Box 1 Medical training grades in Ireland

Intern – the grade undertaken immediately upon completion of medical school. Completion of this grade is required as a component of under-graduate medical education in Ireland.

Senior House Officer (SHO) – this grade comprises the first (initial) stage of specialist training in hospital medicine and is usually 2 years in duration.

Specialist Registrar (SpR) – this grade comprises the second (higher) stage of specialist training in hospital medicine and can be up to 7 years in duration depending on the specialty.

GP Trainee – this grade comprises the combined equivalent of SHO and SpR training in general practice and is 4 years in duration.

Registrar/Senior Registrar – this is a grade, usually undertaken between SHO and SpR grades in hospital medicine. This grade is not officially recognised as a training grade although some posts may be assigned as training posts.

Consultant – this is the pinnacle grade in hospital medical training and comprised those doctors who have completed their SpR training and who can practice independently.

General Practitioner (GP) – the equivalent grade of a consultant in general practice.

Clinical Attachment/Observer – this is not an official medical grade but rather a shadowing role that is used to give the doctor familiarity with a new hospital or health system environment. This role is unpaid.