Following completion of the House Jobs, and acquisition of Full Registration, UK doctors may begin specialist training. In the initial phase, this involves seeking further six month contracts in appropriate specialities at the grade of Senior House Officer (SHO). Over a period of two to four years, a prospective specialist will change jobs (and frequently hospital) every six months so as to gain experience in and around their chosen subject. What counts as appropriate is determined semi-explicitly by the various Royal Colleges, who exercise responsibility for the Post-Registration training of all UK Doctors. During this period of time, it is common (well, effectively mandatory) to sit the relevant examination of the Royal College, since advancement to the next grade of training is virtually impossible without this. By the completion of the SHO phase, the doctor is usually 4 years out of Medical School.
SHO hours of duty are very similar to that of the JHO, and although they often have a JHO whom they supervise, they are often very much in the front line. Remuneration is calculated in exactly the same way, from a starting basic salary of £23190 rising to £ 30965 after 6 years. Additional duty hours (On-Call) are also calculated at 50% of the normal hourly rate. Malpractice insurance remains covered by the State.