A senior house officer (SHO) is a junior doctor undergoing training within a certain speciality in the United Kingdom National Health Service or in the Republic of Ireland. SHOs are supervised by consultants and registrars, who oversee their training and are their designated clinical (and in many cases educational) supervisors. In the United States, physicians in training are also referred to as "senior house officers" in their later years of residency, but the term is more variable in its American than British usage.
A doctor typically works as an SHO for 2-3 years, or occasionally longer, before deciding to pick a certain speciality where he takes up a Specialist registrar/speciality registrar post to train as a specialist in that particular field registrar. SHOs must be in posts approved by a postgraduate dean, as well as passing postgraduate exams (such as the Membership of the Royal College of Physicians, MRCP), in order to qualify for a registrar post.
SHO jobs typically last 4 or 6 months and are often in rotations, where the junior doctor is appointed for 2-3 years and spends 6 months at a time in different departments or allied hospitals.
In 2002, the Department of Health announced reforms in the training of newly qualified doctors under the banner of "Modernising Medical Careers"[1], merging the internship year ("pre-registration house officer", "PRHO" or "house officer") and the first year of SHO training into a "foundation programme". This programme was formally introduced in August 2005.
In 2005, the British Medical Association (BMA) reported that there were insufficient SHO posts available to provide training for newly qualified doctors who had completed their PRHO year[2]. Postgraduate deans and the Department of Health disputed this. 2005 also saw the introduction of "foundation year 2", a one-year post-registration year of basic training. Many SHO posts were absorbed into this programme. In 2007, the remaining SHO posts were transformed into core specialty training posts (ST1/2, in some fields CT1/2). As a result, the term "senior house officer" has ceased to exist as a job description, although it is still used unofficially as a collective term for FY2 and CT/ST doctors on hospital rotas as doctors from these groups usually fill the same duty rota tier.
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| Old system | New system (Modernising Medical Careers) | |||
| Year 1: | Pre-registration house officer (PRHO) - one year | Foundation House Officer - 2 years | ||
| Year 2: | Senior house officer (SHO) a minimum of two years, although often more |
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| Year 3: | Specialty Registrar (StR) in a hospital speciality: six years |
Specialty Registrar (StR) in general practice: three years |
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| Year 4: | Specialist registrar four to six years |
GP registrar- one year | ||
| Year 5: | General practitioner total time in training: 4 years |
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| Years 6-8: | General practitioner total time in training: 5 years |
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| Year 9: | Consultant total time in training: minimum 7-9 years |
Consultant total time in training: 8 years |
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| Optional | Training may be extended by pursuing medical research (usually two-three years), usually with clinical duties as well |
Training may be extended by obtaining an Academic Clinical Fellowship for research. |
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