Following medical school, foundation training and core training, the final part of training in the progression from trainee to consultant is specialty training, or 'higher specialty training' (HST).

Internal medicine curriculum and Group 1 and Group 2 specialties

The revised internal medicine curriculum and introduction of the three-year IMT core programme, has led to changes for physician higher specialty training. Specialties are categorised into two groups: Group 1 and Group 2; the JRCPTB website details which specialties fall into each group. 

  • Group 1 - these specialties' programmes start at ST4-level, require the full three years training in internal medicine training (IMT) or equivalent and all programmes will dual specialise with general internal medicine.
  • Group 2 - programmes start at ST3-level, can be entered after two years of IMT or equivalent and do not involve training in general internal medicine. Many of these specialties also accept trainees from a non-physician pathway. 

Applying for HST

Trainees can start applying for HST in the final year of the programme required for entry to that specialty; for Group 1 this is the third year of IMT and Group 2 is the second year. This website has been set up to guide trainees through the process of applying and competing for HST programmes. 

Further training

Upon selection to an HST programme, a trainee will then progress through several further years of training (typically between four and five) in the chosen specialty.

This will continue until the trainee completes their training and becomes a fully-qualified consultant in that specialty.

Completing training

Completion of higher specialty training in a GMC approved programme within the UK, will result for most trainees in the award of a CCT (certificate of completion of training).

Trainees who seek to reduce the length of their HST by gaining recognition for experience outside of UK training, will receive a CESR-CP (certificate of entry to the specialist register - combined programme).

More information about certification can be found on the JRCPTB website.

Types of post

NTN posts

Most posts within the HST recruitment process are those described above, i.e. higher specialty training posts of several years in duration. Each trainee in one of these posts will be awarded a unique 'national training number'; hence these posts are often referred to as 'NTNs'.

LAT posts

The other type of post included in the process is the 'locum appointment for training', or LAT post. These are short-term training posts in a specialty, typically between six and 12 months in duration.

LAT posts are only available in Northern Ireland, Scotland and Wales.

Trainees in LAT posts will be assigned educational supervisors and given appropriate clinical supervision; and as noted in the Gold Guide, documented competences gained in LAT posts by trainees can be taken into account by training programme directors on future specialty training programmes.