Ultimate NHS & Doctor's Training Guide 2026
Doctors who graduate in the UK will typically end up working for the National Health Service (NHS) in England, Scotland, Wales or Northern Ireland.
This article will tell you all about the NHS, the benefits and drawbacks of working for the NHS and what some key NHS principles are. It will also explain what foundation doctor means, the different training pathways and everything that you need to know about the NHS to ace your medicine interview.
This is especially useful for interviews within the NHS and for medical school interviews that may draw on key points in this article. Anyone deciding on becoming a doctor or working within the NHS should know these topics.
An Introduction to the NHS: The Cornerstone of UK Healthcare
The National Health Service (NHS), established in 1948, is a beacon of public healthcare not only in the United Kingdom but across the globe. Built on the principle of universal healthcare, the NHS offers comprehensive medical services that are largely free at the point of use to all UK residents. This remarkable institution, borne out of a post-war vision for a fairer society, remains one of the UK’s most revered accomplishments.
A Global Benchmark for Universal Healthcare
What sets the NHS apart is its commitment to providing healthcare that is not determined by personal wealth, but by the citizen's need for medical care. This concept of health equity and universal access makes the NHS a rarity in the world today, serving as a benchmark for many nations striving to achieve similar healthcare standards.
Four Regional Systems: A Closer Look
While 'NHS' often conjures the image of a single entity, it's essential to note that the National Health Service is a collection of four separate health services aligned in purpose and function but operating regionally. Each system caters to the specific needs of its jurisdiction while sharing the core principle of free healthcare for all:
- NHS England: Serving over 55 million residents, NHS England is the largest component of the NHS structure. It's not only responsible for healthcare provision but also commissions and funds specialised services.
- NHS Scotland: NHS Scotland delivers public health and social care services for the 5.4 million residents of Scotland. Unique to NHS Scotland is its integration of health and social care under the Public Bodies (Joint Working) Scotland Act 2014.
- NHS Wales (GIG Cymru): Responsible for the health and well-being of the 3.1 million residents in Wales, NHS Wales offers a distinct approach, focusing on long-term well-being and prevention.
- Health and Social Care in Northern Ireland (HSC): While not formally branded as NHS, HSC shares the same principles and structure, providing integrated health and social care services for Northern Ireland's 1.8 million inhabitants.
The NHS's existence over seven decades demonstrates its resilience and its essential role in society. The institution has seen multiple reforms and innovations, ever-evolving to better serve the health and wellbeing of the UK's diverse population.
The NHS’s four systems - NHS England, NHS Scotland, NHS Wales, Health and Social Care in Northern Ireland - each with its unique features, collectively continue the mission of delivering comprehensive healthcare that is free at the point of use for everyone.
How many NHS core values are there?
There are six core NHS values. All employees of the NHS - from doctors to gardeners - are expected to demonstrate their 6 core values (outlined below).
These are the principles upon which the NHS seeks to operate (sometimes known as the NHS constitution values), and guide its mission statement:
- Working together for patients: The core value covers two important features: teamwork and patient prioritisation. Patients come first in the NHS mission statement, and all NHS employees must work together to benefit them.
- Respect and dignity: Patients, their families and members of NHS staff are all humans who matter and ought to be treated with dignity and respect. Their aspirations and hopes ought to be considered, making autonomy a crucial principle.
- Commitment to quality of care: The NHS seeks to prioritise three aspects of quality of care: safety, effectiveness, and patient experience. It is important to live up to the trust placed nationally in the NHS.
- Compassion: Patients aren’t just medical puzzles - they are human beings. Everyone’s pain and emotional responses to the volatile situations inherent to medicine are important, and NHS employees need to recognise this and respond with compassion.
- Improving lives: People who engage with the NHS ought to leave their experience in a better place than they would have been in without the NHS. It is important to improve the lives of patients and staff.
- Everyone counts: No one should be discriminated against for any reason, excluded, or left behind. Equal access to healthcare is of the utmost importance.
👉🏼 Read More: NHS Core Values
A common point of confusion is the difference between the 6 NHS core values above (from the NHS Constitution) and the '6 Cs of care' (care, compassion, competence, communication, courage and commitment), which are the values for nursing and care staff introduced in 2012. They overlap but are not the same thing. For a deeper interview-ready breakdown, see our full guide to the 6 NHS core values for medicine interviews.
