CPSP Second Fellowship: Subspecialty Routes After FCPS Medicine or Surgery

Most FCPS-I candidates think about one Fellowship. CPSP's structure, however, has a second tier: subspecialty Fellowships that a doctor may pursue after completing a first FCPS. The college's FCPS page says it offers Fellowship training in 98 specialties and Membership in 19, lists 48 first-Fellowship specialties and 44 second-Fellowship specialties, and explains that those who complete a first FCPS in Medicine or Surgery are "also eligible to pursue a second FCPS" in allied subspecialties. This article explains how the route works and what to plan early.

First and second Fellowships

A first Fellowship is the broad specialty: Medicine, Surgery, Paediatrics, Obstetrics and Gynaecology, Anaesthesiology, the dental branches and the rest of the 48. A second Fellowship is a subspecialty entered after the first. CPSP's examples for the Medicine and Surgery routes include Cardiology, Pulmonology, Neurology, Nephrology and Urology; the second-Fellowship list also carries fields such as Critical Care Medicine, Gastroenterology, Vascular Surgery and paediatric subspecialties. Some specialties have moved between tiers over time: the college notes that Medical Oncology was a first Fellowship in 1994, a second Fellowship in 2004 and a first Fellowship again from 2009, a reminder that the list is maintained, not fixed.

What the second Fellowship involves

• Training time. Fellowship training takes about four to five years for a first FCPS depending on the specialty; the second Fellowship adds its own structured training period in an accredited subspecialty unit.
• Supervised work and the e-Logbook. As in the first programme, rotations, procedures and research are recorded and signed off.
• Workshops. The college's mandatory workshops (ACLS, BLS, Research Methodology, Biostatistics and Dissertation Writing, Communication Skills and others) are prerequisites for examinations; some carry over, some must be refreshed, so check the current requirement for your subspecialty.
• Examinations. The final examination of the second Fellowship follows the college's theory and clinical pattern; its theory dates sit within the FCPS-II calendar, which for 2027 lists 16 February and 17 August for major subjects and 13 April and 28 September for other subjects.

Planning from FCPS-I onward

1. Choose the first Fellowship with the second in mind. A doctor set on cardiology or nephrology enters through Medicine; one set on urology or vascular surgery enters through Surgery. The FCPS-I subject group, Medicine and Allied or Surgery and Allied, is where that choice begins.
2. Pick rotations that build the subspecialty record. Supervisors and accredited units for the second Fellowship look at what you did in the first.
3. Keep research continuous. A dissertation in the first Fellowship on a subspecialty topic is a head start for the second.
4. Watch accreditation. Only CPSP-accredited units can train second-Fellowship candidates; confirm a unit's status before committing years to it.

Alternatives and parallels

Some doctors take the overseas route to subspecialty training after a first FCPS, through membership examinations or licensing exams such as PLAB or USMLE, and return with a foreign subspecialty qualification. PM&DC maintains lists of recognised foreign postgraduate qualifications and has recently issued alerts about unrecognised programmes, so recognition should be checked before enrolment, whichever route is chosen.

What this means for you

If subspecialty practice is the goal, the decisions that matter are made at FCPS-I: the subject group, then the first Fellowship, then the units you rotate through. FAME's FCPS-1 plans are organised by subject group, and the platform's specialty classes extend into the Medicine and Surgery allied fields that lead to a second Fellowship.

Two questions trainees ask

Is a second FCPS the only way into a subspecialty? No. Overseas membership and licensing routes lead to foreign subspecialty qualifications, and PM&DC keeps lists of the foreign postgraduate qualifications it recognises. Whichever route you choose, confirm recognition before enrolling; the council has issued alerts about unrecognised programmes.

How long does the whole journey take? CPSP gives four to five years for a first Fellowship depending on specialty; the second Fellowship adds its own training period. The college does not publish one combined figure, and the real answer depends on induction timing and exam results.

Sources and references

• CPSP: FCPS programme, first and second Fellowship specialties, workshops
• CPSP: 2027 examination schedule
• PM&DC: recognised foreign postgraduate qualifications and doctor alerts