Senior house officer
A senior house officer (SHO) is a non-consultant hospital doctor in the Republic of Ireland and many Commonwealth countries. SHOs usually have a minimum of 1 year post medical school training. SHOs are supervised in their work by consultants and registrars. In training posts these registrars and consultants oversee training and are usually their designated clinical supervisors.
The same structure to junior doctor grades also applied previously in the National Health Service in the UK, and informal use of the term persists there.
Irish usage
NCHD grades in order, from most junior to most senior:[1]
- Intern — (post-graduate year 1)
- Senior house officer — (PGY ≥ 2)
- Registrar — (PGY ≥ 3)
- Specialist registrar— (PGY ≥ 4)
- Fellow (PGY variable)
In Ireland, physicians typically spend one year as an intern, before becoming a Senior House Officer (SHO). Most doctors spend between 2–4 years working as an SHO. Advancing to registrar level is dependent on experience and aptitude within a specialty; in most cases, becoming a registrar depends primarily on having successfully passed postgraduate examinations such as MRCP/MRCS, although this is not a strict requirement. Most doctors work at registrar level for 1–3 years before being accepted onto a training programme in a particular subspecialty (e.g. Cardiology), after which time, they are known as SpRs (Specialist Registrars). SpR programmes typically last for between 3–6 years. On completion of an SpR programme, doctors are eligible to apply for consultant positions, although the majority opt to undertake 1–2 years of fellowship training – often abroad – prior to appointment at consultant level.[citation needed]
Former UK usage
Since the introduction of Modernising Medical Careers (MMC), grades in the UK differ from those in the Republic of Ireland.
British postgraduate training
Before MMC, physicians applied for SHO posts after completing their mandatory
Modernising medical careers
Year | Current (Modernising Medical Careers) | Previous | ||
---|---|---|---|---|
1 | Foundation doctor (FY1 and FY2), 2 years | Pre-registration house officer (PRHO), 1 year | ||
2 | Senior house officer (SHO), minimum 2 years; often more | |||
3 | Specialty registrar, general practice (GPST), minimum 3 years |
Specialty registrar, hospital speciality (SpR), minimum 5 years | ||
4 | Specialist registrar , 4–6 years |
GP registrar, 1 year
| ||
5 | General practitioner, 4 years total time in training | |||
6–8 | General practitioner , minimum 5 years total time in training | |||
9 | Consultant, minimum 7 years total time in training | Consultant, minimum 7–9 years total time in training | ||
Optional | Training is competency based, times shown are a minimum. Training may be extended by obtaining an Academic Clinical Fellowship for research or by dual certification in another speciality. | Training may be extended by pursuing medical research (usually 2–3 years), usually with clinical duties as well |
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Current status in the UK
Some hospitals use the term senior house officer in an unofficial capacity for physicians in FY2 and CT1/2 year, who often have similar working patterns in duty shift rotas.[citation needed]
The term still applies to non training posts, those organised by a hospital/trust as opposed to a Deanery, where a physician is employed at a level after full registration with the GMC and before entering higher specialty training. These posts are typically referred to as "Trust SHO", "Junior Clinical Fellow" or other such terms.
United States
In the United States, physicians in training are also sometimes referred to as "senior house officers" in their later years of residency, but the term is more variable in its American than its European usage.
Use in the rest of the world
Specializing post-graduate clinical students are still referred to as Senior House Officers in many other countries around the world, most of which were British colonies and adopted the British education system like Uganda.
See also
References
- ^ "Career Pathway - Postgraduate Specialist Training Opportunities". Royal College of Physicians of Ireland. Archived from the original on 2015-07-18. Retrieved 2015-09-02.
- ^ Department of Health, UK government. "Modernising Medical Careers". Archived from the original on 2013-09-05. Retrieved 2011-08-19.
- ^ a b "Operational framework for foundation training". The Stationery Office. 2005-07-18. Retrieved 2011-08-19.
- ^ Donaldson L (August 2008). "Unfinished Business; Proposals for reform of the Senior House Officer grade" (PDF). Archived from the original (PDF) on 2011-09-27. Retrieved 2011-08-19.