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in the
General Medical Council’s list
, or resister – in order to prac-
tise. A doctor who treats patients, as opposed to one who only does re-
search, is called a clinician. Primary care for patients (the first contact
with the medical team) is provided by a doctor who is known as a
general practitioner (GP),
or family doctor. GPs usually work in a
group practice. Larger group practices work in a building called a
health center.
The basic hospital chain of command remains unchanged. In Brit-
ish hospitals, for example, it is the
consultant
– a doctor, whose name
appears on patients’ notes and who carries ultimate responsibility. A
consultant is a fully qualified specialist. There may also be some asso-
ciate specialists – senior doctors who do not wish to become consult-
ants. In addition, there is at least one medical (or clinical) director,
who is responsible for all of the medical staff.
Next in the line is the registrar, then senior house officer and then
house officer. A
specialist registrar
(SpR) is a doctor who has com-
pleted the Foundation Programme, and is training in one of the medi-
cal specialties. There are also some non-training registrars – doctors
whose training has been completed, but they don’t wish to specialize
yet. A
senior house office (SHO)
is in the second year of postgradu-
ate training. The title is now Foundation Year 2 doctor (FY2), but the
old terms SHO are still used. A
pre-registration house officer
(PRHO),
or house officer, is a newly graduated doctor in the first year
of postgraduate training. After a year, he or she becomes a registered
medical practitioner. In the current system of training, the Foundation
Programme, the name for these junior doctors is Foundation Year 1
doctor (FY1).
Specialist doctors
, for example pediatricians, generally work in
hospitals. Such specialist as
cardiologist
specializes in diseases of the
heart and circulation, or cardiology, a
geriatrician
is a specialist in
diseases of elderly patients, or geriatrics, etc.
Nurses working in a hospital have the following grades:
1)
student nurse
– a nurse who is still in training
2)
staff nurse
– a nurse who has completed the training course
3)
charge nurse
– a more experienced nurse who is in charge of, or
responsible for, a ward or department
4)
nurse manager
– a nurse who is in charge of several wards.