Hospital doctors diagnose and treat illness, disease and infection in patients admitted into hospital or treated in outpatient clinics. They examine patients and carry out necessary treatment. Patients may be referred by a GP or other doctor, or admitted to hospital as an emergency.

Hospital doctors work within one of around 60 specialist fields which can be divided into four main groups:

Medicine - this area involves treating general medical conditions and emergencies. Specialisms within this field include paediatrics, cardiology, dermatology, geriatrics, neurology and tropical medicine.

Surgery - surgeons are responsible for patients before, during and after operations. They work in one of nine surgical specialties including cardiothoracic, general surgery, neurosurgery, and plastic surgery.

Pathology - this area involves investigating the cause and consequences of disease. Specialists in this field include histopathologists (diagnose disease from changes in tissue structure), chemical pathologists (detect biochemical changes related to medical conditions) and molecular geneticists (identify abnormalities in DNA and chromosomes).

Psychiatry - psychiatrists work with patients with mental illness or disability, prescribing drugs and managing drug regimes for their patients.

Other specialist areas include anaesthetics (check the Anaesthetist job profile for details), obstetrics, gynaecology, radiology and oncology.

Some doctors lead a team or manage one of the departments they play a key role in, and many are involved in teaching and supervising trainees or other groups such as undergraduate medical students and nurses.

As well as treating patients they also have administrative duties such as keeping patient records, writing reports, attending committee meetings, auditing and sending letters to general practitioners.

Hours and Environment

As a hospital doctor, you will work relatively long hours, especially as a junior doctor. You will work shifts and an out of hour’s rota system. Sometimes you may need to work for around 56 hours a week. By 2009 this will be reduced to a maximum limit of 48 hours a week.

Generally, working conditions in hospitals are clean, modern and comfortable. You may spend time in a variety of settings including consulting rooms, wards, operating theatres, and special units such as accident and emergency.

This work can be mentally and physically demanding.

Skills and Interests

To be a hospital doctor you should:

• be able to demonstrate integrity in both your personal and professional life
• have an interest in the well-being of patients
• have excellent communication skills, able to explain patient choices and share decisions
• be prepared to continually update your knowledge and learn new techniques
• be able to absorb and draw on large amounts of scientific and technical information
• be able to put people at their ease and inspire their trust and confidence
• have the practical ability and manual dexterity for examining patients and performing clinical procedures
• have an interest and ability in science
• be able to work under pressure and make quick clear decisions
• have strong analytical skills
• have the potential to train, teach and supervise staff.

Entry

To become a hospital doctor you need to complete:

• a degree in medicine, recognised by the General Medical Council (GMC)
• a two year foundation programme of general training (see Training section for details)
• an accredited specialist training programme in your chosen area of medicine (see Training).

The GMC hold details of recognised degree courses, see Further Information for details.

The entry requirements for a five-year degree in medicine usually include three A levels at grades AAB in subjects such as chemistry, biology and either physics or maths. If you have qualifications from Scotland you need H grades and Advanced Highers in subjects such as chemistry and biology. The subjects and grades you achieved at GCSE/S level will also be taken into account.

If you do not have qualifications in science, there is a six-year degree course in medicine that includes a one-year pre-medical (or foundation) course.

If you are a graduate with a first or upper second class honours degree in a science subject, you may be able to join a four-year graduate entry programme to medicine. Some universities will accept non-science graduates. The British Medical Association (BMA) website has details of course providers, see Further Information for contact details.

You may also be asked to take the UK Clinical Aptitude Test (UKCAT), which is used by 23 UK universities to identify students with the appropriate attitude, behavioural attributes and mental abilities for a degree in medicine. The university you wish to join will tell you if you need to take the test. For more details and to register for the test, go to the UKCAT website.

Before you apply for a course you can gain insight into this field by doing some relevant paid or voluntary work, for example working as a care assistant in a hospital, residential or nursing home. Some hospitals allow potential medical students to observe a qualified doctor at work. You can contact local hospitals directly to discuss these possibilities.

Training

As a medical student you are exposed to many of the specialties within medicine. You will learn basic medical science, communication skills and practical clinical techniques. You will work, under supervision, in a range of areas such as general practice, accident and emergency, and outpatient clinics.

When you have achieved your degree in medicine, you need to complete two further stages of training to become a senior doctor or consultant in your chosen field:

• a two-year foundation programme. This can include placements in acute care settings, mental health and general practice. Successful completion of year one (known as F1) leads to full registration with the GMC. During year two of the programme (F2) you will experience a range of specialist areas. At the end of F2 you make your career choice to pursue specialist training in your chosen area (leading to consultancy).
  
• specialist training programme in your chosen area of medicine (often known as 'run-through' training). You will apply in open competition for a place on one of these programmes, which can take between three and seven years depending on the specialism. During the programme you will learn and practice in increasingly advanced areas. There are usually basic, intermediate, higher and advanced levels of training.

As a trainee you will be assessed in the workplace, and you will only progress to the next stage when you have met the required standard. For many areas of medicine you will be required to sit formal examinations which are often set the Royal College associated with your specialism.

When you have successfully completed the specialist training programme, you will be awarded the Certificate of Completion of Training (CCT). This means you will be eligible to join the GMC Specialist Register, and apply for consultant positions in the NHS.

As a consultant you are expected to continue learning throughout your career. Many of the Royal Colleges hold details on all aspects of training and continuing medical education. Check with The Royal College of Physicians for more details; see Further Information.

This new way of training is part of the NHS Modernising Medical Careers Review. For more details, check the NHS Modernising Medical Careers website.

Opportunities

Competition for promotion through the various training grades can be strong as places on specialist programmes are limited in number. When you qualify, you may also need to relocate to take up a more senior position.

As a consultant you will often find opportunities to work in the private sector. With experience, you may go onto lead a team or manage a unit. You may also progress to teaching and training students, trainee doctors and other healthcare professionals.

Annual Income

Figures are intended as a guideline only.

Junior doctors, on the foundation programme, can earn between £21,000 and £26,000 a year.
Doctors in specialist training can earn up to £44,000.
In addition, doctors in training will receive extra payments depending on the hours worked, workload, and the amount of time spent working unsocial hours.

Consultants can earn between £70,000 and £94,000 a year.
With additional payments and merit awards, consultants can earn considerably more. 

Consultants often supplement their income with private work. Those working in private hospitals may negotiate higher fees. 

Further information

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