What Is An SHO Doctor? (Senior House Officers Explained)

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.

Whether you’re a patient or medical professional in the NHS, you may come across the term “SHO doctor”.

An SHO, or Senior House Officer, is a non-consultant hospital doctor, often in the early stages of their medical career. They have completed at least one year of postgraduate medical training but are still supervised by consultants and registrars during their day-to-day work in hospital.

Working as an SHO allows doctors to broaden their clinical experience and develop their skills in a specific specialty, such as surgery, paediatrics, or emergency medicine.

SHOs typically work in different rotations, gaining experience across multiple medical fields, which ultimately helps them to determine their area of interest and pursue further postgraduate training if desired.

Key Takeaways

  • An SHO is a non-consultant hospital doctor in the early stages of their postgraduate medical career.
  • SHOs work under the supervision of consultants and registrars, gaining experience in various medical specialties.
  • Completing an SHO role is a crucial step in a doctor’s career development, leading to further qualifications and training opportunities.

Understanding What An SHO Is

The term “SHO” is actually a legacy title for doctors. However, it’s still used today but with a slightly different meaning.

What Is An SHO Doctor Pixel Infographic

Historical Doctors’ Titles

Historically, in the medical profession in the United Kingdom and some other countries, the terms “house officer” and “senior house officer” referred to specific stages of training for junior doctors.

House Officer (HO):

  • This was the initial and most junior clinical grade for a doctor who had just graduated from medical school. Doctors would spend one year as a house officer.
  • During this year, they would typically undertake two six-month rotations in different specialties to gain a broad base of clinical experience.

Senior House Officer (SHO):

  • Following their year as a house officer, doctors would then progress to the role of senior house officer.
  • This stage of training could last for several years and would involve rotations through various specialties.
  • The SHO grade provided the doctor with the opportunity to hone their clinical skills, often with a view to specialising in a particular field in the future.

Modern Use Of The Term SHO

In 2005, the UK introduced the Modernising Medical Careers (MMC) initiative, which reformed postgraduate medical training.

As a result of this initiative, the traditional house officer and senior house officer roles were replaced by the Foundation Programme, which comprises Foundation Year 1 (FY1) and Foundation Year 2 (FY2).

After this, doctors choose a specialty and enter specialty training, which can vary in length depending on the chosen field.

The modern equivalents of HOs and SHOs are FY1 and FY2 doctors respectively.

While the term HO (House Officer) is not used as frequently today, SHO as a title for junior doctors has persisted.

However, its modern use refers to any doctor FY2 and above, who hasn’t entered specialty training as a registrar yet.

This generally encompasses doctors anywhere from 1 to up to 5 years post-graduation from medical school.

Qualifications And Training Of An SHO

As described above, an SHO is a junior doctor who has completed at least one year of work in the NHS after graduating from medical school.

This means they are officially a ‘doctor’, can prescribe medicines, review patients and do everything else you might expect a doctor to do.

However, an SHO doctor is still very much in training.

That’s because it can actually take a doctor up to a decade after graduating from medical school to complete their postgraduate training.

An SHO doctor working with a more senior surgeon

This means that while they can operate independently as a doctor, they will always, on paper at least, be supervised by a more senior doctor.

This means that there should always be a more senior doctor that they could turn to and ask any questions about a patient’s treatment that they might need to.

SHO Salary In The NHS

As an SHO doctor working within the NHS, your pay depends on various factors, such as your experience and how many hours you work.

Generally, you can expect to earn a basic salary while working 48 hours per week.

You’ll also receive extra pay for additional hours, night shifts, weekend work, and on-call allowance.

SHOs in England can expect an approximate basic salary between £34,000 and £40,00 per year, depending on exactly where in their training they are.

It’s important to note that NHS pay is reviewed annually by the Review Body on Doctors’ and Dentists’ Remuneration (DDRB).

They make recommendations to the government, and any changes to pay rates apply starting April 1st.

Roles And Responsibilities Of An SHO Doctor

In this section, I wanted to explain in a bit more detail what an SHO doctor actually does.

Ward Round And Ward Jobs

As an SHO doctor, your primary responsibility involves participating in ward rounds where you assess and review patients’ care plans with a more senior doctor.

During these rounds, you liaise with the multidisciplinary team, ensure proper documentation, and update patient records.

Your ward jobs may also include the timely prescribing of medications, ordering investigations, and discharging patients.

Assisting With Procedures

In the role of an SHO doctor, you may also be actively involved in assisting with various procedures and operations.

Depending on your specialty, you may find yourself working alongside consultants and registrars to carry out tasks such as suturing, catheterisation, or even assisting in surgeries.

This hands-on experience helps you to develop your clinical skills and knowledge, making you a more competent physician.

Showing More Junior Doctors The Ropes

As an SHO, another essential part of your role is providing guidance and support to more junior doctors, such as those in their first foundation year.

You’ll be expected to share your knowledge and experience by offering practical advice, answering questions, and helping them navigate the challenges of their early medical careers.

This mentorship role is entirely informal but is a crucial skill to develop as you advance further in your medical career.

Career Path And Advancement

SHO doctors, in the grand scheme of things, are very much at the start of their medical careers.

From SHO To Registrar

An SHO is a junior doctor in training, working towards becoming a registrar or consultant in their chosen specialty.

During a doctor’s time as an SHO, they gain extensive hands-on experience, develop their diagnostic and treatment skills, and learn how to interact effectively with patients and colleagues.

To progress from an SHO to a registrar role, a doctor needs to enter into specialty-specific training.

This transition typically requires completing additional examinations, interviews, and rotations based on the chosen specialty.

Continuing Professional Development

As a doctor, your learning journey doesn’t stop after completing your medical degree or transitioning to a higher position.

Continuing professional development (CPD) is an essential aspect of maintaining your skills, knowledge, and competencies throughout your career.

CPD can take various forms, such as attending conferences, participating in workshops, publishing research articles or taking additional courses relevant to your field of practice.

SHOs, just like any other type of doctor, will have to do some form of CPD over the year that they’re practising in the NHS.

Final Thoughts

The evolution of the SHO role within the medical profession underscores the dynamic nature of healthcare and the UK’s commitment to refining medical training.

This transitional phase for junior doctors is not just about accruing clinical skills, but also about character-building, decision-making, and developing the interpersonal skills vital for patient care.

As the term “SHO” retains its resonance, even with its changing definitions, it stands as a testament to the adaptability and progressiveness of medical education in the NHS.

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.