Modernising Medical Careers


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Person

FAQs on specialty/GP training

Applying to specialty/GP training

Recruitment and selection

Specialty/GP run-through training programmes

Fixed-term specialty training appointments (FTSTAs)

Foundation doctors (including F2 pilots)

Existing SHOs in the transition period

Existing SpRs in the transition period

Research and specialty training

Advice for overseas doctors

MTAS

Round 1 Review

  

  

Applying to specialist/GP training 

How will junior doctors be selected for entry to specialist training programmes, and how can they maximise their chance of being selected in a given specialty, given the common competences of foundation training?

Recruitment into specialist training programmes will be through a process of open and fair competition, using national person specifications and application forms.

In most specialties selection will be under the auspices of the Postgraduate Deanery and will be undertaken by appointment panels. While procedures will vary between specialties and deaneries, recruitment will involve a structured interview as a minimum.

The minimum criterion for UK graduates entering a specialist or GP training programme is that they have all the Foundation competences. Individual specialties will develop the person specification to decide how best to select candidates for entry to their run-through training programme. The four UK countries are jointly funding a project specifically to ensure that the selection procedures are appropriate and fit for purpose.

For advice about the relative competitiveness of the various specialties see the following article:
Choosing your hospital specialty; Heard S; BMJ Career Focus 2006; 332: 221  

As a foundation doctor, will I need to complete the royal college exams before I apply for specialty training?

Royal college exams will play no part in selection of trainees for ST1 & ST2. Foundation doctors are being actively discouraged from taking these exams in the foundation years.

What will the role of the royal colleges exams be in the future?

Most trainees should complete exams during ST1 and ST2. The person specification for ST3 will most likely reflect the requirements for entry into the current SpR programme including the requirement for royal college exams. Royal college exams will continue to play a part in education and will undoubtedly be a requirement for progression within the specialty and all trainees must pass all parts of the royal college exams prior to CCT (Certification of Completion of Training).

How will I know what level of run-through training to apply to?

In most specialties the medical royal colleges are currently developing national person specifications that are relevant and suitable to each level of competitive entry. You should apply at the level which is the closest match to your personal skills, competences, qualifications and experience.  

How many specialist training posts will there be? How do these account for junior doctors wishing to apply to enter the system from overseas?

Trusts, medical royal colleges and others are working together to create as many entry points to specialist training as possible. There are large numbers of SHO posts that will no longer exist in August 2007, and this will provide scope to create significant numbers of training posts in run-through specialty programmes.

International medical graduates will continue to have opportunities to train in the UK, however they will require a work permit to do so, and trusts will have to show that a genuine vacancy exists that cannot be filled by a doctor with right of residence in the UK.

I am currently an NCCG doctor – should I be thinking of applying for a run-through post during the transitional period, or will I have a better chance of getting a place if I wait for a few years?

If you are thinking of applying for a run-through training programme you are advised to take every available opportunity to apply for a post.

What advice can you give junior doctors who are unsuccessful in applying to a run-through programme in a given specialty? Will there be a limit to number of applications?

As has always been the case, doctors in training are not guaranteed a post in the specialty of their choice as this is a competitive process. Doctors who are unsuccessful in their application to run-through training programmes can apply for a fixed-term specialist training appointment (FTSTA). These one year posts provide doctors with broadly equivalent training to the first (or second) year (with the exception od paediatrics and psychiatry, where this is up to ST3) in the appropriate run-through programme, but do not form part of a run-through training programme. There will be some opportunities for junior doctors completing FTSTAs to competitively apply for run-through training at an advanced level. FTSTAs should be used for doctors to consider their career options, which should include a realistic consideration of specialty opportunities and the potential to apply for a career post after two years training in an appropriate specialty.

How can junior doctors avoid being left in a dead-end situation?

No-one should be left in a dead-end situation. At every stage of the MMC career pathway there are opportunities for doctors to progress. However junior doctors who persist in seeking a career in a highly competitive specialty, where they are not the most competitive candidate, will have to rethink their career aspirations. Expert career and training advice will be available to junior doctors from their postgraduate deanery and foundation school.

