RT Journal Article SR Electronic T1 Post-Certificate of Completion of Training fellowships JF Clinical Medicine JO Clin Med FD Royal College of Physicians SP 441 OP 443 DO 10.7861/clinmedicine.9-5-441 VO 9 IS 5 A1 Andrew RL Medford YR 2009 UL http://www.rcpjournals.org/content/9/5/441.abstract AB Postgraduate medical training has changed. There is a significant reduction in hours of experience and training time due to the European Working Time Directive, a relative lag in substantive consultant post expansion and a resulting ‘bulge’ of trainees joining the specialist register having attained a Certificate of Completion of Training (CCT). Until the necessary expansion takes place, it is therefore less likely that all post-CCT trainees will immediately acquire substantive positions. Traditional historical alternatives for career progression at this point have been a locum consultancy, a period of research or an overseas fellowship. This article discusses the pros and cons of another more controversial alternative: a post-CCT fellowship.