NHS Overview & Structure: A Comprehensive Guide
The Funding of NHS
The National Health Service (NHS) is primarily funded by the UK government through general taxation. The Department of Health and Social Care budget for England is now close to £200 billion a year (2025/26), with the lion's share going to front-line NHS services. The government's 10-Year Health Plan, 'Fit for the Future', published in July 2025, sets out three big shifts: from hospital to community care, from analogue to digital, and from treatment to prevention.
How the NHS Spends Its Budget
While some NHS funding is earmarked for national initiatives, such as specialised treatments for rare cancers, the majority is now distributed through Integrated Care Boards (ICBs). ICBs replaced the old Clinical Commissioning Groups (CCGs) in July 2022 and are responsible for planning and funding most NHS services for their local population, working as part of wider Integrated Care Systems (ICS).
Understanding CCGs: The Gatekeepers of Local Health Services
ICBs play a pivotal role in the structure of the NHS. Their funding allocation is influenced by various factors, such as local population size, average age, and levels of deprivation. As of 2026 there are 42 ICBs in England, though these are being merged into around 26 larger ICB clusters during 2026 to 2027 as part of wider NHS reform. For interviews, the key point is that funding follows local need.
The Role of CCGs in Broader NHS Structure
Beyond their individual remits, ICBs sit alongside Integrated Care Partnerships (ICPs), a statutory committee that brings the NHS together with local authorities and the voluntary sector to set the strategy for health and care across a region. Together an ICB and ICP make up an Integrated Care System (ICS). This replaced the older Sustainability and Transformation Partnership (STP) model.
From STPs to Integrated Care Partnerships (ICPs)
ICPs are the operational units within this system. They bring together NHS trusts that provide acute, community, and mental health care, along with other providers of NHS-funded care, such as GPs, voluntary sector organisations, social enterprises, and even private sector partners. This collaborative approach enables a holistic delivery of care that meets the diverse needs of each locality.
Navigating the Future with Integrated Care System (ICS) Boards
Since July 2022, Integrated Care Systems (ICS) have been the legal framework for planning and delivering health and care in England. Each ICS is built around an ICB and an ICP, replacing the previous patchwork of CCGs and STPs. The aim is to join up hospital, community, mental health, social care and GP services so care is more joined-up and focused on prevention. A separate but major 2025 reform is the abolition of NHS England itself: announced in March 2025, it is being merged into the Department of Health and Social Care (DHSC), with the transition targeted for completion by 2027. This is worth knowing as a current affairs talking point.
In this way, the complex system of NHS funding, and the interconnected roles of CCGs, STPs, and ICSs, allow for flexible, community-focused healthcare throughout the UK.
The Structure of NHS Trusts
The NHS is comprised of numerous trusts, each responsible for different aspects of care. They include:
- Acute Trusts: These trusts are responsible for short-term care, typically in a hospital setting, such as emergency medicine, surgery, and general medical care.
- Mental Health Trusts: These specialise in mental health services, including counselling, psychotherapy, and psychiatric care.
- Community Trusts: These provide care in a community setting, such as district nursing, health visiting, or care in a patient’s home.
- Ambulance Trusts: These trusts are responsible for providing responsive care in emergency situations and patient transport.
Understanding how these trusts interact and collaborate can help you navigate the system more efficiently and advocate for your patients better.
Primary Care Networks (PCNs)
Primary Care Networks are groups of local GP practices working closely with community, mental health, social care, pharmacy, hospital and voluntary services in their local areas. They are an essential part of the NHS structure and are designed to offer integrated, patient-centred care.
Healthcare Professions Regulators
As a prospective doctor, you should also be aware of the General Medical Council (GMC). The GMC maintains the official register of medical practitioners within the United Kingdom, sets the standards for medical schools, and manages the licensing process.
For interviews, it helps to read around how the NHS in England actually fits together. See our guides to the structure of the NHS, what happened when NHS England was abolished, and the GMC and Good Medical Practice.
