Who's who in an Irish hospital team: consultants, registrars, SHOs and interns
Job titles in Irish hospitals can look familiar but work differently from where you trained. This guide explains the usual grades and how escalation tends to run. Titles and duties vary by hospital and specialty, so check how your own team works.
Consultant-led care
Patients in Irish hospitals are under a named consultant, who holds overall responsibility for their care. Doctors below consultant level are known collectively as non-consultant hospital doctors, or NCHDs. Team size varies: some teams have a registrar, an SHO and an intern, while others are thinner, especially out of hours.
The usual NCHD grades
Broadly, from most to least senior:
- Consultant: the senior clinician with overall responsibility for patients under their care.
- Registrar: a more senior NCHD who often leads rounds when the consultant is absent, takes referrals and supports SHOs. Specialist registrars are in higher specialist training.
- Senior House Officer (SHO): frequently runs the ward day to day, keeps the jobs list, reviews patients and covers on call.
- Intern: the first postgraduate year for Irish graduates and some others, working under close supervision.
Training and non-training posts
Some NCHD posts are part of structured training programmes run by postgraduate training bodies such as RCPI or RCSI. Others are non-training posts, sometimes called service posts, filled directly by hospitals. Both are real clinical jobs; they differ in supervision structures, rotations and how experience counts later. Check the current entry requirements with the relevant training body rather than relying on summaries.
NCHD posts are generally recorded through the NCHD Employment Record, overseen by HSE National Doctors Training and Planning. It is worth confirming with medical workforce that your record is correct.
Who you escalate to
As an SHO your registrar is usually your first point of escalation, then the consultant. On call, the chain may run through the on-call registrar for the specialty. Learn your team's chain on day one. Escalation is an expected part of the job, not a failure, and in an emergency you follow your hospital's emergency procedures.
What this guide does not cover
This is independent orientation, not clinical, employment or registration advice, and it is not affiliated with the HSE, the Medical Council, any training body or hospital. Local arrangements always take precedence.
Official sources
External organisations, independent of First Shift. Links checked in October 2026; always read the current page.
- National Doctors Training and Planning (NDTP) HSE National Doctors Training and Planning
- Basic Specialist Training (BST) Royal College of Physicians of Ireland
- Surgical training Royal College of Surgeons in Ireland
- Safe Start Guide Medical Council (Ireland)
Go further
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