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Recruitment and selection 

 What happens if a trainee is on maternity or sick leave during the recruitment period, or goes on such leave once they have successfully secured a training programme? (20th February 2007)

In general, if the period of sickness or maternity leave precludes participation in specialty recruitment and the contract would have ended had sickness or maternity not occurred, their contract will normally be extended as set out under Terms and Conditions of Service (TCS) paragraphs 241 and Temporary Appendix VI(i) paragraph 31 respectively, to allow them to receive their contractual entitlement to paid leave. On their return the doctor will normally need to seek an interim post (e.g. LAT, LAS) prior to application to a later round of specialty recruitment.

An important question to ask in respect of maternity leave is 'was the post held when maternity leave commenced part of a planned rotational appointment?' If the doctor is participating in a planned training rotation, rather than one of a series of stand-alone posts, when she takes maternity leave, TCS will require extension of the contract to allow for the doctor’s return, following maternity leave, to their post(s) and the completion of the planned rotation as set out in paragraph 35 of Appendix VI of TCS. If the post at the time of maternity leave was stand-alone, not as part of a rotation, and would have ended in any case had maternity not occurred, then it would be appropriate to treat it as a contract which expired during the period of maternity leave with no right of return, and for it to be extended only as appropriate and necessary to cover the paid maternity leave, as set out in paragraph 31 of the Appendix.

If a doctor commences paid maternity leave or sick leave between securing a specialty training place and taking up that appointment, normal processes will apply, their existing contracts will be extended if necessary to cover the paid period of absence, and they will take up their new appointments on their return.

UoAs: Why is histopathology a single UoA? (26 January 2007)

As part of both the NHS Plan and the NHS Cancer Plan, histopathology has been running a coordinated recruitment process for some time in England and Wales. In recognition of this they opted to have a separate UoA set up on the MTAS system. Put simply, you cannot apply locally to histopathology. When you apply to histopathology, you apply to the single histopathology (England/Wales) UoA. If shortlisted, you will be asked to identify the histopathology schools in which you would prefer to be placed. These preferences are then taken into consideration if you are successful at interview. If you wish to apply to histopathology, then you could use the 2 specialties/2 UoAs combination, for example: ST1, Histopathology (Specialty A), England & Wales UoA ST1, Histopathology (Specialty A), Scotland UoA ST?, Specialty B, West Midlands ST?, Specialty B, Wessex For further details relating to each histopathology training school, please visit http://www.nhshistopathology.com/.


The GP specialty tab – why is this so different from others? (26 January 2007)

Applying to GP is similar to applying to other specialties but there are some significant differences since recruitment to GP is co-ordinated nationally by the GP recruitment office. The GP recruitment process has been developed over the last five years with the aim of using one standardised assessment. The GP specialty tab looks different because the assessment process for GP applications is different. GP applicants are not shortlisted from the application form but are required to complete an initial assessment test instead. Please go to www.gprecruitment.org.uk to find out more.


If I tick the ‘Prefer Academic’ box on the application form, how will my application be assessed? (26 January 2007)

When you tick ‘Prefer Academic’ on the application form, you are indicating that you would prefer an academic programme rather than a clinical programme in the UoA/Specialty/Level to which you are applying. When you tick this option, supplementary academic questions will appear at the bottom of the specialty-specific tab on the application form. These questions will be assessed in conjunction with your clinical application. If short-listed, you will attend a single interview covering both academic and clinical selection. Finally, the allocation process takes place on the premise that an academic allocation takes precedence over a clinical allocation that takes precedence over an FTSTA allocation. All allocations are offered on the basis of an applicant’s ranking after interview and the number of places available. For example: If an application applies to 1 specialty in 4 UoAs and selects ‘Prefer Academic’ for all application choices, the allocation process will attempt to allocate them to an academic programme in any one of their four UoA choices before attempting to allocate them to a clinical programme. Therefore, this applicant would be offered an academic programme in their 3rd choice UoA, in preference of a clinical programme in their 1st choice UoA.


My partner and I want to do a linked application but I want to apply to two specialties in two UoAs and they want to apply to one specialty in four UoAs. Can we still link our applications? (26 January 2007)

Yes, provided the common UoAs are ranked in the same order – eg the 1st and 2nd choices of the applicant applying to 4 UoAs match the 1st and 2nd choice of the applicant applying to 2 UoAs.
Applicant 1:
1. ST1, Paediatrics in Trent
2. ST1, Paediatrics in East of England
3. ST2, Psychiatry in Trent
4. ST2, Psychiatry in East of England
Applicant 2:
1. ST1, Core Medical Training, Trent
2. ST1, Core Medical Training, East of England
3. ST1, Core Medical Training, LNR
4. ST1, Core Medical Training, Yorkshire
In this example, the pair would only be considered as linked if they are both successful in either Trent or East of England. As with all linked applications, if they are not both successful in one of the common UoAs, they will be treated as individual applicants.


