The Bottom Line
- These titles are often <strong>service posts</strong> designed to cover rota gaps. The key is the contract details, supervision model, and portfolio support — not the label.
- <strong>LAT</strong> is usually a training-recognised locum post; <strong>LAS</strong> is usually service-only (not training-approved).
- For IMGs, these roles can be a high-signal pathway to <strong>credible NHS experience</strong> and future applications — if you structure the year properly.
Why this matters
Many IMGs lose time because they misunderstand role titles. A “Clinical Fellow” can be a structured post with teaching/research time, or it can be a service-heavy rota filler. A “Trust Grade” can be supportive, or chaotic. Your job is to interrogate the post details and optimise your year for future optionality.
Quick definitions (useful but not perfect)
Trust Grade: typically employed directly by a trust for service provision (often similar duties to trainees at that grade, but not within a deanery training programme). Clinical Fellow: often a trust-employed role that may include extra teaching/research/audit components, depending on the post. LAS (Locum Appointment for Service): service post covering training gaps but typically not recognised for training. LAT (Locum Appointment for Training): a training-recognised locum post (where available and approved).
Do not assume ‘training value’ from the title
Always ask: Who is the educational supervisor? Is there protected time? Is there portfolio support? Is the post deanery-approved? If the answers are vague, treat it as service-first and plan accordingly.
How to choose the right ‘first job’ post in 2026
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1) Prioritise supervision and safe onboarding
A supportive rota, named supervisor, and clear escalation culture matter more than a prestigious hospital name for your first NHS post.
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2) Prioritise evidence you can later use
Ask whether you can do audit/QI, teaching, and documented appraisals. These turn a service year into a credible portfolio year.
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3) Clarify rota reality
Get a sample rota. If it is permanently underfilled with heavy nights, expect burnout and limited development time.
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4) Ask about study leave and courses
Even in non-training posts, many trusts have study leave policies. It’s variable — but it changes the quality of the year.
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5) Aim for a ‘convertible year’
A year that gives you UK references, governance language, and credible examples is convertible into future applications (training or non-training).
Where iatroX fits
Once you’re in post, iatroX helps you stay sharp (quiz blocks) and move quickly through UK guideline context (Knowledge Centre + Ask iatroX). This is particularly useful in the first 3 months when everything feels unfamiliar.
Practice
Test your knowledge
Apply this concept immediately with a high-yield question block from the iatroX Q-Bank.
SourceBMA: Doctors’ titles explained (UK role terminology)
Open Link SourceMRCPUK Federation: Glossary definition of LAT
Open Link SourceNHS Wales: LAT vs LAS (service vs training recognition explanation)
Open Link SourceScotland Deanery: LAS posts (service roles, not training posts)
Open Link SourceiatroX: Knowledge Centre (UK guideline index + Q&A library)
Open Link