Candidates often get confused by the job titles used by hospitals and clinics in the Middle East and other parts of the world. "Consultant" is used often interchangeably with "Specialist" but sometimes it's not and "Specialist" actually means quite a different role. Likewise, a "General Practitioner" is not a GP as we understand to be an independent primary care physician but a house officer and a "Family Physician" is a GP. If that is not confusing enough, there are also "Consultant Family Physicians" and "Specialist Family Physicians". And what is a hospitalist, a pulmonologist and a physiatrist? How can you know what job you are actually applying for?
Many candidates get very frustrated when they apply for a job only to find out that the job is not actually what they thought it was. In this article we explain how to decipher job titles, understand what skills and experience the employer is looking for and find the right roles for you.
After graduating from medical school, junior doctors start their career with an internship in most countries of the world followed by several years of postgraduate training in their chosen specialty, culminating in a final exam, usually called a board certification or fellowship. At the end of this lengthy training, one is considered to be a specialist with an area of expertise in a clearly defined field such as primary medical care or one of the secondary medical care specialisms. Some doctors proceed to sub specialist training by completing further fellowships and become super specialists or sub specialists with a high degree of expertise in a narrow field.
The UK and Ireland, which always like to be different, add an extra component to the specialist training called a Certificate of Completion of Specialist Training (CCT) in the UK or Certificate of Specialist Doctor(CSD) in Ireland. These certificates conclude specialist training and are obtained without examination but do require a period of time spent in higher professional training. The fellowship exam is taken at the conclusion of basic or intermediate level specialist training usually 2-4 years before the CCT is obtained.
The majority of medical graduates become general practitioners, that is specialists in primary care, usually practising from community clinics or occasionally hospital based primary care departments.
A medical job title describes the speciality of the physician and the level of seniority, from recent medical graduate to experienced specialist.
A consultant is the title of a fully qualified medical specialist in the United Kingdom and Ireland and is commonly used in healthcare systems which are based on those of the United Kingdom and Ireland such as Australia, New Zealand and the Middle Eastern gulf states. That seems straight forward but there are regional variations on how this title is applied and if you are not familiar with this, you may find yourself applying for a job which is completely unsuitable.
United Kingdom and Ireland : this title is limited to specialists in secondary or tertiary care and is not used for physicians practising in primary care. Doctors using this title must be listed on the specialist register of the General Medical Council or Irish Medical Council, the national professional regulatory authorities.
Australia and New Zealand: as with the United Kingdom, doctors using this title must be registered specialists in a secondary or tertiary care field with the Medical Council of New Zealand (vocational registration) or the Medical Board of Australia (specialist registration).
Middle East: in this area, the title consultant means a specialist in primary, secondary or tertiary care and is usually applicable only after one to five years experience of working as a specialist after passing the board or fellowship exams and obtaining specialist registration with the appropriate licencing body. This means that a typical General practitioner uses the title consultant in family medicine or consultant family physician. Each jurisdiction has its own regulatory authority and requirements.
A specialist is the most commonly used title worldwide for a physician who has completed postgraduate medical training and obtained specialist registration or status. The exceptions are the UK, Ireland and the Middle East Gulf States which use the term consultant, as described above.
The Middle East uses the term specialist for a junior consultant who has less than one to five years experience after specialist registration. This includes general practitioners who are called specialists in family medicine or specialist family physicians.
Another complicating factor is the use of the term “associate specialist” in the UK. This is a title for a subconsultant grade physician who is not accredited as a specialist formally but has some experience working in a field of secondary healthcare. In other words the associate specialist is not a specialist at all but a junior doctor who has not completed specialist training.
General practitioners are primary care physicians, and this is the title used in the United Kingdom, Ireland, Australia and New Zealand. In Canada and the USA the title family physician is used instead and the Middle East complicates the situation further by using the terms consultant or specialist family physician, or consultant or specialist in family medicine, depending upon the number of years of experience the physician has after the completion of postgraduate training and certification.
In the Middle East, a General Practitioner is a junior doctor and the equivalent of a house officer or registrar as described below. Candidates should be aware of this when considering jobs in the UAE, Qatar, Saudi Arabia, Oman, Bahrain and Kuwait.
In the USA, junior doctors are described as interns and residents, the former completing their first postgraduate year and the latter in specialist training programmes from postgraduate year 2 (PGY2) upwards.
In the UK, Ireland, Australia and New Zealand, junior doctors are referred to as house officers or registrars. House officers are physicians in the postgraduate years 1 to 5 who work under the supervision of registrars and consultants or specialists. Registrars are middle grade doctors who are at the level of PGY3 and upwards and usually well on the way to training in their chosen medical speciality.
We have now sorted out the various titles for different levels of seniority but different countries use different names for some of the medical specialisms. the common ones are listed below.
Hospitalist is a unique North American job title which is now being copied in the Middle East and in other parts of the world. The position is that of a specialist or consultant in general internal medicine who manages in -patients only and does not conduct any outpatient clinics. This specialist forms the backbone of a hospital service on a 24 hour basis, managing acute medical admissions. Paediatric hospitalists are the equivalent of adult hospitalists working in children’s hospitals.
The pulmonologist is a North American job title for a respiratory physician; that is a physician trained as an internist or general physician, and subsequently specialising in respiratory diseases.
The physiatrist is a North American job title for a physician specialising in rehabilitation and physical medicine.
Now that we have given an overview of the various job titles which are used by jobs in different parts of the world, the candidate must now face the task of selecting suitable jobs for applications.
The first step is to review the job title and the location of the job. This will give you some idea of what the title actually means. For example, if the job title is for a consultant family physician in Dubai, you know that this job is for a qualified and experienced general practitioner / family physician. You must have at least one to five years of experience after certification as a general practitioner to qualify for this position. You will be expected to hold the MRCGP and CCT if from the UK, the American Board of Family Medicine if from the USA or equivalent qualifications from other countries.
If the job title is a family physician and the location is Canada or Australia, you can be confident that this job is for standard general practitioner and the number of years of experience post qualification is generally not an issue unless the employer specifically seeks an experienced physician.
In Saudi Arabia, the job title radiologist specialist is generally for a recently qualified radiologist whereas the title radiologist consultant is for a more experienced specialist with at least three to five years experience after specialist certification.
Once you understand the job title and location, your next step should be to read the job description thoroughly including the essential (ie. non negotiable) and preferred (ie. negotiable) requirements for the position. Many candidates skip this step and end up applying for jobs they are not qualified to do. Most job descriptions will include a list of duties followed by a list of requirements for eligibility for the position. You should pay attention to the qualifications which are required by the employer and the number of years experience the employer is stipulating.
It should be noted that in the Middle East, the requirements for credentialing (ie obtaining a licence to practice) can be different from those for privileging (ie. obtaining rights to practice in a specific hospital or clinic). Hospitals often have criteria which are more stringent than those of the regulatory authority which means that you may be granted a licence to practice your speciality in a jurisdiction but may be rejected by a hospital on the grounds of qualifications or experience. Some hospitals accept only applicants holding preferred qualifications and / or defined levels of experience regardless of licence status. For more information, read about credentialing and privileging of physicians in the Middle East.
These tips should help you understand the meaning of the job titles across the world and help you to search for the appropriate job titles for job applications. If you have any questions or doubts please contact us for clarification.
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