depends on International Doctors
The NHS would not function without its international workforce—nearly 1 in 5 NHS staff come from overseas, and 1 in 3 NHS doctors are International Medical Graduates (IMGs).
🙌 IMGs – we salute you! Your dedication and hard work keep the NHS running, and your contributions are deeply valued. 💙
NHS Principles
- Universal Service – The NHS is available to everyone.
- Access Based on Need – Treatment is based on clinical need, not the ability to pay.
- Commitment to Excellence – The NHS strives for the highest standards of care.
- Patient-Centred Care – Patients are at the heart of NHS services.
- Collaboration – Works across public, private, and voluntary sectors.
- Value for Money – Committed to efficient use of taxpayer funds.
- Accountability – The NHS is responsible to the public and patients.
NHS Values
- Working Together for Patients – Patients come first.
- Respect & Dignity – Every patient, carer, and staff member is valued.
- Commitment to Quality Care – High standards in safety, effectiveness, and patient experience.
- Compassion – Care delivered with kindness and empathy.
- Improving Lives – Dedicated to enhancing health and well-being.
- Everyone Counts – No one is excluded or left behind.
Doctors’ Titles and Training Pathways
After medical school (5+ years), doctors follow structured training programmes before becoming a Consultant, General Practitioner (GP), or SAS (Specialist and Associate Specialist) doctor.
Doctor Training Levels
| Job Title | Details |
|---|---|
| Foundation Year 1 (FY1) | First year after medical school. Doctors have provisional GMC registration. Formerly called “House Officer”. |
| Foundation Year 2 (FY2) | Second year post-graduation, considered a Senior House Officer (SHO). Some IMGs enter at this level via standalone FY2 programmes. |
| Specialty Trainee (ST1-ST8) | Specialty training (e.g., paediatrics, radiology, cardiothoracics). First year = ST1, second = ST2, etc. Doctors may work at SHO or registrar level. |
| General Practice Registrar (GPST1-3) | GP trainees in hospital or general practice. |
| Core Trainee (CT), Internal Medicine Trainee (IMT), Acute Care Common Stem (ACCS) | Early-stage specialty training (e.g., surgery, anaesthetics, medicine). IMT is for medical specialities, ACCS rotates through Emergency Medicine, Internal Medicine, Anaesthetics, and ICU. |
| Senior House Officer (SHO) | A doctor supervised by a Registrar (SpR). |
| Registrar / Specialty Registrar (SpR) | A middle-grade doctor responsible for SHOs, supervised by a Consultant. |
| General Practitioner (GP) | First point of contact for patients, responsible for managing chronic conditions and primary care. |
| Consultant | A fully trained specialist with clinical and teaching responsibilities. Similar to an “Attending Physician” in other countries. |
| Locum Doctor | A doctor filling a temporary vacancy due to staff shortages. |
| SAS (Specialist, Associate Specialist) Doctor | Experienced doctors who choose not to become Consultants or GPs but work in a specialty. |
Surgeons & the ‘Mr/Ms’ Title
Unlike most doctors who are addressed as “Dr”, surgeons in the UK revert to “Mr”, “Miss”, “Mrs”, or “Ms” after completing their surgical exams—a tradition dating back to when surgeons were not medically qualified.
The General Medical Council (GMC)
All doctors in the UK must follow the GMC’s Good Medical Practice guidelines, which focus on:
- Safe, high-quality patient care
- Doctor well-being (including equality, diversity & inclusion)
The GMC regulates medical practice, ensuring doctors meet professional standards.
