The MBBS house job: rotations, pay and registration

The house job is the first year after MBBS. It is a paid or unpaid hospital post, and it is also the year that turns a graduate into a fully registered doctor.

Students often plan the admission and forget the year after the degree. This guide covers the structure, the money question and the choices that follow.

What the house job is

A house job is a supervised rotating internship in a hospital. It usually lasts 12 months. You work in wards, outpatient departments and theatres under the supervision of senior doctors.

The year has two purposes. It gives you supervised clinical responsibility, and it completes the requirement for full registration with the Pakistan Medical and Dental Council. You graduate with provisional registration. The house job converts that into full registration.

It is not a final year of medical school. You are an employee or a trainee, depending on the post. You will be expected to admit patients, write notes, present cases and stay for calls.

A house officer is a trainee, not a fully independent doctor. After full registration, some doctors work as a medical officer in a hospital or a basic health unit before postgraduate training. The two roles have different contracts and different responsibilities.

The rotation structure

A typical house job rotates through four core areas: internal medicine, general surgery, obstetrics and gynaecology, and paediatrics. Many hospitals add electives such as casualty, anaesthesia, radiology, dermatology, psychiatry or community medicine.

Rotations are commonly three months each, but the blocks differ by hospital. Some hospitals use two-month blocks and add more specialties. Some require a rural or peripheral rotation. Check the hospital's house job notice before you apply, because the structure is set locally within the national requirement.

The work is not evenly distributed. A medicine ward has a different rhythm from a theatre list. A casualty rotation can be the busiest month of the year. Ask current house officers what a typical day looks like in each block.

Calls are part of the job. A night call can remove the next morning from your study plan, so build the week around the rota rather than around an ideal timetable. Learn the handover format before your first night.

Provisional and full registration

After MBBS, you can register provisionally with PMDC. Provisional registration lets you work in a supervised house job. It does not make you an independent practitioner.

After you complete the house job, you apply for full registration. The certificate from the hospital is part of the application, so keep every document the hospital issues. A missing rotation certificate can delay registration by weeks.

Check the current PMDC process and fees on the PMDC site. The rules and the forms change, and a batchmate's checklist from last year may be out of date.

House job pay

A house job is a paid training post in the public sector. PMDC's admission FAQ says private teaching hospitals must pay a stipend no less than the stipend paid to house officers in public-sector hospitals in the same province or territory. Pay, leave and accommodation still depend on the employer.

Some posts are advertised as unpaid or ask for a deposit. That is a warning, not a normal category. PMDC says private teaching hospitals must pay at least the public-sector house officer stipend in the same province. Ask for the rate, the payment date and the leave terms in writing, and check the current PMDC rule before you accept an unpaid slot.

There is a third category that students often miss: a post that is described as paid but pays late. Ask when the first payment is made, not only how much it is.

Why stipends vary by province and employer

There is no single national house job stipend. The amount depends on who employs you and how the post is funded.

Provincial health departments fund posts in their public hospitals. A hospital with its own budget may set a different rate. A private hospital sets its own. A trust or military hospital may have a separate scale. The cost of living in the district and the availability of accommodation also change what the number is worth.

This is why a figure quoted in a group chat is close to useless. Ask the hospital's human resources office for the current rate, the payment date, the leave policy and the accommodation terms in writing. Then compare two offers on the same four items.

How to apply for a house job

Watch the provincial health department and the hospital websites. Some provinces run a central process; others leave each hospital to advertise its own posts. Deadlines are often short.

Prepare a file with your MBBS degree, provisional registration, CNIC, photographs and any hospital-specific forms. Keep certified copies and a digital scan of each. Apply to more than one hospital, because a single application is a single chance.

If a senior doctor offers to recommend you, thank them and still complete the formal application. A recommendation is not a slot.

Start the file about six months before graduation. Certificates, photographs and signatures take longer than students expect, and a missing document at the deadline is a lost slot.

What to learn in the year

The house job is the year to build habits that will follow you into postgraduate training.

Learn to take a focused history and present it in two minutes. Learn to write a note that another doctor can read at 3am. Learn to interpret a basic blood count, a chest X-ray and an ECG with supervision. Learn to ask for help before a patient deteriorates, not after.

Learn to say "I do not know, I will ask my senior" without embarrassment. That sentence protects patients, and it is the habit a good supervisor is looking for.

Keep a logbook of procedures and cases. Ask for feedback after a difficult shift. The logbook is useful for postgraduate applications, and the feedback is useful for you.

How the house job affects postgraduate applications

Completion of a house job is an eligibility requirement for FCPS Part-I and for most MS and MD programmes. The exact requirement belongs to CPSP or the university, so check the current prospectus.

The house job also shapes your references and your clinical confidence. A consultant who has watched you work for three months can write a more specific letter than a professor who knows your roll number.

Some induction processes score the institution or the rotations. The Central Induction Policy for public-sector FCPS-II training uses its own criteria, and those criteria change. Check the current CPSP and health department notice rather than relying on a senior's memory.

Questions to ask before you accept a slot

Ask about the contract length, the stipend and the payment date. Ask which rotations are fixed and which are negotiable. Ask about leave, accommodation, indemnity cover and the certificate at the end.

Ask whether the post is recognised for full registration and for the postgraduate route you want. Ask what happens if you need to swap a rotation. Get the answers in writing if you can.

How we checked this

The registration requirement and the 12-month structure come from PMDC guidance. The postgraduate eligibility points come from CPSP. Stipend amounts are set by employers and change, so this guide deliberately quotes no figure. Check the current provincial health department notification before you accept a post, and browse the career guides for the wider picture.

For the next decision, read FCPS or MS/MD. For the wider set of routes, read MBBS, BDS or allied health.