Taking time out
At some point during your medical career you may want to take time away from medicine or from a formal speciality training programme.
In recent years a higher proportion of doctors completing foundation training do not go straight on to specialty training. Another popular time to take time out of training is in the period between entering into further training and gaining a Certificate of Completion of Training (CCT).
Reasons are varied but can include:
- A desire to explore activities away from medicine
- Explore an area of research related to medicine
- Personal or health-related reasons
- Wanting to study or work abroad
This section outlines some key points to consider if taking time out and provides a number of resources for you to explore further.
When to take time out
There are certain points within your medical career when you may consider taking time out.
1. During medical school
This is an uncommon option, but can happen. It is important to speak to your clinical sub-deans and us if you feel like you wish to take some time out during your degree
2. Before Foundation Training
There are two key things to consider if you are thinking of taking time out straight after medical school:
- GMC provisional registration
- Sponsorship of your application to Foundation Training
General Medical Council Provisional Registration
In order to start Foundation Training you need to have registered provisionally with the GMC.
The GMC allows you to hold your provisional registration for three years and 30 days. You need to be on the provisional register until you successfully complete your Foundation Year 1; when you can apply to be on the full register.
After three years and 30 days of holding provisional registration you won’t be allowed to reapply for provisional registration again in the UK.
Most medical students apply for provisional registration during their final year so that they can undertake Foundation Training straight after graduation. However, it is not necessary to apply for provisional registration at this point if you know you are going to take time out. This decision should be taken only after consulting with a Medical Sub Dean at the medical school.
There is currently no time limit for applying for provisional registration after completing your medical degree but bear in the mind that the GMC would want to know how you had spent your time since medical school to understand how you have kept our skills and knowledge up to date.
GMC - provisional registration
Application to Foundation Training
Applicants to Foundation Training are sponsored by your medical school for the year in which you graduate and the following 1 or 2 years.
If you delay beyond this time you will need to apply independently via the medical school an Eligibility Application for UK Foundation Programme. As part of this process you will be required to sit a Clinical Assessment.
Please check with the person in the Medical School responsible for Foundation Training.
Deferring Foundation Training
An applicant who has been accepted onto the Foundation Programme may normally only defer the start date of their training for statutory reasons (for example, maternity/paternity/adoption leave and ill health) as detailed in the Guide for Foundation Training in the UK 
.
Foundation Training website
3. Between F1 and F2
A small number of Foundation Schools will support time out between FY1 and FY2. A very small number also accredit an FY2 year abroad (where the FY2 year is seen as equivalent to that of a UK programme). If you did decide to go down this route, you would need to find out how allocation to your FY2 would happen upon your return. You will need to contact Foundation Schools individually as to what regional arrangements are in place.
Ensure you enquire early with the local Foundation School Director of that region, if you are considering any of these options.
Some doctors may also apply to take time out of the foundation programme for a number of reasons such as gaining additional clinical experience, undertaking a period of research or planned career break. More information about this and important issues to consider can be found in the Foundation Programme Reference Guide.
COPMED A Reference Guide for Postgraduate Foundation and Specialty Training in the UK
4. Before Specialty Training
You are able to take time out after your FY2 before applying for specialty training. This is the most common time for a break as you have medical experience, you may like more time to decide on which specialty/ies or programmes to apply for. You will also have your full GMC registration allowing your to work as a doctor.
In terms of how much time you can take out, be aware that all applicants to specialty training are required to provide evidence of achievement of Foundation Competence within three and a half years prior to the intended commencement date for the advertised post.
Also, for a number of specialties or programmes at ST1/CT1 level, you cannot exceed between 18 and 24 months (post-foundation or equivalent) experience in the specialty to which you have applied by the appointment date of that post. It is important to check the person specification for the specialty or programme you are considering as time limits may differ.
Specialty Training - person specifications
You may be able to defer your place to Specialty Training for some specialties (for example, GP) but the majority of specialty programmes have not offered this opportunity to date (unless for statutory reasons such as maternity leave), and the opportunity may vary from year to year.
Health Education - GP recruitment
Foundation year 3
Taking time out after F2 has become common (in 2019 35% of F2 doctors went straight on to specialty training) and has developed it's own term - the F3 year.
Many NHS trusts are now offering F3 type jobs with job titles such as ‘FY3 Clinical Fellow’, ‘Junior Specialty Doctor,’ ‘Locally Employed Doctor,’; ‘Trust Junior Doctor’ and ‘Trust Doctor.’
Some offer educational supervision, study leave and other support mechanisms as an incentive for doctors to join them. This can be an attractive option for some doctors to also consider future specialty choice. This can also help Trusts fill service gaps whilst balancing the desire of the doctor to try something different.
Post foundation training breaks are generally believed to be viewed positively by both trainees and educators according to GMC research
Useful resources:
GMC Research on the impact of post foundation training breaks
HEE - beyond foundation
Messly - our F3 options explained
What to consider if you're thinking about a year out
5. During Specialty Training
The GMC has a number of Out of Programme (OOP) options available. The Gold Guide details what is possible but normally there are four options available:
- Undertaking clinical training that is not part of the training programme
- Gaining professional skills to enhance future practice (for example, medical leadership, patient safety) which may include working in a different environment/country
- Undertaking research
- Taking a career break
GMC website
Health Careers - programme opportunities
BMA-Flexibility in PG Training
Considerations on taking time out
As with any decision it is important that you make it with as much information and consideration as possible. Here are some points that you may wish to think about or discuss with others.
Length of break
How long are you considering taking time out for? Three months? Six months? A year? Longer? Once you’ve decided how long you want away, then think about the following points.
Implications of a break
Ask yourself if taking time out will affect your career progression? For example, you may also need to consider NHS length of service, your ability to practice on return, National Insurance, pension and tax contributions and other factors personal to you as part of your decision-making process.
What you plan on doing?
Are you wishing to do a postgraduate course? Undertake some independent research? Write a book? Recharge the batteries? Travel?
Some elements of your time away may be used toward your Certificate of Completion of Training (CCT), others such as volunteering overseas, may not.
Supervisors and training programme to arrange a suitable return to work package.
How easy will it be to pick up where you left off? Will you need to undertake clinical refreshers?
It is a very good idea to keep in touch with your supervisors and Local Education Training Board (LETB) or local Deanery to arrange a suitable return to work package.
More information
British Medical Association - Taking time out of programme
COPMED - A Reference Guide for Postgraduate Foundation and Specialty Training in the UK
NHS - Terms and Conditions of Service Handbook (Employment Break Scheme)
The Adventure Medic - case studies, tips and advice from medics