We offer training in 29 specialties. Here you can find out more about these specialties and what they involve.
Remember, before you undertake Higher Specialist Training, generally speaking you must complete Basic Specialist Training (BST) in a relevant specialty.
Training bodies are supported and funded by HSE NDTP
2021 Basic Specialist Training curricula
2020 Basic Specialist Training curricula
Please click on required specialty below
Cardiology deals with diseases of the heart and circulatory system.
Pathological processes in the vascular tree can arise as a consequence of dysfunction in other systems. The pathological processes involved, the physical impact of these conditions, and their psychosocial effects must be thoroughly understood.
Cardiology sits on the cusp between medicine and surgery. There are a lot of practical aspects to the specialty so cardiologists require good hand-eye coordination as well as good decision making skills.
Cardiology has a rich and rapidly evolving evidence base. Developments in the specialty have led to sub-specialisation is areas such as cardiac ultrasound, electrophysiology, adult congenital heart disease, or preventive cardiology. Your interest in sub-specialty topics will be facilitated during training.
Training in Cardiology is completed in two stages:
Our Higher Specialist Training programme in Cardiology offers Dual Training, which is additional training in General Internal Medicine.
Dermatology deals with the structure, functions and appearance of the skin, hair, nails and mucous membranes (mouth and genitalia), and the impacts on these of primary and systemic diseases.
Skin, the largest organ in the human body, can be affected by over 2,000 diseases. Besides the pathological processes involved and the physical impact of these conditions, the psycho-social effects must also be understood. Diseases affecting skin and hair can have a serious impact on a patient’s appearance, comfort, and psychological well-being. A dermatologist is in a position to drastically improve a patient’s quality of life, which brings enormous job satisfaction.
Dermatologists have at their disposal, a huge variety of treatments to manage a tremendous number of diseases, including novel immunomodulatory drugs, phototherapies, laser treatments and cryotherapy.
Dermatologists can develop subspecialty interests such as paediatric dermatology or occupational dermatoses.
Mainly an outpatient specialty with a less demanding on-call workload, Dermatology offers wide clinical variety and a good work-life balance.
Training in Dermatology is completed in two stages:
Gastroenterology is the study of diseases involving the digestive tract, liver and pancreas, which include chronic inflammatory bowel disease, autoimmune conditions involving the liver and pancreas, functional bowel disorders, coeliac disease, dysmotility disorders, GI cancers and many more.
Besides the theory behind GI disease, Gastroenterologists spend a significant proportion of their time performing procedures ranging from basic diagnostic endoscopies including gastroscopies and colonoscopies to both diagnostic and therapeutic procedures including Enodscopic ultrasound, ERCP (endoscopic retrograde cholangiopancreatopgraphy), double balloon enteroscopy and more advance interventional luminal endoscopy.
Within the specialty there is considerable scope for sub-specialisation e.g. Hepatology (viral Hepatology, transplant Hepatology), luminal Gastroenterology, functional disease, interventional endoscopy and pancreaticobiliary medicine with significant opportunity for research.
Training in Gastroenterology is completed in two stages:
General Internal Medicine deals with the prevention, diagnosis and treatment of adult diseases. Doctors specialising in General Internal Medicine are known as physicians.
Physicians need expert knowledge of a wide range of common acute disorders due to the type of patients they encounter. They often have to manage seriously ill patients with undifferentiated or multi-system disease processes.
The vast majority of physicians have a subspecialty interest in diseases affecting particular organs or organ systems. In Ireland there are 16 General Internal Medicine subspecialties:
Generally speaking, if you want to pursue a career in one of the above specialties, you will need to complete two stages of training:
You should read the entry requirements for Higher Specialist Training in your preferred specialty carefully. You will find this information in the Higher Specialist Training curriculum for that specialty, available on this web page.
We do not offer Higher Specialist Training in General Internal Medicine, however the following specialties offer ‘Dual Training’ in Higher Specialist Training, which means that you complete additional training in General Internal Medicine (e.g. participating in acute unselected medical take):
Dual Training is of considerable benefit to doctors in the above specialties due to the type of the patients they encounter.
Genitourinary Medicine (GUM) is a varied specialty primarily related to the treatment and prevention of sexually transmitted infections (STIs).
A large part of the work is involved in the clinical management of patients with HIV infection at all stages of disease, including inpatient management. The work involves a number of non-infectious medical genital problems such as dermatoses. A number of GUM departments also offer other sexual health services such as contraception, colposcopy (for the diagnosis and treatment of cervical dysplasia) and sexual dysfunction.Doctors in this specialty work closely with colleagues in Public Health Medicine, Infectious Diseases, Clinical Microbiology and Obstetrics/Gynaecology. They also work with marginalised groups for whom they frequently advocate as they may not have a voice of their own. Doctors in this specialty see lots of younger people. It is very rewarding to see patients (particularly our HIV positive patients) respond quickly to treatment. Also, as a specialty, GUM is fast changing and never boring. There are loads of research opportunities.
