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What Is A Registrar? (Key Roles And Responsibilities)

What Is A Registrar? (Key Roles And Responsibilities)

Updated on: December 3, 2023
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Written By Dr Ollie

Every article is fact-checked by a medical professional. However, inaccuracies may still persist.

The world of medicine and medical professionals is full of jargon and often confusing titles if you’re not a part of that world.

Before I started training to be a doctor myself, I definitely wouldn’t have been able to tell you what a registrar was.

A registrar is a middle-grade doctor who is training to be a specialist in one particular area of medicine. A registrar will have been a doctor for at least 4 years and will generally train for a further 4-6 years until they’re ready to take on the top job role of consultant.

If you’re ever admitted to hospital as a patient, you’ll likely meet a lot of registrars.

They’re a step between the more junior doctors who make up the majority of the physician workforce and the senior consultants who lead the team.

In this article, I’m going to look at the different types of registrar, what training you have to undergo to become one, what skills you need to be a good registrar and what they can expect to be paid working in the NHS.

Career Path And Progression

To start with, let’s look at how a doctor actually becomes a registrar and the training pathway that gets them there.

As I mentioned, a registrar is a middle-grade doctor, so they’re sort of halfway up the ladder from most junior doctor to senior consultant.

To begin, after graduating from medical school, every doctor has to complete the foundation training programme.

Foundation Programme

The foundation programme serves as an entry point for medical graduates to kick-start their careers.

It’s a two-year programme, during which doctors rotate through various specialties, often including general medicine, surgery, and emergency medicine, to gain a wide range of clinical experience.

These doctors are referred to as FY1s or FY2s, or indeed house officers or senior house officers.

Upon completion of the programme, medical graduates can choose to apply for a specialty training programme in order to become a registrar.

Specialist Training

Specialty training starts when a doctor decides on a particular area of medicine that they want to specialise in.

Instead of rotating through a lot of different teams as in the foundation training programme, they choose one department that they want to work in.

The term registrar refers to a doctor in a specialty training programme in their chosen field.

This specialty training typically takes 4-6 years and involves gaining more focused experience in their chosen field.

A paediatrics registrar taking a baby between hospital wards
A paediatrics registrar transporting a baby between wards

Registrars work closely with consultants to gain expertise and may engage in research, leadership or management activities to advance their knowledge and skills.

Throughout their training, medical registrars must complete assessments, attend workshops and conferences, and participate in audit and quality improvement projects.

These activities not only contribute to their professional development but also ensure they remain up-to-date with the latest medical advancements.

Consultant Role

Upon successful completion of specialist training, doctors become eligible to apply for a job as a consultant.

As consultants, they assume greater responsibility in decision-making and patient care.

They may manage and lead teams of junior doctors, nurses, and other healthcare professionals, as well as play a pivotal role in shaping the direction of their specialty within the hospital.

Consultants can also choose to further specialise in a sub-specialty, engage in medical education, or take on various leadership positions within the hospital or healthcare organisations.

Types Of Registrar

The term registrar is a general catch-all for any doctor who is currently in a specialty training programme.

What Is A Registrar Pixel Infographic

However, there are different ‘types’ of registrars, depending on their training pathway.

Medical Registrar

A medical registrar is a doctor specialising in a ‘medical’ specialty.

I know this might sound strange (aren’t all doctors specialists in medicine?) but areas of medicine are broadly divided up into either ‘medical’ or ‘surgical’ specialties.

Medical specialties include areas such as:

  • Cardiology
  • Hepatology
  • Dermatology
  • Respiratory
  • Rheumatology

A medical registrar is often one of the most senior doctors in the hospital overnight and out-of-hours, such as at weekends.

They’re who more junior doctors will call if they need advice about a patient and the consultant isn’t available.

They have relatively broad medical knowledge and will be able to come up with sensible treatment plans for almost any patient that they’re asked about.

Surgical Registrar

A surgical registrar is a doctor in the middle of their training to become a consultant surgeon.

While they’re ‘in training’ to become a consultant surgeon, they’re already generally regarded to be a ‘surgeon.’

They’ll perform operations by themselves, without the supervision of a consultant, with senior registrars only requiring advice or assistance with the most complex of procedures.

If you were to have your operation performed by a registrar, you’re having it done by a doctor who’s likely done that same procedure many hundreds of times before- not by a trainee.

Surgical specialties include areas such as:

  • Orthopaedics
  • Vascular surgery
  • Plastic surgery
  • General surgery
  • Neurosurgery

Surgical registrars will also work alongside consultant surgeons, assisting with surgical procedures, pre-operative assessments, post-operative care, and patient management.

GP Registrar

A GP registrar is a qualified doctor who is furthering their training within the field of general practice, preparing for a career as a general practitioner.

If you’re seen by a GP registrar at your local practice, you’re still being seen by a qualified doctor, just one that hasn’t fully completed their GP training yet.

Their role involves providing primary care services to patients under the indirect supervision of a qualified GP.

They essentially do the same job as a normal GP, but will just be able to ask questions to another GP should they come across a particularly tricky case they’re not sure how to manage.

A GP registrar is responsible for diagnosing and treating various medical conditions, offering preventative healthcare advice, and managing long-term health conditions.

What Does A Registrar Do?

Registrars play a crucial role in managing patient care in hospitals.

Their responsibilities vary depending on the setting they work in, but generally, they are involved in providing inpatient care, offering advice to other doctors, and conducting outpatient clinics.

The following subsections explore these aspects of a medical or surgical registrar’s role in more depth.

Inpatient Care

A registrar is responsible for overseeing and managing the care of patients admitted to the hospital under their specialty, ensuring their treatment is appropriate and effective.