What is the difference between, 'General Surgery' and 'Surgery in General'? (26 January 2007)

General Surgery is one of the recognised surgical specialties for higher specialist training, leading to the award of a CCT and entry on the Specialist Register. Previous SpR training programmes were offered in this specialty. General Surgery programmes are available at ST3 only. Surgery in General is the collective name for the early years training of the new run-through surgical curriculum. The Joint Committee for Higher Surgical Training (JCHST) issued guidance that the early years of surgical training in the new run-through curriculum would be broader programmes, either a. themed towards a single surgical specialty or b. generic. Surgery in General places are available at ST1 and ST2 only.


How many themed Surgery in General programmes can I apply for? (26 January 2007)

It is important to remember that the ‘specialty’ in this case is classed as Surgery in General and so the same rules apply and the available application combinations are the same as for any other specialty, for example: 
-2 specialties, each in 2 UoAs
-1 specialty in 4 UoAs
-4 specialties in 1 UoA

If you choose the 2 specialties, each in 2 UoAs then you could potentially apply to two different themed programmes in 2 different UoAs. For example:
1. ST1, Surgery in General – T&O in North West
2. ST1, Surgery in General – ENT in Mersey
3. ST1, Core Medical Training in North West
4. ST1, Core Medical Training in Mersey

If you choose the 1 specialty in 4 UoAs, then you could potentially apply to four different themed programmes in 4 different UoAs. For example:
1. ST2, Surgery in General – T&O in London/KSS
2. ST2, Surgery in General – ENT in Oxford
3. ST2, Surgery in General – General Surgery in East of England
4. ST2, Surgery in General – Plastic Surgery in Wessex

You cannot apply to more than one themed programme in the same UoA as this would equate to applying to the same specialty more than once in the same UoA.

Does A and E count towards "experience in the specialty" if seeking to do either surgery or medicine at ST1 or ST2?

You will have the option of deciding whether or not your A and E experience contributed to the competences you currently have in either surgery or medicine. The application will ask you to indicate why you believe you are eligible to apply at the level and in the specialty for which you are applying. You will therefore have the opportunity to describe the competencies you gained during your A&E experience in terms of generic (most relevant in terms of foundation competencies) or specialty specific competencies.

Does ITU/HDU experience count towards "experience in the specialty" if seeking to do either surgery or medicine at ST1 or ST2?

You will have the option of deciding whether or not your ITU/HDU experience contributed to the competences you currently have in either surgery or medicine. The application will ask you to indicate why you believe you are eligible to apply at the level and in the specialty for which you are applying. You will therefore have the opportunity to describe the competencies you gained during your ITU or HDU experience in terms of generic (most relevant in terms of foundation competencies) or specialty specific competencies.

Do pilot foundation programmes contribute to experience "at the SHO level"?

F2 pilots generally had a structure and content which reflected the curriculum and generic experience expected from foundation training, rather than early specialty training. In general therefore, they should not be counted towards your specialty specific experience, but if you wish to make the case that your particular F2 pilot did offer you the opportunity to gain specialty specific competences you should do so as part of your statement of eligibility so that this can be taken into account.  

Does any job or post that I held either in the UK or abroad (aside from an F2 pilot - see FAQ 3 above) at the SHO level have to be counted as part of my experience?

On the application you will be required to list all of the posts you have held and some details about these. All posts – whether undertaken abroad or in the UK at all levels - must be listed. You will also be required to indicate why you meet the eligibility requirement to apply for the specialty and level of specialty training (ST1/ST2/ST3/ST4) at which you are applying. Any post in the relevant specialty which contributed to your experience and to the gaining of specialty competences should be used to demonstrate your eligibility for the specialty and level at which you are applying. Note that the person specifications indicate that the experience that is relevant is experience in the specialty. For core medical training, this means experience which has largely involved acute medical take; for surgery in general, the experience and competences relate to surgery in general and not to specific experience/competences in a particular surgical specialty.

