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Legislative changes
  1. J Brinklow1,
  2. A J Freemont2,
  3. H Zakhour1
  1. 1Royal College of Pathologists, 2 Carlton House Terrace, London SW1Y 5AF, UK
  2. 2Department of Pathology, University of Manchester, Manchester M13 9PT, UK
  1. Correspondence to:
 Professor T Freemont
 Division of Laboratory and Regenerative Medicine, School of Medicine, Stopford Building, University of Manchester, Oxford Road, Manchester M13 9PT, UK;

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Changes governing entry to the GMC’s Specialist Register and training in pathology specialties

The organisation and administration of postgraduate medical education and training in the UK is currently undergoing substantial change. One aspect of this change is the introduction of the Postgraduate Medical Education and Training Board (PMETB), which will subsume the Specialist Training Authority as the UK competent authority for postgraduate medical training.

The “general and specialist medical practice (education and qualifications) order”, which sets out the legislative framework for the PMETB was passed by the Westminster and Scottish parliaments during March and April 2003, respectively, and made law at the May 2003 Privy Council meeting, although the PMETB will not take up its full statutory powers until September 2005.

Since 1996, it has been a legal requirement for a doctor to have his or her name entered on the Specialist Register of the General Medical Council (GMC) before taking up a substantive, honorary, or fixed term National Health Service consultant post in the UK. One of the major roles of the PMETB will be to oversee important legislative changes for direct entry to the GMC’s Specialist Register.

There are currently a variety of routes for entry to the Specialist Register, including direct entry for overseas qualified doctors who can provide evidence that they have been awarded a specialist qualification from outside the UK, which demonstrates that they have received training and acquired the breadth and depth of expertise equivalent to that required for the award of a certificate of completion of specialist training in their specialty.

The new legislation, commonly known as “Article 14”, will allow the PMETB to consider any combination of qualifications and/or training and experience gained anywhere in the world to be evaluated as part of an application for entry to the Specialist Register. Those doctors not reaching the standard required for entry to the register will be able to have top up training recommended. The PMETB has indicated that medically qualified doctors wishing to apply to the register under Article 14 will provisionally be considered from July 2005, although the PMETB will be unable to give doctors a decision on their application until they take up their statutory powers in September.

“Those doctors not reaching the standard required for entry to the register will be able to have top up training recommended”

Doctors wishing to apply for entry to the Specialist Register in a pathology or related specialty (excluding haematology and immunology) will have their application evaluated in the first instance by the Royal College of Pathologists. Recognising the importance of ensuring that potential applicants are as well informed about the new process as possible, the Royal College of Pathologists has set up a system to facilitate this.

The first step for anyone interested in potentially making an application to the register under Article 14 is to read the information provided on the college website ( >Education> Changes to Postgraduate Medical Education> Article 14 and new arrangements for specialist registration).

Those who decide that they want to take an application forward can express an interest in applying for entry to the register under Article 14 in the same section of the college website. Doctors who express an interest will be kept informed of developments by the college.

Applications to the register in haematology and immunology and related subspecialties will be dealt with by the joint committee on higher medical training at the Royal College of Physicians, and doctors wishing to apply to the register under Article 14 in these specialties should look at the committee’s website for further details ( >Other routes).

As its name suggests, the PMETB is also charged with taking an overview of the provision and standards in medical postgraduate education and assessment. There have already been changes in the structure of medical training that could impact greatly on trainees from abroad who might wish to join pathology training programmes in the UK. The assessment processes are also changing. In general, these will have less of an effect, but it is well worth prospective overseas candidates for the MRCPath examination finding out what changes are being instituted and when.

In this area too, the Royal College of Pathologists is only too willing to assist. The first step for anyone wishing to use the assistance offered through the college is to read the documents on the website ( The postgraduate education department at the college is pleased to deal with any enquiries, either by telephone, email, or post. Anyone wishing to make an enquiry should email Jennifer Barber in the first instance at Any emails that require the attention of another member of staff or department in the college will be forwarded appropriately.

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