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Working for the NHS
Working for the NHS poses numerous challenges, but can also be highly rewarding. By working in accordance with the core values outlined above, NHS workers contribute a lot to society and help to maintain a system where those in need can receive the help that they need without needing to worry about payment.
However, there are plenty of challenges posed by working within the NHS which has been criticised for its working conditions in the past. For more information about these, including a rundown of the junior doctors' strikes, check out our guide to NHS hot topics.
Challenges facing the NHS
Of course, the NHS is facing numerous challenges today. Three of the biggest include:
- Ageing population in the UK: Key demographic shifts are causing problems for the NHS. Not only is the population growing, but it is also ageing. No longer is a 50-year-old diagnosed with a single condition that ails them until they pass away 20 years later. Now, people are living into their 80s, 90s and 100s, accumulating numerous medical conditions and requiring a complex network of medications. These all interact with each other to make individual patient cases not only more complex but also less confined to a single speciality. Therefore, the importance of teamwork between specialities becomes far more important as each patient demands more time, resources and energy from physicians.
- Privatisation: The NHS’s key goal is to provide high-quality care that is free at the point of use. Privatisation of various components threatens this, as the possibility of a US-style insurance-based system looms large. Key things to consider here are wealthy lobbyists for the privatisation of parts of the NHS, and deals that the government may make with the US government as part of trade negotiations to give large pharmaceutical companies more power in the UK.
- Understaffing: Understaffing is both a contributing factor to the problem of the ageing population and an issue in its own right. Many healthcare workers move to countries with better working conditions such as Australia, and Brexit has significantly decreased the number of international workers coming to the UK to contribute to the NHS. This stretches resources thinner and makes it more difficult to give patients the care that they deserve.
What other issues is the NHS facing?
Take a look at our guide to NHS hot topics to learn more about contemporary issues within the NHS. Alternatively, check out our guide to a doctor’s progression through the NHS!
Dig into the NHS hot topics and current affairs hub for interview-ready summaries of the big issues, including the NHS GP shortage, AI in medicine and the NHS, and the NHS waiting list and backlog crisis.
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How long does it take to become a UK doctor?
It takes 5-6 years to become a doctor in the UK.
UK medical training is a long process - it doesn’t stop when you graduate from medical school! In fact, there are many years of working as a doctor and continuing to study and sit exams after your university graduation ceremony.
It is fundamental that anyone applying to study medicine or with an upcoming interview knows this - it is a common medical school interview question!
Some universities will also provide the opportunity to undertake an intercalated degree, which will extend your time in university by one year in exchange for the receipt of a second degree (often a Bachelor of Medical Sciences). In some universities such as Oxford, Cambridge, Imperial and UCL intercalation is mandatory, in most others, it is optional.
After you graduate from medical school, you will start practising medicine as an FY1 doctor - however, this isn’t the end of your medical training pathway. It takes 5-6 years to become a UK doctor, but many more to become a consultant or GP.
Is medical specialities a good career path?
We think so - it offers such a unique variety of specialities that you can choose to pursue, where your interests really can be tailored to help create a fulfilling career for you.
What are the different types of doctors? What do their names mean?
What is the hierarchy of doctors in the UK?
There are various doctor ranks in the UK, and it’s important to understand the progression between each one after your time in medical school ends.
Foundation years
First, you will spend two years as a foundation year doctor, initially an F1, then an F2 doctor. At this point, you are a fully qualified doctor in clinical training. Note that F1 and F2 doctors are now officially called 'resident doctors', the term that replaced 'junior doctors' in 2024. As an F1 doctor, your registration with the General Medical Council (GMC) is provisional until you complete F1.
F1 and F2 doctors rotate between specialities and departments every 4 months, so may end up travelling a lot around the region in which they are working. This is a great opportunity to experience not only a variety of healthcare settings but also places to live and lifestyles.
At the end of F2, you will receive a Foundation Achievement of Competence Document (FACD) which signifies that you are ready to begin the next stage of your career.
Junior Middle Grade
At this point, doctors will generally know roughly in which area they would like to specialise. You will have a few options:
- Core GP Training: This three-year program fully qualifies you as a General Practitioner upon completion.
- Core Medical Training: This two-year program gives you a general overview of medical specialities.
