Trust grade
A service post employed by one NHS trust — clinical fellow, junior clinical fellow or LED. Open year-round, IMG-friendly, and the usual first NHS job.
Training post
A national training number in a deanery programme, leading to CCT and the specialist register. Fixed recruitment rounds and heavy competition.
What is the difference between a trust grade job and a training post?
| Trust grade | Training post | |
|---|---|---|
| How you get in | Apply directly to trusts on NHS Jobs, often year-round | National recruitment rounds with fixed windows and scoring |
| Competition for IMGs | Realistic first job with no UK experience | Highly competitive; UK experience usually expected |
| Visa sponsorship | Almost always available (Health and Care Worker visa) | Available, but you must first win the training number |
| Progression | No CCT; progress via portfolio, exams and later applications | Structured to CCT and the specialist register |
| Rotations | Set by the trust; may stay in one department | Planned rotations across the deanery |
| Study leave and budget | Varies by trust and contract — check before accepting | Funded study leave and defined curriculum support |
| Best for | Getting into the NHS quickly and building UK evidence | Doctors ready for a defined route to consultant |
How do you move from trust grade into training?
- 1. Build 12–24 months of UK evidence. Audits, quality improvement, teaching, and a completed portfolio with WBAs signed off.
- 2. Pass the right exams. MRCP, MRCS, MRCPCH or MRCOG part exams score heavily in specialty applications.
- 3. Get a UK-based referee. Consultant references from your trust carry far more weight than overseas references.
- 4. Apply in the national round. Watch the Oriel timetable — missing a window costs a full year.
Trust grade vs training: frequently asked questions
What is a trust grade job in the NHS?
A trust grade post (also called clinical fellow, junior clinical fellow, LED or SAS-track) is a service job employed directly by an NHS trust rather than a national training programme. It does not carry a National Training Number, but it counts as NHS clinical experience and usually offers visa sponsorship.
Is a training post better than a trust grade post for an IMG?
A training post leads to a CCT and consultant eligibility, so it is the stronger long-term option. But training recruitment is competitive and usually expects UK experience, so most IMGs start in a trust grade post for 12–24 months and apply to training from there.
Do trust grade jobs sponsor Skilled Worker visas?
Most do. NHS trusts are licensed sponsors and doctor roles sit on the eligible occupation list, so trust grade posts routinely issue a Certificate of Sponsorship for the Health and Care Worker visa.
Does trust grade experience count towards training?
Clinical competence gained in a trust grade post counts towards your evidence and portfolio, and can support specialty application scoring. It does not automatically shorten a training programme, though it can support an application for a Portfolio (CESR) route later.
Do trust grade doctors earn less than trainees?
Basic pay is broadly comparable at equivalent levels, and some trust grade posts pay more because of enhanced rotas or recruitment premia. The difference is structure: trainees get funded study leave, guaranteed rotations and progression; trust grade terms vary by trust.