They work closely with junior doctors, nurses, and other healthcare professionals to create and implement care plans, monitor progress, and make necessary adjustments in response to a patient’s changing condition.

They also review medical notes and schedule follow-up appointments as needed, ensuring patients receive the highest quality of care during their hospital stay.

Medical registrars are often charged with leading the acute medical on-call, serving as a referring doctor for the entire hospital, and acting as a general practice helpline.

Advice To Other Doctors

As relatively experienced medical professionals, registrars are often called upon to provide advice and guidance to other doctors in the hospital.

Because they’re training in only one area of medicine, a registrar’s knowledge of that particular area will far exceed other doctors who aren’t focused on that specialty.

This can include giving input on difficult or unusual cases, sharing their expertise on specific medical conditions, and offering support on clinical decision-making.

They also play a pivotal role in the education and training of junior doctors, offering guidance and mentorship to help them develop their skills and knowledge in a clinical setting.

Registrars may additionally be contacted by GPs working in the community as subject matter experts regarding their specialty.

Outpatient Clinics

In addition to their responsibilities in a hospital setting, registrars often run outpatient clinics where they diagnose, treat, and manage patients with a wide range of health issues.

Patients may be referred to these clinics by their GPs or they may be invited to return to the clinic following a recent hospital stay.

A junior doctor sat working in a clinic room
A registrar working in an outpatient clinic

They work closely with patients to develop individualised treatment plans, coordinate any necessary tests or investigations, and monitor progress over time.

Registrars may also be involved in conducting research, auditing clinical practice, and participating in continuing education to stay up-to-date with the latest advances in their chosen specialty.

UK Registrar Salary

A registrar’s salary depends on various factors such as their grade, years of experience, and the region in which they’re based.

In the NHS, a registrar’s base salary is broadly calculated depending on how long they’ve worked:

Years As A RegistrarBase Pay In The NHS
1-2£40,257
3-5£51,017
6-8£58,398

In addition to their base salary, registrars may also receive additional supplements based on factors like working hours and on-call commitments.

The more out-of-hours shifts you work as a doctor, the more supplemental pay you get.

Registrars can also choose to take on extra overtime shifts, as a locum, which will further increase their take-home pay.

It’s essential to note that the salary of a registrar can differ significantly depending on their location within the UK.

For example, doctors working in London may receive a higher salary due to the cost of living in the capital compared to other areas.

Additionally, various regional allowances and supplements may apply, further impacting the final salary package.

Skills and Competencies

Being a registrar is arguably one of the most difficult jobs in a hospital. To be able to do the job effectively, a doctor needs to have honed a certain set of skills.

Specialist Knowledge

A registrar must possess comprehensive specialist knowledge in their specific area of medicine or surgery, enabling them to accurately assess and treat a wide range of medical conditions.

This expertise is developed through years of education, training, and hands-on experience.

They should be familiar with the latest developments in their field, ensuring they provide the most up-to-date and evidence-based care to their patients.

Communication

Effective communication skills are essential for a registrar (as well as doctors in general).

They should be able to clearly and succinctly convey complex medical information to patients, families, and colleagues, both in spoken and written form.

Developing rapport and empathy with patients is crucial, as well as being able to listen actively and respond appropriately to their concerns.

Clear communication helps build trust between a registrar and their patients, which in turn can improve patient outcomes.

Leadership

Leadership skills are vital for a registrar, as they often oversee a team of junior doctors, nurses, and other healthcare professionals.

They should be able to delegate tasks efficiently, manage their team’s workload, and make confident, well-informed decisions in high-pressure situations.

Registrars also act as mentors for less experienced team members, providing guidance and support as needed.

A successful registrar should exhibit a strong sense of responsibility, accountability, and professionalism in their daily practice.

Frequently Asked Questions

How is a registrar different from a doctor?

A registrar is a type of doctor on a specific training pathway as opposed to being a distinct entity from a doctor. Every consultant physician, surgeon or GP will have been a registrar at one point in their careers, as they progressed up the training ladder to the top position of consultant.

What’s the difference between a GP and a GP registrar?

A GP registrar is a doctor training to be a GP. They’re fully qualified doctors and will have worked in the NHS for at least 2 years, but haven’t completed their postgraduate GP training. GP registrars do the same job as a GP but will always have the opportunity to ask questions to a more senior GP.

How long does it take to become a registrar?

It takes a doctor at least 2 years to become a registrar in the NHS. However, this is the minimum amount of time required to become a GP registrar and most doctors will have been qualified for at least 4 years before becoming a medical or surgical registrar.

Is a registrar a junior doctor?

A registrar is technically a grade of junior doctor. However, the term can be misleading as a senior registrar can have been practising medicine for over 8 years, seen thousands of patients in that time and potentially performed hundreds of solo operations.

What’s the difference between a senior registrar and a consultant?

A senior registrar is one step below a consultant on the medical training ladder. Once a senior registrar has completed their final specialty exams they’re eligible to apply for consultant job posts. Occasionally, a senior registrar will only remain a registrar as they’re unable to find a consultant job.

Final Thoughts

Registrars play an invaluable role in healthcare teams both inside and outside of hospitals.

Although technically a type of junior doctor, senior registrars will possess a vast wealth of knowledge and experience and are valuable resources to their patients and GPs alike.

Hopefully, you now more fully understand what a registrar is and what their roles and responsibilities are in a healthcare setting.

About the author
After studying medicine at the University of Leicester, Dr Ollie now works as a junior doctor in London. His interests include medical education and expedition medicine, as well as having a strong belief in the importance of widening access to medicine.