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Taking time out

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At some point during your medical career you may want to take time away from medicine or from a formal medical training programme.

In recent years over half 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 higher specialty 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.

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At the inception of the foundation programme, the expectation was that on completion of FY2 the doctor would progress to specialty training. The review [HEE: The Postgraduate Medical Foundation Programme Review, 2018] acknowledged the current trend for more than half of those completing the foundation programme to take one or more years out of training. Many of these doctors remain in the healthcare workforce either on a regular or ad-hoc basis.

Source: Health Education England: Postgraduate Medical Foundation Programme Review 2018

 

Source: GMC Training pathways: analysis of the transition from the foundation programme to the next stage of training Working paper 1 - November 2017

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 thinking of taking time out straight after medical school:

  • GMC provisional registration
  • Sponsorship of your application to Foundation Training

General Medical Council Provisional Registration

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 your 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.

GMC - provisional registration

Application to Foundation Training

Applicants to Foundation Training are sponsored by your medical school for two years (that is, the year in which you graduate and the following year).

If you delay beyond the two years, you will need to apply independently of the medical school via UKFPO’s Eligibility Office. You will subsequently sit a Clinical Assessment at the end of October of the year you apply.

Deferring Foundation Training
An applicant who has been accepted onto the Foundation Programme may only defer the start date of their training for statutory reasons (for example, maternity leave and sickness) as detailed in the Guide for Foundation Training in the UK PDF file icon.

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.

Find out more - UK Foundation Programme Reference Guide

 

4. Before Specialty Training

You are able to take a break in practice 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 (see header evidence 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 (e.g. GP) but the majority of specialty programmes have not offered this opportunity to date, 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 2018 only 37.7% of F2 doctors went straight on to specialty training) and has developed it's own term - the F3 year.

An "F3" year could be spent doing locum work in the UK or overseas as a doctor, travelling, or trying out other non-medical work. However, many NHS trusts are now offering F3 jobs with job titles such as FY3 Clinical Fellow, Junior Specialty Doctor, Locally Employed Doctor, Trust Junior Doctor and Trust Doctor. Some offer training, study leave and other support mechanisms as an incentive for doctors to join them and fill service gaps whilst balancing the desire of the doctor to try something different to give them a break before specialty training, and help them decide which specialty to choose.

Useful resources:

HEE - beyond foundation

Messly - after completing foundation programme

Life as an F3 doctor blog post

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:

  • Out of Programme Experience for Training
  • Out of Programme Experience for Clinical Experience
  • Out of Programme for Research
  • Out of Programme for a Career Break (e.g. to work in industry, for ill health or domestic responsibilities)

GMC website

Health Careers - programme opportunities

Health Careers - case study on out of programme

 

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, will not.

Transition back into practice

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

British Medical Journal - Taking time out of training

British Medical Journal - Health and wellbeing is the most common reason for doctors to take a break from training

Foundation Programme - Reference Guide PDF file icon

Health Careers - options for medical experience abroad

NHS - Terms and Conditions of Service for NHS Doctors and Dentists in Training (England) 2016 PDF file icon

NHS - Terms and Conditions of Service Handbook (Employment Break Scheme) PDF file icon

The Adventure Medic - case studies, tips and advice from medics

 

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