- Core Surgical Training: This two-year program gives you a general overview of surgical specialities.
- Applying to a run-through program: These programs require you to apply only once, rather than twice, before you become a consultant. Core medical & surgical training programs, once completed, will require you to apply to higher speciality training. Specialities with run-through training include paediatrics, neurosurgery, cardiothoracic surgery, and more.
Senior Middle Grade
Senior Middle-Grade doctors work for 4-6 years towards a full qualification in their chosen speciality. After this, they receive a Certificate of Completion of Training (CCT) and gain entry into either the GMC Specialist Register or GP Register.
Consultant or GP
These doctors are fully qualified, have completed their training, and are free to work independently. This is the highest achievable rank of doctor in the UK.
SAS doctors
SAS doctors are speciality and speciality grade doctors with at least four years of postgraduate training. Instead of becoming a consultant or GP, they may choose to be an SAS doctor for numerous reasons - the ability to live in one geographical location rather than rotating, freedom from the requirements of a formal training program, and more regular hours.
How much do doctors earn in the UK?
A foundation doctor's basic starting salary in England is £38,831 (FY1, 2025/26), rising further with the new pay scale from April 2026.
Many people considering a career in medicine wonder how much UK doctors make. The rates vary significantly depending on speciality, experience, and job title.
Below, salaries are outlined for various positions. Please note that these are for standard 40-hour weeks. Additional hours, on-call time and weekend work will all result in extra pay so almost all doctors actually make more money than is outlined below. Therefore, at any level of doctor eg junior doctor's salary can be highly varied.
Generally, doctors who have more experience will be paid at the upper end of given ranges. Additionally, many doctors take on work in the private sector which can be significantly more lucrative.
- F1 (resident doctor) basic salary, the UK doctor starting salary: £38,831 (2025/26)
- F2 (resident doctor) basic salary: around £44,439 (2025/26)
- Specialist training doctor salary: £40,257-58,398
- Specialty doctors salary: £50,373-78,759
- Specialist grade doctors salary: £80,693-91,584
- Consultants salary: £84,559-114,003
On top of basic pay, resident doctors earn enhancements for nights, weekends and on-call work, typically adding around 20-30% to gross earnings. Doctors are comparatively well-paid, but the work is hard and requires a long, demanding training pathway. Pay has also been a major point of dispute, driving the resident doctor strikes of recent years.
👉🏼 Read More: How Much Do Doctors Earn In The UK?
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Does your medical school influence where you will work as a doctor?
No it doesn't. There is a common myth amongst prospective (and even current) medical students that the location or city that you attend medical school in will mean that you will get your first job in that city. This is wrong!
You can work in any part of the country upon completing medical school, as determined by set criteria, and an examination. However, having spent 5-6 years living in one city, many doctors do choose to stay in that city once they begin working as a doctor - but remember, this is optional!
Frequently asked questions
What are the 6 NHS core values?
The six NHS core values, set out in the NHS Constitution, are: working together for patients, respect and dignity, commitment to quality of care, compassion, improving lives, and everyone counts. All NHS staff, from doctors to porters, are expected to demonstrate them. Knowing and giving examples of these values is essential for both medical school and NHS job interviews.
What is the difference between the 6 NHS core values and the 6 Cs?
They are two separate frameworks. The 6 NHS core values come from the NHS Constitution (first published 2009) and apply to all NHS staff. The 6 Cs (care, compassion, competence, communication, courage and commitment) were introduced in 2012 specifically as values for nursing, midwifery and care staff. They overlap but are not interchangeable, so use the correct one in an interview.
What are the 6 Cs of care?
The 6 Cs are care, compassion, competence, communication, courage and commitment. Introduced in 2012, they are the core values and behaviours for nursing, midwifery and care staff in the NHS. They are sometimes confused with the NHS Constitution's six core values, which are a broader set applying to every NHS employee.
When was the NHS founded and on what principle?
The NHS was founded on 5 July 1948 by then Health Secretary Aneurin Bevan. It was built on the principle that good healthcare should be available to all, free at the point of use, and based on clinical need rather than ability to pay. It is funded mainly through general taxation and remains one of the largest publicly funded health systems in the world.