I have done a medical rotation for 3 years. Before that I did a 6 month stand-alone A and E post. I do not yet have MRCP. I want to apply for core medical training at ST2. Am I eligible or am I outside the 12 - 36 months experience requirement?

You may consider that your stand-alone A and E post allowed you to gain generic competencies rather than specialty specific competencies. Competences around acute medical care are required for CMT. If your medical rotation included posts (e.g. dermatology, rheumatology, ITU, A and E ) which did not involve you in the “acute take” you may consider that this experience did not provide you with the key competencies required in core medical training. The application will ask you to indicate why you believe you are eligible to apply at the level and in the specialty for which you are applying – in your case, core medical training at ST2. You will therefore have the opportunity to make the case to either include or exclude, A and E and parts of your medical rotation, depending on whether it contributed specifically to you gaining competences through that experience in the specialty of core medical training. From the information you have supplied, you would be eligible to apply for core medical training at ST2.

I have done a surgical rotation for 3 years. Before that I did a 6 month stand-alone A and E post. I do not yet have MRCS. I want to apply for a themed surgical programme at ST2 in ENT. Am I eligible to apply or am I outside the 12- 36 months experience requirement?

You may consider that your stand-alone A and E post allowed you to gain generic competencies rather than specialty specific competencies required for surgery in general. The application will ask you to indicate why you believe you are eligible to apply at the level and in the specialty for which you are applying – in your case, the specialty is surgery in general with a themed programme in ENT. You will therefore have the opportunity to make the case to either include or exclude your A and E and parts of your surgical rotation depending on whether it contributed specifically to you gaining competences through that experience in the specialty of surgery in general. So for example, if one of the posts was in ITU or HDU, you might wish to consider whether this did contribute to the acquisition of your surgical competences. If you do not think it did, you should say this on your statement of eligibility. If you think this was also the case for your A and E post, you should indicate this. Under these circumstances, you would be making the case and that you were eligible to apply at ST2 because you have 30 months of relevant experience in surgery in general. This would also apply if you undertook a surgical rotation which included A and E or ITU, if you do not think that you gained relevant surgical competences in such posts.

The person specifications for Surgery in General – for both generic and themed programmes – says that experience should be “in this specialty”. Does this mean the specific themed specialty or does it mean “surgery in general”?

For both generic and themed programmes at both ST1 and ST2, “in this specialty” means surgery in general. It does not mean experience in the specific themed specialty, although it is possible that if you are applying for a themed programme at ST2 you may have had some experience in the specialty theme for which you are applying. This is not the experience being referred to in the person specification, although it will be a part of your overall surgery in general experience. The sort of experience which you should be considering is that which you might have acquired on a basic surgical rotation.

Under Career Progression in the person specifications for ST2 in most specialties, it says that 12 – 36 months experience is required. If I will have exactly 36 months experience in medicine and my MRCP, am I eligible to apply for core medical training at ST2 or must I apply for a specific medical specialty at ST3?

You are within the eligibility requirements for ST2, i.e. you do not have more than 36 months experience in the specialty. You are, however, also eligible to apply for ST3 in a specific medical specialty. You would be advised to consider applying at ST3 since there are many opportunities at this level in the medical specialties this year, and you have the eligibility requirements for that level. However, you may choose to apply at ST2 if you wish to do so. However you may not apply at ST2 and ST3 in the same specialty or specialty group. In your case, core medical training and any of the 28 medical specialties comprise one specialty group, so you can apply either to ST2 in core medical training, or to medical specialties at ST3, but not to both ST2 and ST3 in medicine.

Does the 36 month “rule” mean ‘less than’ or ‘less than or equal to’ 36 months?

The 36 month “rule” means “less than or equal to” 36 months. In completing your statement of eligibility on the application form, you should include all relevant experience in the specialty you are applying for that will have contributed to you gaining competences in that specialty. If you have done posts, e.g. in A and E or ITU which will have given you generic skills, rather than specialty specific skills in say core medical training or surgery in general, you may wish to consider this when making your statement with regard to eligibility and include them as providing generic training experience. Conversely you may consider that posts in A&E or ITU have indeed provided you with specialty specific competencies, and in this case you would wish to make this clear in your statement regarding eligibility.