Training in Genito-Urinary Medicine is completed in two stages:
Geriatric Medicine is the branch of medicine that focuses on health care of older people. It aims to promote health and to prevent and treat diseases and disabilities in older adults.
A trainee in Geriatric Medicine should develop expertise the clinical, rehabilitative, preventive, and social aspects of illness in the older adult. Specific expertise should be gained in the comprehensive assessment and management of older people with acute and chronic illness in a wide variety of clinical settings – in hospital, at the out-patients department, in an ambulatory care setting, in continuing long term care & in the patients’ own home.
This group of highly trained and experienced geriatricians are experts at managing the complex care of older adults, and they work closely with other physician specialists to achieve the best results for each patient.
Our geriatricians act as liaisons between patients and their loved ones, their medical teams, and their nursing homes or senior living communities. They keep everybody in the loop concerning treatment plans, day-to-day progress, and any necessary follow-up arrangements.
Training in Geriatric Medicine is completed in two stages:
Training Haematology is completed in two stages:
The three main aspects of this specialty are diagnostic histopathology, cytopathology and autopsies.
Diagnostic histopathology involves making diagnoses based on the microscopic examination of tissues removed during various operative interventions and procedures such as endoscopy, biopsy or resections. The biopsy or surgical specimen is processed and histological sections are placed onto glass slides.
Cytopathology deals with diseases on the cellular level. A common application of cytopathology is the smear test, used to detect precancerous cervical lesions and prevent cervical cancer.
A histopathologist also conducts postmortem examination of the body to determine the cause of death (autopsy).
Training in Histopathology is completed in two stages:
Training in Immunology is completed in two stages:
Infectious Diseases is a clinical specialty of internal medicine focusing on the assessment, diagnosis and management of acute and chronic infections. Besides these specialty specific elements, trainees in Infectious Diseases must also acquire certain core competencies which are essential for good medical practice. These comprise the generic components of the curriculum.
Training in Infectious Diseases is completed in two stages:
Medical Oncology is a medical discipline rather than surgical, and focuses on developing expertise in the management of cancer patients.
The management of care should be based on well-established standards and should ensure that the patient is cared for as a whole person. This care involves clinical and other investigations, management of the complications of the disease and its treatment and the provision of appropriate emotional, social and psychological support for patients and their families.
The medical oncologist is an essential member of the cancer team and is frequently the central figure in the provision of total care for the cancer patient in the multidisciplinary setting.
Training in Medical Oncology is completed in two stages:
A Trainee in Neonatology must have experience in the transport of the sick newborn and have a full understanding of the principles and practice of regionalisation of perinatal care including transfer of high risk pregnancies to appropriate centres. The practice of neonatal/perinatal medicine involves the treatment of newborn infants at all levels of care from healthy newborns to those who require special and intensive care. An element of counselling is also incorporated within the practice, especially with regards to parents whose foetus is at significant risk.
Neonatology encompasses the management of prematurity and all the attendant physiological and pathological challenges as well as the diagnosis and management of congenital anomalies (identified both ante- and postnatally). It includes care of the well and sick infant in the newborn period, as well as long term follow-up of certain infants at risk of complications including neuro-disability. As such it has a very broad remit. There are significant acute and neonatal intensive care (NIC) components, but it also addresses the chronic management and developmental issues of graduates of the NIC unit.
Many neonatologists are involved in clinical and basic science research to further our understanding of this special population of patients. Trainees must participate in care and management of the foetus and new-born in collaboration with maternal foetal medicine specialists and paediatric subspecialists. Trainees must be competent in the management of the critically ill newborn infant, including techniques of resuscitation, airway support, electric vital signs monitoring, temperature control and nutritional support.
This specialty training builds on and further develops the knowledge and skills acquired during the first two years of the HST General Paediatrics programme.
Nephrology is a predominantly clinical specialty dealing with diseases of the kidneys as they affect people of all ages.
Besides the pathophysiological processes involved and the physical impact of each condition, psycho-social effects must also be understood. The potential benefits and risks of specific treatments must be learned and experience gained in the multi-disciplinary approach to management of patients with kidney disease.
The physician may later wish to may develop subspecialty expertise in areas such as transplantation, obstetric medicine, vasculitis, etc so it is important that an interest in such topics can be facilitated during training.