Is NHS England being abolished?
Yes. In March 2025 the government announced that NHS England would be abolished and merged into the Department of Health and Social Care (DHSC) to cut duplication and bring the NHS under closer political control. The transition is being legislated through a Health Bill and is targeted for completion by 2027. It is a strong current-affairs topic for 2026 interviews.
What are ICBs and ICSs in the NHS?
Integrated Care Boards (ICBs) are NHS bodies that plan and fund most local health services. They replaced Clinical Commissioning Groups (CCGs) in July 2022. Each ICB sits within an Integrated Care System (ICS) alongside an Integrated Care Partnership (ICP), which brings in councils and the voluntary sector. The aim is to join up hospital, GP, community, mental health and social care services.
How is the NHS funded and what is its budget?
The NHS is funded mainly through general taxation, topped up by National Insurance contributions. The Department of Health and Social Care budget for England is close to £200 billion a year (2025/26). Most of this funds front-line services through Integrated Care Boards, with the rest covering national programmes, training, capital and public health.
What is the 10-Year Health Plan 'Fit for the Future'?
Published in July 2025, the 10-Year Health Plan for England, 'Fit for the Future', sets out three strategic shifts: from hospital to community care, from analogue to digital, and from treatment to prevention. It is the government's main blueprint for NHS reform and a useful talking point for interviews on the future of the health service.
How long does it take to become a doctor in the UK?
Medical school takes five to six years (six if you intercalate or do a gateway/foundation year). After graduating you complete two years of foundation training (F1 and F2), then specialty training of around three years for GP or five to eight years for hospital specialties. From starting medical school to becoming a consultant or GP can therefore take roughly 10 to 16 years.
What is a foundation doctor (F1 and F2)?
A foundation doctor is a newly qualified doctor in their first two years of practice after medical school, known as Foundation Year 1 (F1) and Foundation Year 2 (F2). They rotate through different specialties roughly every four months. Since 2024 F1 and F2 doctors are officially called 'resident doctors', the term that replaced 'junior doctors'. Full GMC registration is granted after completing F1.
How much does a UK doctor earn?
A foundation (F1) doctor's basic salary in England is £38,831 in 2025/26, rising in F2 and further through specialty training. Specialty registrars, SAS doctors and consultants earn progressively more, with consultant basic pay ranging from roughly £105,000 to £140,000. Most doctors also earn enhancements for nights, weekends and on-call work, adding around 20-30% to basic pay.
What are the four NHS systems in the UK?
Healthcare is devolved, so each UK nation runs its own service: NHS England, NHS Scotland, NHS Wales (GIG Cymru), and Health and Social Care (HSC) in Northern Ireland. They share the founding principle of care free at the point of use but differ in structure and policy, for example prescription charges apply in England but not in Scotland, Wales or Northern Ireland.
What are the different types of NHS trusts?
NHS trusts deliver care and fall into broad types: acute trusts (hospitals providing emergency, surgical and general care), mental health trusts, community trusts (district nursing and care at home), and ambulance trusts. Some are foundation trusts, which have more financial and operational freedom. Trusts work together within Integrated Care Systems to coordinate care across a region.
What is the hierarchy of doctors in the UK?
After medical school, doctors progress through foundation training (F1 and F2), then core or specialty training as resident doctors (formerly junior doctors), often as registrars. The most senior grades are consultant and GP, who work independently. SAS doctors (specialty and specialist grade) are an alternative senior route for experienced doctors who do not pursue the consultant pathway.
What are the biggest challenges facing the NHS in 2026?
Major pressures include an ageing population with complex long-term conditions, workforce shortages and retention problems, long elective waiting lists and the backlog, funding constraints, and debates over privatisation. Recent resident doctor strikes over pay, the abolition of NHS England, and rising demand on GP and emergency services are all strong current-affairs topics for medicine interviews.
Does your medical school decide where you work as a doctor?
No. Where you study does not determine where you work after graduating. Foundation jobs are allocated through a national application process, and you can be placed anywhere in the UK based on your preferences and ranking. Many doctors do choose to stay near where they trained, but it is not a requirement, so do not pick a medical school based on this myth.
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