I want to apply to O and G and have done 2 years as a trust doctor in the specialty. I believe that I can provide evidence that I have the foundation competences. However, I understand that if I enter the training programme at ST2 that I will not be eligible at the end of my training programme for a CCT because my whole training programme has not been prospectively approved by PMETB. I would therefore have to apply to go on the specialist register through Article 14. Is this true? Do I have to apply at ST2? Can I apply at ST1 if I want to so that I am eligible for a CCT?

The PMETB has recently published clear guidance on the routes to the specialist register. Click here to view it. The guidance is clear that a full programme of prospectively approved training must be undertaken in order to be eligible for award of a Certificate of Completion of Training (CCT), but that this is only 1 way to enter the Specialist Register. Another route is by acquiring a Certificate confirming Eligibility for Specialist Registration (CESR) through application to the Specialist Register via Article 14 or Article 11 (for general practice). You should carefully consider the person specification for entry to O and G at ST1 and ST2, (available at www.mmc.nhs.uk/pages/specialties-personspecs) and review this with the O and G curriculum which is available on the RCOG website. You will then need to consider your 2 years’ experience as a trust doctor in O and G. Make sure that these posts, and any others that you have undertaken in any specialty at the SHO level are listed on your application form in the appropriate place. You will then need to consider what competences you gained from your experience and training in these posts. If you gained the competences set out in the O and G curriculum for broadly the first year of training in the specialty, then you will need to provide evidence of this and you should apply at ST2. Your route to the Specialist Register will be through application for a CESR. If you do not think that you acquired the competences for ST1 in the specialty and cannot provide evidence of having done so, then you must indicate this and apply at ST1.

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Specialist/GP run-through training programmes

Will all specialties begin run-through training programmes at the same time (ie August 2007)? If all programmes start in August 2007, what is the advice for those whose contracts end before then?

Run-through programmes for most specialties will begin in August 2007, although indvidual posts may start at an alternative time.

From August 2007 there will be no further entry to the SHO grades, and existing SHO contracts will expire. A small number of SHO level contracts have been issued which extend beyond August 2007 – these will of course be honoured by employers. Entry to the SpR grade will cease at the end of December 2006, and doctors already in the SpR grade at this point will conclude their training (either to CCT if they hold an NTN or to the end of their FTN contract) under the old arrangements – although it will be possible to train using new curricula through local discussion.

Will run-through programmes be available in all specialties in all areas?

It is anticipated that run-through programmes will be available in the specialties and areas that specialist training is currently available in. Not all deaneries offer training in all specialties, especially those with relatively few training posts (eg allergy).

Will all doctors who enter run-through specialist training programmes eventually receive a Certificate of Completion of Training (CCT), subject to satisfactory progress?

Any doctor who enters and successfully completes a whole run-through programme will receive a CCT. Doctors who do not complete a run-through programme but who use their previous experience and training to reach the required standard will be eligible to apply to the PMETB for entry to the GP / Specialist Registers through Article 11/14, but will not receive a CCT, as per the PMETB ruling.

I want to take some time out to travel and work abroad in the next few years – will that be possible with these new arrangements for training?

Yes. Be sure to discuss your plans with your postgraduate dean, and make sure you are aware of application deadlines and so on when you are away.  However you cannot defer your start date - you will simply need to make your application when you are ready to return.

What happens if I decide halfway through my run-through programme that I want to switch to another specialty?

You will, of course, need to carefully consider your career options. You will be able to change specialties only by applying competitively for, and being appointed to, a run-through programme in another specialty. However, relevant competences achieved in the first specialty will be taken into account by the specialty into which you have entered.

Why is the position at the end of training in the MMC Career Framework diagram designated as a ‘Senior Medical Appointment’ and not broken down into ‘Consultant Appointment’, ‘General Practitioner Appointment’ and NCCG appointment?

We use the term senior medical appointment because to spell out the long list this covers would be cumbersome. In fact, we mean any job where the holder would require an entry on the Specialist or GP Register in order to take up the post. For example, this would include GP principals, employed GPs, consultants, specialists, clinical directors, medical managers as well as many who work in the academic world. The relative number of these will, as now, be decided by the service and its requirements for senior medical staff.

What realistic options are there for junior doctors who are appointed into a specialist training post at the end of foundation training, but who do not achieve the criteria required to progress further in that specialty?

Doctors who make satisfactory progress will emerge with a CCT. Those who do not make such progress despite remedial support, but who have achieved useful competences and progressed beyond year ST2, may apply for career posts where those competences are recognised and valued. They will have the opportunity to progress within the new career grade framework, having their cumulative experience and competences recognised, with the potential to gain access to the Specialist or GP Register via Article 14/11 of the PMETB order.