Training in Nephrology is completed in two stages:
Trainees in Neurology must take responsibility for seeing new patients, undertake ward consultations, and operate at a level of responsibility which would prepare him/her for practice as an autonomous consultant neurologist. The trainee should undertake three outpatient clinics weekly throughout the training period. This may be reduced to two, but never routinely increased to four. New patients should be seen throughout the training period under suitable supervision in outpatients and the consultant trainer should review ward consultations directly with the trainee. Supervision should be particularly close during the first one or two years. Particularly experienced trainees may undertake the running of an outpatient clinic on their own without direct consultant supervision. The trainee must be involved in the day to day care of neurological patients, supervise their clerking and investigation, and be responsible for organisation and dictation of discharge summaries. The trainee must have experience in organising an inpatient waiting list, counselling patients and their relatives and communicating with GPs.
Obstetrics and Gynaecology is concerned with women’s health – before, during and after the reproductive years.
Doctors in this specialty provide medical and surgical care to women and have specialist expertise in pregnancy, childbirth, fertility, family planning and disorders of the female reproductive system.
It provides a good mix of medical and surgical skills and one can really follow a life from cradle to the grave. It is a field at the cutting edge of medicine and so always throws up ethical considerations.
Obstetrics focuses on childbirth, providing pre-natal care and pregnancy support along with post-partum care. Gynaecology focuses on the health of the female reproductive system including the diagnosis and treatment of disorders and diseases. Combined training in both Obstetrics and Gynaecology is important because these specialties often overlap.
Working in women's health is a stimulating and rewarding career. Childbirth is an important event for any woman, and obstetricians are central to providing support and ensuring safety in maternity care. But Obstetrics & Gynaecology goes beyond just childbirth, and if you choose this career you'll be focusing on improving women's health at all stages of their lives.
Training in Obstetrics & Gynaecology is completed in two stages:
Occupational Medicine is a clinical medical specialty that deals with the interface between work and health. It is a small but long established specialty, both in Ireland and internationally.
Occupational physicians need to have a broad knowledge of clinical medicine. Typically, entrants to specialist training have already gained qualifications in General Internal Medicine, General Practice or another clinical field. They also need additional knowledge of basic science (e.g. noise exposure and effects on hearing, radiation exposure effects, toxicology), along with an awareness of legal issues pertaining to workplace safety and employment equality. A good understanding of how business works and what constitutes good management is essential. Occupational Medicine also has various subspecialties, such as Diving Medicine or Aviation Medicine.
Typically, medical students or doctors in postgraduate training come into contact with the occupational health department in the context of sharps injuries or hepatitis B immunization in a hospital setting. In fact, this is just one small area of the specialty. Occupational Medicine involves preventative programmes such as immunisations, health surveillance (e.g. audiology for noise exposure), rehabilitation of workers with an illness or disability, and advising organizations (governmental and business) on how to best optimize the health of their most important asset, their employees.
Occupational Physicians need to know how to “get to the bottom” of sometimes complex cases or issues. They must give decisive medical advice and be prepared to explain this medical advice to both the employee and the employer, while respecting confidentiality when dealing with the latter.
Specialist training in Occupational Medicine can be completed in Ireland on the Faculty of Occupational Medicine’s Higher Specialist Training programme. Career prospects are good, with specialists gaining employment in the public sector or the private sector. The lack of ‘on-call’ commitment facilitates a healthy work-life balance.
Your four-year programme will incorporate the following core elements:
You can receive up to 12 months’ credit for overseas training during HST in Occupational Medicine. The overseas post must offer an appropriate level of training and supervision and it must be prospectively approved by the Faculty of Occupational Medicine and the Irish Committee on Higher Medical Training.
Over the four years of your HST programme, you need to attend at least 800 occupational health clinics or equivalent (3.5 hours each). These clinics must include at least 100 sessions in a health service occupational health department.
Over the four years of your HST programme, you should carry out 20 industrial/worksite visits, covering a wide range of working environments. You should identify hazards and their assessment and control, and interact with safety officers, hygienists and environmental safety officers.
You are expected to see at least 400 occupational clinical cases each year. Cases should involve audiology, psychosocial, respiratory, dermatological, toxicological, rehabilitation, disability assessment and musculoskeletal conditions. Uncomplicated pre-employment assessments are not considered as cases.
You are expected to obtain knowledge and experience in other relevant specialties. This experience may be gained through personal reading, attendance at meetings or clinical attachment at outpatient clinics. Your trainer will help you identify which specialties you would benefit from.
Training in Occupational Medicine is completed in two stages:
Palliative Medicine is the branch of medicine involved in the treatment of patients with life-limiting disease for whom the focus of care is to optimise their quality of life through expert symptom management and psychological, social and spiritual support. Palliative Medicine specialists may work in hospital, in the community and in specialist palliative care units. Palliative Medicine specialists provide care directly to patients with complex needs related to life-limiting disease, and support other doctors in providing care for patients with life-limiting illnesses with non-complex palliative care needs. The aim of specialist training is to understand and promote the role of Palliative Medicine, develop and lead services and involve the patients at the centre of this service.
