Pre-registration house officer

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Pre-registration house officer (PRHO), often known as a houseman or house officer, is an obsolete term for a grade of junior doctor that was until 2005 the only job open to medical graduates in the United Kingdom who had just passed their final examinations at medical school and had received their medical degrees.

Newly qualified doctors are only allowed provisional registration with the General Medical Council, hence their first jobs are prior to full registration with the GMC and these jobs were named pre-registration house officer jobs, and they usually consisted of two six-month jobs; one predominantly involved with general surgery (often being called a house surgeon), and one predominantly involved with general medicine (often being called a house physician). PRHO was the lowest grade in the medical hierarchy of qualified doctors in the National Health Service, and was the doctor most often called by nursing staff to see patients on hospital wards, especially at the most unsocial hours of work shifts. After satisfactory work reports in both house jobs the PRHO gained full registration with the General Medical Council, which is a legal requirement to be able to work in all other medical jobs in the UK. Although the PRHO year was taken after graduating from university, the supervision of the PRHO was the responsibility of the medical school from which the PRHO graduated, and a representative of that medical school was responsible for signing the registration forms which go to the General Medical Council to certify that the PRHO year had been completed successfully. After completing the PRHO year, the junior doctors usually became Senior house officers to further their career in the NHS.

NHS Medical Career Grades
Old system New system (Modernising Medical Careers)
Year 1: Pre-registration house officer (PRHO) - one year Foundation Doctor (FY1 and FY2) - 2 years
Year 2: Senior house officer (SHO)
a minimum of two years, although often more
Year 3: Specialty Registrar (StR)
in a hospital speciality:
minimum six years
Specialty Registrar (GPST)
in general practice:
three years
Year 4: Specialist registrar
four to six years
GP registrar- one year
Year 5: General practitioner
total time in training: 4 years
Years 6-8: General practitioner
total time in training:
5 years
Year 9: Consultant
total time in training:
minimum 7-9 years
total time in training:
minimum 8 years
Optional Training may be extended by pursuing
medical research (usually two-three years),
usually with clinical duties as well
Training is competency based, times shown are a minimum.
Training may be extended by obtaining an Academic Clinical
Fellowship for research or by dual certification in another speciality.

Following changes in postgraduate medical education, from 2005, what was the PRHO year now forms the first year of Foundation Training (Foundation Year 1), and trainees during this year now have the job title of Foundation House Officer 1 instead of PRHO. Despite this, they are still often referred to as House Officers by themselves and other hospital staff.

In other parts of the world, this stage is generally referred to as medical internship.

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