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Fixed-term specialty training appointments (FTSTAs)

What if I don’t want to apply for a run-through programme?

You are not obliged to apply for a run-through programme. The alternative posts you could apply to are fixed-term specialist training appointments (FTSTAs), or if you have at least three years of post-registration experience in educationally approved posts you may apply for a career post. You can continue to compete for entry to run-through at the appropriate level from your FTSTA or career post when appropriate opportunities arise.

If I am not accepted for a run-through programme, does this mean I can’t become a consultant?

If you are not accepted for a run-through specialist training programme, you can compete for an FTSTA in a given specialty. After a minimum of two consecutive years training in an equivalent specialty you may then be eligible to apply for an appropriate career post, subject to the person specification for the post.

If you have aspirations to be a consultant you need to work towards getting onto the specialist register.

Your choices for routes to the specialist register are:

  1. As a career post doctor to pursue the equivalence route (articles 11 and 14) to the specialist register, through application to the PMETB for a Certificate confirming Eligibility for Specialist Registration (CESR). To achieve a CESR you will need to work with your employer to gain the necessary experience and qualifications so that you will be able to demonstrate to PMETB that the totality of your training, qualifications and experience are equivalent to a CCT. You will need to do this through full engagement with the appraisal process and best use of opportunities for your continuing professional development.
  2. Having undertaken one or more years in fixed term specialist training appointments you can apply for entry into a run-through training programme in the same or in a different specialty. If you are successful in being appointed, following successful completion of the programme you will be eligible to apply for entry to the specialist Register, probably through a CCT if you have done a full, PMETB prospectively approved training programme in the specialty.

What are the proposals for numbers of fixed term specialist training contracts compared to run-through training posts?

Numbers of run-through and fixed-term specialist training posts are currently being determined at a local level following discussions with the postgraduate deans and the service. The postgraduate deans will be urging trusts to use available resources to develop as many specialty training programmes as possible, subject to educational capacity. Numbers may change during transition to achieve an appropriate balance as doctors apply for the new posts. It is not policy in any of the four home countries to expand the number of limited-term posts at the expense of CCT programmes, and the proportion of posts may vary over time.

How are you working with the royal colleges with regard to fixed-term specialist training contracts and their curricula?

The royal colleges are currently developing specialist training curricula and entry requirements for run-through training programmes. These will be approved by the PMETB prior to implementation.
Fixed-term specialist training appointments (FTSTAs) are limited term, one year contracts that do not form part of a run-through training programme. FTSTAs are training posts at the first or second year level of specialist training (or ST3 in paediatrics and psychiatry). Under the auspices of the postgraduate deans, training will be offered in the specialty to the equivalent standard as offered in run-through programmes, with competence-assessment forming a key element. However doctors in such posts will not be allocated a training number and will not be able to progress to CCT unless they are competitively successful in entering a run-through programme.

The MMC UK Strategy Group has recommended that doctors should have successfully completed four years of postgraduate education (consisting of the two Foundation years plus two years of specialist training) before accessing a career post in the UK.

Are such FTSTA posts really going to be recognised as equivalent for training by colleges – will a junior doctor in such a post be able to apply at some point for entry into run-through training at a higher level than ST1?

Specialist training is recognised by the PMETB, not the royal colleges. Training and the acquisition of competences in FTSTAs will be assessed, documented and recorded in a way that helps PMETB to recognise them, enabling doctors to progress according to the pathways outlined in the MMC career pathway.

If I am accepted for an FTSTA, do I have to repeat the application process again the following year to enter another FTSTA?

Yes. It is anticipated that FTSTA posts will be appointed for one year at a time.

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Foundation doctors (including F2 pilots)

Will sufficient numbers of Foundation Programme posts be available from 2007, given the increased number of medical students being trained in the UK?

Our planning has ensured that the number of F1 places has expanded in line with the expansion of UK medical school places in recent years. The number of F1 places will exceed the number of graduates from UK medical school. Joint planning for Foundation Programme posts will continue throughout the UK to ensure UK graduates have opportunities to compete for work in the NHS.

What advice do you have for those in F2 pilots?

