4 Steps be a Consultant Orthopaedic Surgeon in the UK

Becoming a consultant Orthopaedic surgeon in the UK is an ambitious but achievable goal, even for International Medical Graduates (IMGs). In fact, approximately 9% of training positions in T&O in the UK is filled by IMGs. 

Enrollment in the GMC Specialist Register
To be recognized as a Consultant Orthopaedic Surgeon in the UK, you are first required to enroll in the GMC specialist register. 
There are three possible pathways to the GMC specialist register:

• CCT (Certification of Completion of Training): The CCT route is ideal for new graduates or those without prior post-graduate training. This route involves completing the 2-year UK core surgical training programme (CST) followed by the 6 year Trauma & Orthopaedic (T&O) UK Surgery higher surgical training programme. 
  
  
• CESR-CP (Certificate of Eligibility for Specialist Registration Combined Programme: This route is designed for IMGs who are overqualified for core surgery but wish to pursue orthopaedic surgery training. Typically, the entry occurs at Specialty training 3 level and the programme lasts for 6 years. 
  
  
• CESR(Certificate of Eligibility for Specialist Registration): This route is reserved for experienced practitioners who have not undergone formal UK orthopaedic training. Applicants must demonstrate equivalent experience and training to be considered. 

One of the best things about applying to be a surgeon in the UK is that an IMG can choose any of the 3 routes above. In this blog, we will look at the CCT route to discuss 4 steps to become a Consultant  Orthopaedic Surgeon in the UK.


STEP 1: Applying for UK Core Surgery Training
Orthopaedic surgery training in the UK follows an “uncoupled” structure as opposed to a “run through” programme where both core and specialty training occurs simultaneously. The uncoupled programme in T&O consists of two phases: 

• Core Surgery (CT) spanning over 2 years (CT1 & CT2)
• Orthopaedic Surgery Training (ST) spanning over 6 years (ST3 to ST8)
  

Before commencing specialty training, ensure you meet the pre-requisites for UK core surgery placement. These include full GMC registration, 24 months of clinical experience (including 12 months of internship) and either F2 competences or CREST certification (Certificate of Readiness to Enter Specialty Training).

STEP 2: Pass the MRCS
Upon completing the Core Surgery Training, the applicant must pass the Membership of the Royal College of Surgeons (MRCS) exam. This test comprises both a written test (Part A) and a practical exam (Part B). Qualifying both the parts of this test is essential for doctors to apply for ST3 in Trauma & Orthopaedics.

STEP 3: Applying for UK Orthopaedic Surgery Training (Residency)
After successfully passing the MRCS exam, doctors can commence the ST3 Level. Apart from MRCS, other prerequisites for this include a validated logbook of surgical procedures, a portfolio of assessments relevant to the Core Surgery Curriculum, and a Certificate of Readiness to enter Higher Surgical Training.

STEP 4: Pass the FRCS Trauma & Orthopaedics

FRCS (Fellowship of the Royal College of Surgeons) consists of a written (Section A) as well as an oral/practical exam (Section B). It is mandatory for trainees to pass both sections by the end of ST8. This final exam determines whether you are ready to be a Consultant or not. 

After completing the 8 years training, you will receive a Certificate of Completion of Training (CCT) in Trauma and Orthopaedic Surgery.

If you’ve read this far, do try Medlogbook to log your medical experiences. I’ve created this to organise your competencies which could help with moving abroad. You can be better prepared for submitting work evidence, a requirement in most countries for practising.