Senior house officer
Encyclopedia
A senior house officer is a junior doctor
undergoing training within a certain speciality in the British
National Health Service
or in the Republic of Ireland
. SHOs are supervised by consultants and registrars, who oversee their training and are their designated clinical (and in many cases educational) supervisors. In the United States, physicians in training are also referred to as "senior house officers" in their later years of residency, but the term is more variable in its American than British usage. Since the introduction of Modernising Medical Careers
, the relevant grades have been replaced with other terms, but the term remains in use in many organisations.
(PRHO) year after qualifying from medical school
. They would typically work as an SHO for 2–3 years, or occasionally longer, before to a certain subspeciality where they would take up a specialist registrar
post to train as a specialist in that particular field . To qualify for these, SHOs had to be in posts approved by a regional postgraduate dean
, as well as passing postgraduate exams (such as the Membership of the Royal College of Physicians
, MRCP).
SHO jobs typically lasted 4 or 6 months in various departments and were often provided in 1- or 2-year rotations. Posts not recognised by the Deanery were typically referred to as "Trust SHO", "Junior Clinical Fellow" or with similar terms.
", merging the PRHO year and the first year of SHO training into a "foundation programme" (FY1 and FY2). This programme was formally introduced in August 2005.
In August 2002, Professor Sir Liam Donaldson
, the then Chief Medical Officer, published a report titled "Unfinished Business", which focused on reforming SHO training. The SHO grade was abolished and renamed specialty registrar. This change took place in 2007. Amongst the many changes, many doctors who had completed their Foundation Training were now appointed into a "run-through" training programme that incorporated the previous SHO and specialist registrar grades. The job title changed from "SHO" to "ST1/ST2" (specialist trainee year 1 & year 2). Part of this decision was subsequently reversed in a number of specialties, with competitive entry into the registrar grade ("uncoupled training"), and in these specialties the SHO level posts are referred to as "CT1/CT2" (core trainee year 1 & year 2) and in some "CT3".
Many hospitals use the term "senior house officer" unofficially for doctors in FY2 and CT1/2 year, who often have similar working patterns in duty shift rotas.
Junior doctor
Junior doctors in the United Kingdom and the Republic of Ireland are those in postgraduate training, starting at graduation with a medical degree and culminating in a post as a Consultant, a General Practitioner, or some other non-training post, such as a Staff grade or Associate Specialist...
undergoing training within a certain speciality in the British
United Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...
National Health Service
National Health Service
The National Health Service is the shared name of three of the four publicly funded healthcare systems in the United Kingdom. They provide a comprehensive range of health services, the vast majority of which are free at the point of use to residents of the United Kingdom...
or in the Republic of Ireland
Republic of Ireland
Ireland , described as the Republic of Ireland , is a sovereign state in Europe occupying approximately five-sixths of the island of the same name. Its capital is Dublin. Ireland, which had a population of 4.58 million in 2011, is a constitutional republic governed as a parliamentary democracy,...
. SHOs are supervised by consultants and registrars, who oversee their training and are their designated clinical (and in many cases educational) supervisors. In the United States, physicians in training are also referred to as "senior house officers" in their later years of residency, but the term is more variable in its American than British usage. Since the introduction of Modernising Medical Careers
Modernising Medical Careers
Modernising Medical Careers is a programme for postgraduate medical training introduced in the UK from 2005 onwards. The programme replaced the traditional grades of medical career before the level of Consultant. The different stages of the programme contribute towards a "Certificate of...
, the relevant grades have been replaced with other terms, but the term remains in use in many organisations.
Postgraduate training
Before MMC, doctors applied for SHO posts after completing their mandatory pre-registration house officerPre-registration house officer
Pre-registration house officer , often known as a houseman or house officer, was until 2005 the only job open to medical graduates in the United Kingdom who had just passed their final examinations at medical school and had received their medical degrees.Newly-qualified doctors are only allowed...
(PRHO) year after qualifying from medical school
Medical school
A medical school is a tertiary educational institution—or part of such an institution—that teaches medicine. Degree programs offered at medical schools often include Doctor of Osteopathic Medicine, Bachelor/Doctor of Medicine, Doctor of Philosophy, master's degree, or other post-secondary...
. They would typically work as an SHO for 2–3 years, or occasionally longer, before to a certain subspeciality where they would take up a specialist registrar
Specialist registrar
A Specialist Registrar or SpR is a doctor in the United Kingdom and Republic of Ireland who is receiving advanced training in a specialist field of medicine in order eventually to become a consultant...
post to train as a specialist in that particular field . To qualify for these, SHOs had to be in posts approved by a regional postgraduate dean
Deanery (NHS)
An NHS Deanery is a regional organisation, within the structure of the UK National Health Service , responsible for postgraduate medical and dental training...
, as well as passing postgraduate exams (such as the Membership of the Royal College of Physicians
Membership of the Royal College of Physicians
Membership of the Royal Colleges of Physicians is a postgraduate medical diploma. The examinations are run by the Federation of the Medical Royal Colleges of the United Kingdom – the Royal College of Physicians of London, the Royal College of Physicians of Edinburgh, and the Royal College...
, MRCP).
SHO jobs typically lasted 4 or 6 months in various departments and were often provided in 1- or 2-year rotations. Posts not recognised by the Deanery were typically referred to as "Trust SHO", "Junior Clinical Fellow" or with similar terms.
Modernising Medical Careers
In 2002, the Department of Health announced reforms in the training of newly qualified doctors under the banner of "Modernising Medical CareersModernising Medical Careers
Modernising Medical Careers is a programme for postgraduate medical training introduced in the UK from 2005 onwards. The programme replaced the traditional grades of medical career before the level of Consultant. The different stages of the programme contribute towards a "Certificate of...
", merging the PRHO year and the first year of SHO training into a "foundation programme" (FY1 and FY2). This programme was formally introduced in August 2005.
In August 2002, Professor Sir Liam Donaldson
Liam Donaldson
Sir Liam Joseph Donaldson was the Chief Medical Officer for England, the 15th occupant of the post since it was established in 1855...
, the then Chief Medical Officer, published a report titled "Unfinished Business", which focused on reforming SHO training. The SHO grade was abolished and renamed specialty registrar. This change took place in 2007. Amongst the many changes, many doctors who had completed their Foundation Training were now appointed into a "run-through" training programme that incorporated the previous SHO and specialist registrar grades. The job title changed from "SHO" to "ST1/ST2" (specialist trainee year 1 & year 2). Part of this decision was subsequently reversed in a number of specialties, with competitive entry into the registrar grade ("uncoupled training"), and in these specialties the SHO level posts are referred to as "CT1/CT2" (core trainee year 1 & year 2) and in some "CT3".
Current status
Doctors not on a formal training programme may still be appointed in what is referred to as "Fixed Term Specialty Training Appointment" (FTSTA). Many of these positions are advertised by employing hospitals under different names, similar to the pre-MMC situation.Many hospitals use the term "senior house officer" unofficially for doctors in FY2 and CT1/2 year, who often have similar working patterns in duty shift rotas.