If, at the end of your F2 pilot post in August 2006, you meet the entry requirements for a general practice or specialist training programme, you should consider applying for entry to this before the end of 2006. If not, you may apply for an SHO post in the usual way, and will then be subject to the transitional arrangements for SHOs and other doctors in training as outlined below and at http://www.mmc.nhs.uk/pages/specialties.

I am an F2 pilot doctor. Will I get a job next year?

It is anticipated that a reasonable number of hospital SHO posts will be available in August 2006 and you will be able to apply for them in the usual way. If you are considering a career in general practice, there will be the usual number of opportunities available in vocational training schemes for which you can apply. You should be aware that entry to the SHO grade will close at the beginning of August 2007.

I am an F2 pilot doctor. Will the job I do next year count toward my application into specialist training?

It is intended that any competences achieved in previous training posts will help determine the most appropriate point at which you should continue development in the specialty for which you have competed. In most specialties you will be able to compete with doctors at a similar stage to your own for entry to specialist training, and in some cases you may be able to enter training at an advanced level, depending on the competences you have previously gained.

What jobs will be available in August 2006 for those completing F2 placements?

One-year hospital SHO posts, and places on general practice vocational training schemes will be available, and doctors may apply for these in the usual way. If you are eligible, you may also consider applying to histopathology, which has begun recruitment into new run-through training programmes. The histopathology curriculum has been approved by PMETB.

If we were to work in an SHO post for a year, would we then be able to enter run-through training at year two level in August 2007?

Junior doctors entering run-through training from an educationally approved SHO post may apply for entry to run-through programmes at a more advanced level than those entering directly from the Foundation Programme.

In many specialties (but not all) it is anticipated that there will be peer group competition for entry into ST1 (from the foundation programme and those with very little SHO experience); ST2 (for doctors with some SHO experience); and ST3 (for those who would have the current entry requirements for specialist training).


Agreement is being sought from the PMETB for these proposals, and the medical Royal Colleges are developing appropriate person specifications for recruitment at each level.

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Existing SHOs in the transition period

What is the timescale for current SHO posts to be converted into ST1 / ST2 posts and other specialty training opportunities?

Draft plans will be available from mid-September 2006.  These will be reviewed by the Workforce Review Team and available as a ministerial submission by mid-October.  Plans will then be refined, amended and approved for final, confirmed release by the end of 2006.

I am currently an experienced SHO, but I think my chance of getting into a run-through programme will be best if I apply for entry at the beginning, rather than at a more advanced level of the programme. What should I do?

The person specifications for entry to run-through programmes are likely to indicate the level of previous training that is necessary / acceptable at each entry point to the programme. So if you have held recognised SHO training posts, you are unlikely to be eligible to apply for entry to the run-through programme at an earlier level.

My SHO contract expires before August 2007; what should I do?

You should apply for advertised jobs as you would normally do. Entry to the SHO grade will end on 31 July 2007, but short-term contracts can be issued up until that date.

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Existing SpRs in the transition period

Will specialist training rotation posts undergo transition to run-through training?

Doctors who already hold a National Training Number (NTN, in Type 1 training) by 31 December 2006 will complete their specialist training under the existing arrangements, in the current SpR grade – although it will be possible to train using new curricula through local discussion.

Doctors who are currently undertaking fixed-term appointments (Type 2 training) under existing curricula will, of course, need to apply for competitive entry into specialist training, once their fixed term appointment has come to an end. 

What mechanisms are in place to recognise existing training in the run-through training pathway?

Doctors already in the SpR grade at the end of December 2006 will complete their existing training programme subject to satisfactory progress, though in some specialties there may be an option for them to change their programme  to the new curriculum.

Doctors currently in the SHO or NCCG grades will have opportunities to compete for places in specialist training, entering at a level appropriate to their level of competence. In most specialties competition for places will be amongst doctors with a similar level of experience and training to date.

What will happen to posts which are currently designated as LAT, FTTA and LAS?

There are no posts as such which are designated as LAT, FTTA or LAS. These are placements which contractually are of limited duration. Anyone who has a contract when transition starts will have it honoured unless they decide to relinquish it. We foresee that there will still be a need for LAS equivalents to provide cover for short-term absences. The role of LATs and FTTAs will need to be considered in the new arrangements.

I am due to enter the SpR grade in the next few months – with all the doctors who will be entering specialist training while I am completing my training as an SpR, will there be sufficient capacity in the system for us all to train?

