Become a member
To apply for SBNS membership click the link below and visit our application page.
SBNS is unable to give medical advice or recommend neurosurgeons. Please use an appropriate support group or your GP.
Become a Neurosurgeon
The management of neurosurgical patients requires excellent medical and surgical skills, a career in Neurosurgery offers many challenges and rewards.
Contact the SBNS Office
Follow the link below to use our contact form or to find the appropriate telephone numbers.
The foundation programme started in August 2005; some doctors obtain a limited amount of neurosurgical experience during their foundation years. There is then competitive entry into an eight-year run through neurosurgical training programme. Selection has been centralised for the UK (Ireland remains separate) and is hosted by the Yorkshire Deanery.
Basic Neuroscience Training (ST1, ST2, ST3)
- The exact content of this stage depends on the training programme. A typical training programme would include two years of neurosurgery and one year of four or six month blocks in related specialties including neurology, neuro-rehabilitation or neurophysiology, ENT, plastic surgery, neuro-intensive care or emergency medicine
- Training focuses on diagnosis and management of urgent and emergency neurosurgery patients, including acute brain and spine trauma
Intermediate Neurosurgery training (ST4, ST5)
- Full time neurosurgery
- Training concentrates on the range of basic neurosurgery, including basic micro-neurosurgery
Final Neurosurgical training (ST6, subspecialty year, ST8)
- Full time Neurosurgery
- Training concentrates on advanced neurosurgery, subspecialty care, and advanced micro-neurosurgery
- The subspecialty year will require prospective approval, may be taken at any time during final neurosurgical training and will frequently occur in a different training programme, or even abroad (see OOPE & OOPT)
- Final assessment for CCT
OOPE, OOPT, OOPR
- Out of Programme Experience (OOPE) is permitted when agreed prospectively by the programme director, post-graduate dean, SAC/JCST and GMC. A good reason to obtain experience outside of the scheduled programme is needed
- Out of Programme Training (OOPT) is permitted when agreed prospectively by the programme director, post-graduate dean, SAC/JCST and GMC. A good reason to obtain experience outside of the scheduled programme is needed. If approved for training, a number of specific additional requirements apply to the time spent
- Out of Programme Research (OOPR) is permitted when agreed prospectively by the programme director, post-graduate dean, SAC/JCST and GMC. A good reason to obtain research experience outside of the scheduled programme is needed for non-academic trainees
GMC (Post-graduate training page)
Note: This is the old system of training - it has been replaced by the Modernising Medical Careers training scheme. Doctors applying for neurosurgical training jobs should see the MMC website
From 1st July 1996 neurosurgical trainees entered the then newly-defined Specialist Registrar (SpR) training programme. The ultimate goal of training became the award of a Certificate of Completion of Specialist Training (CCST). Whereas in 1996 this came under the control of the Specialist Training Authority of the medical Royal Colleges (STA), it was still on the recommendation of the SAC. In September 2005 the Postgraduate Medical Education & Training Board (PMETB) took over this role for specialty and general practice training, so the term CCST was changed to Certificate of Completion of Training (CCT). The GMC has now taken on the responsibilities of PMETB, and is also responsible for maintaining and publishing a specialist register. All consultants, except those who have only been appointed in a locum capacity, and all those previously accredited through the SAC are included in the register. The Joint Committee on Surgical Training (JCST) is still responsible, on recommendation of the appropriate SAC, for recommending the award of CCT for UK-based trainees (or Certificate of Specialist Doctor in Ireland).
From January 1st 1997 it became a legal requirement for all doctors to be on the specialist register before they could take up a substantive consultant appointment.
The arrangements for flexible training within the specialist registrar grade were beneficial. The trainee could work a percentage of full time and if he / she so wished, could automatically work at 100% full time. The CCT date could therefore be annually modified according to the total time for the year.
All the training & accreditation requirements are held at the JCST website.
The SpR Training (NTN & VTN)
All training programmes in neurosurgery were for 6 years. Programmes had been devised by local trainers and agreed by the SAC. Many included rotational commitments such as Edinburgh – Dundee, or Bristol – Plymouth. It was possible for trainees to move between regions and deaneries where they had well-founded reasons, at the discretion of the postgraduate dean.
Assessment of progress remains a key feature of the training programmes and a Record of In-Training Assessment (RITA) is kept by the trainee and the postgraduate dean. Failure to maintain the RITAs or failure to inform the postgraduate dean of changes in training may mean that the SpR might lose their NTN. Assessments are carried out annually by the Dean or his representative. The trainee should make sure that any period of research or optional experience has prospective educational approval.
The intercollegiate specialty exam may be taken in two parts from the first year and usually from the fifth year. Alternatively it can all be taken together from the 5th year onwards, but failure in the exam does not prevent the trainee from entering the subsequent years; preparation for the examination should be part of the SpR training programme.
Failure to progress satisfactorily
The process for dealing with trainees not progressing well in their training programmes is in place mainly for the benefit of the trainees. If the training programme director identifies problems with training then the following stages of further review must be followed:
Stage 1 will be a period of targeted training to provide specific training needs, the trainee will be provided with a written statement of the programme they have to undertake and the criteria by which it will be judged they have achieved the required standard.
Stage 2 is a period of intensified supervision with the repetition of a part of the training programme and the lengthening of overall training.
Stage 3 is withdrawal from the training programme and would only follow formal action as described in stages 1 and 2. Trainees have the right to appeal against any actions that mean lengthening of training or withdrawal from the training programme.
SpRs should receive day release for 1 day a week during university terms or leave with pay and expenses to maximum of 30 days per year. These 30 days can accumulate over the whole programme but the full amount cannot be taken until after one year. In other words 6 months leave in a block can be taken with pay and expenses at some point in the programme.
Employment will not end for a period of six months after the date of completion of training, or after the date that the trainee is formally notified by the postgraduate dean that training is complete and he/she is eligible for CCT, whichever date is the later. A further contract can be awarded, at the dean's discretion, if the trainee is making reasonable steps to find a consultant post, is for a limited period and cannot be renewed or extended. After that the postgraduate dean offers counselling to those who are not placed in consultant posts. The position with regard to sub-specialty appointments remains unclear.
FTTAs, LATs, LASs
CCT training was open to all EU nationals with EU qualifications who satisfied the minimum criteria to enter the specialist grade. All overseas doctors with a right of residence in the UK could also enter CCT training and be given an NTN. Overseas doctors without right of residence could hold a visiting SpR post and required a Visiting Training Number (VTN), though recent changes to immigration law have now ended this option.
A Locum Appointment for Service (LAS) is designed to fill an SpR vacancy for a short period of time where there is little educational benefit in the post. When the vacancy is for a period longer than three months, prospective approval for a Locum Appointment for Training (LAT) can be given by the deanery, and recognised by the SAC. The LAT contract is the same as for any SpR, but the holder is not issued with a NTN or VTN. To count the LAT in later CCT training, prospective approval for this purpose is required from the SAC. LATs should not last for more than one year. A Fixed-term Training Appointment (FTTA) can also be offered to overseas doctors with no right of residence, the candidate would not be wishing to enter CCT training but wish to undertake some of the elements of a training programme.