Palliative Care focuses on relief of the pain, symptoms and stress of serious illness. The goal of palliative care is to help people live more comfortably and to provide the best possible quality of life for patients and their families.
Palliative Care is offered to patients who are terminally ill, those who are managing a complex, chronic condition, and patients who are focused on recovery. It can be offered in conjunction with curative medical care and all other appropriate forms of medical treatment.
Training in Palliative Medicine is completed in two stages:
Public Health Medicine is about improving and protecting the health of the population, rather than treating individual patients. Public Health physicians have specialist knowledge of health protection, health service development and health improvement, as outlined in the table below.
Public Health Medicine reaches beyond the usual boundaries of the healthcare system. Doctors in this specialty work in national government agencies, local community and voluntary organisations.
Health Service Development
The Faculty's approach is that public health:
Specialists in Public Health Medicine operate a 24-hour Public Health Out Of Hours Service. This service provides national cover for the International Health Regulations (IHR), an Irish government commitment to the World Health Organisation and its Member States. The service also provides out of hours guidance on infectious disease control and outbreak management, for example in a crèche, hospital or nursing home.
To prepare for out of hours specialist cover, you will be required to participate in a health protection working hours on-call rota during HST. In the first two years of HST this is at the level of first or second responder on call during working hours under supervision of a Specialist in Public Health Medicine. In your third year you will be expected to take a lead in health protection incidents and investigations. In your final year you may work as acting Specialist on call. Out of hours work will be introduced in the coming year.
During HST, you need to become competent in each of the following aspects of Public Health Medicine. You need to record progress in achieving these competencies on a quarterly basis in a Competency Log, which must be scanned and uploaded to your ePortfolio
Rehabilitation Medicine is the branch of medicine that aims to enhance and restore functional ability and quality of life to those with physical impairments or disabilities.
Training in Rehabilitation Medicine requires expertise in a broad range of clinical skills, not only medical, but also psychological, technical and social. A sound knowledge and experience of the wide variety of disorders encountered is necessary together with skills to co-ordinate a range of medical and paramedical expertise, social agencies and personal support services.
Specialists in Rehabilitation Medicine work closely with allied specialties such as Rheumatology, Neurology, Geriatric medicine and Spinal injury.
Training in Rehabilitation Medicine is completed in two stages:
Respiratory Medicine is a clinical specialty dealing primarily with diseases of the lungs but also their effects on other organs. Many diverse pathological processes are involved in producing such disorders and in addition to the common diseases such as asthma, chronic obstructive pulmonary disease (COPD) and carcinoma of the lung, many other inflammatory, infective and degenerative processes lead to a wide variety of diverse diseases.
The experience gained through rotation around different departments is recognised as an essential part of HST. A Specialist Registrar may not remain in the same unit for longer than 2 years of clinical training; or with the same trainer for more than 1 year. The HST in Respiratory is 4 years, one year of which may be gained from a period of full-time research. Those who wish to obtain dual certification in Respiratory Medicine and in General (Internal) Medicine will require at least a fifth year of training.
The training programme offered will provide opportunities to fulfil all the requirements of the curriculum of training for Respiratory Medicine programmes in accredited training hospitals.
Training in Respiratory Medicine is completed in two stages:
Rheumatology is a sub-specialty of internal medicine involving the diagnosis and treatment of rheumatic diseases. It incorporates the study of joints, soft tissues and related structures called connective tissues. Many rheumatic disorders are defined as ‘auto-immune’ conditions because the triggers for disease onset and maintenance are related to immune aberrations that identify ‘self’ proteins as foreign. Equally, newer and more sophisticated treatments use specific components of the immune system to mitigate the disease process.
A trainee in Rheumatology must therefore have an in-depth knowledge of internal medicine, excellent general diagnostic skills, an aptitude for clinical analysis and an ability to work in a team environment with clinicians and health professionals from different specialties. Proficiency in joint and soft tissue aspiration and injection is also essential.
The duration of HST in Rheumatology is 4 years, one year of which may be gained from a period of full-time research. Those who wish to obtain dual certification in Rheumatology and e.g. in General (Internal) Medicine will require at least a fifth year of training.
Training in Rheumatology is completed in two stages:
Each specialty has a National Specialty Director (NSD) who actively leads the development and delivery of training in their specialty.
They are available to provide advice and career guidance relating to their specialty.
If you would like to get in touch with one of our NSDs, let us know by email to Helpdesk@rcpi.ie