The posts usually rotate between approved hospitals and are approved by the relevant Higher Speciality training committee via Speciality Advisory Committees. The numbers of Specialist Registrars are controlled by the Postgraduate Deans. This training is designed to equip the trainee with the skills needed to practise as a specialist and meet the formal requirements for specialist registration. Increasingly this will only be awarded if the trainee has been successful in a speciality exit examination conducted by an Intercollegiate Examination Board. Possession of a CCST certificate is now required for entry to the specialist register.
Specialist registration is in turn necessary for appointment to a consultant post.
See page 8 for an explanation of training numbers. It is possible for doctors to be appointed directly to these posts without the need to go through competitive procedures and therefore overseas doctors have the opportunity to gain specialist skills without the intense competition for Type 1 posts. Type II training does not lead to the award of a CCST although doctors who are subsequently appointed to Type I training following a period spent in Type II may have some or all of that training recognised for CCST purposes. This is an appointment within the Specialist Registrar grade where it is decided that CCST training experience can be offered and this training can count towards a CCST if the trainee is subsequently appointed to an SpR post with a training number. These are shorter term appointments of up to three months within the Specialist Registrar grade which do not offer structured training.