You will continue training in your SpR programme. New posts and programmes will only be agreed where there is sufficient educational capacity for them. 

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Research and specialty training

What advice should we be giving to people in research or contemplating undertaking it?

Currently, some SHOs seem to feel they can only be competitive in applying to specialist training programmes if they acquire research credentials, despite this not being necessary to advance a clinical career. Whilst all doctors need to understand research methodology and its critical application to medicine, it is anticipated that national specialty person specifications which will be developed for use after the transitional period will not give significant weighting for research as an entry criterion into specialty training.

For the transitional year 2007, research will continue to be a feature of the person specifications, particularly for those applying at the ST2 and ST3 levels so that current SHOs who made the career choice to undertake research are not disadvantaged.

Doctors who genuinely want to undertake research and who want to consider an academic research career should seek advice from their postgraduate deans.  There are opportunities at both Foundation level through one and two year integrated academic programmes and at specialty level through the Academic Clinical Fellowship (ACF) programmes for academic development.  Some ACFs are currently being advertised for appointment of SHOs to ACFs at a level equivalent to entry to the SpR grade.  The next allocation of ACFs will be for appointment to posts at the ST1 level, to commence in August 2007. It is also possible for doctors in specialty training to "take time out" to undertake research, but this should be in order to undertake a formal research qualification (e.g. MD or PhD).

If you are currently at SHO level and undertaking research, you are advised to continue with your plans to complete that research. Please note the following:

If you are in the middle of a research degree but have the entry requirements for a specialty, you are eligible to apply for an NTN now and ask for a deferred start date. Deferrals will be for up to 3 years.

If you are currently undertaking research and meet the PMETB requirement of having undertaken 1 year in an educationally approved SHO post in order to offer evidence of the foundation competencies, but do not meet the current requirements for applying for entry into specialty training, you should apply for entry into a specialty training programme for August 2007.  If your research degree is not completed by that date,
you will be able to ask for a deferred start to the programme.  Deferrals will be for up to 3 years.

If you are in research but do not have at least one year of SHO training in an educationally approved post, you are advised to complete your research and then apply for entry into a foundation year 2 programme in order to acquire the foundation competences, prior to applying for specialty training.

If you currently hold a national training number (NTN) and are out of programme undertaking research, you will need to discuss with your programme director the point of entry into the specialty training programme on your return, whether this is to the new specialty curriculum (if you opt to change) or to the old curriculum.

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Advice for overseas doctors

What is the position for doctors with limited leave to remain that does not cover the length of the programme they are applying for?  (April 2007)

The Department issued guidance stating that doctors with insufficient leave to enter or remain in the UK to complete the programme to which they are applying, should be considered as requiring a work permit. This guidance was challenged through Judicial Review. The Judge handed down his judgment on 9 February and found the guidance to be lawful. It has been agreed by the 4 UK Health Departments that the guidance will continue to be held in abeyance for Round 1 of the current recruitment process, including the extended Round 1. The decision to hold the guidance in abeyance recognises the practical difficulties in making changes at this stage in the timetable for short-listing. It will also allow those doctors with limited leave to remain who have applied, to be considered in the way they would have wished when they submitted their application.

How will overseas doctors be accommodated within the new arrangements?
You will be able to apply and will be assessed in exactly the same way as other applicants after you have provided details of your right to work in the UK. A list of the information you need to provide will be available when you apply. If there are sufficient applications from suitable UK and EEA candidates, non-EEA doctors who do not have sufficient leave to complete the programme for which they are applying may not be considered for training programmes.

I haven't got an IELTS qualification, how can I prove my language skills?
Verified written documentation may be provided as evidence. Please note that any evidence you refer to on your application form is subject to approval by the interview selection panel.

I am coming to live in the UK with my UK spouse or civil partner, will I be able to apply for specialty training?
It is likely that as the spouse or civil partner of a UK citizen, you will have the same working rights as a UK or EEA citizen. However, it would be advisable to confirm your status with the Home Office before applying.

I am coming to live in the UK with my spouse or civil partner who is an EEA national. Will I be able to apply for specialty training?
Yes, any doctor can apply and will be assessed against the eligibility criteria set out in the person specifications. It is likely that as the spouse or civil partner of an EEA national living in the UK you will have the same working rights as a UK or EEA citizen. However, it would be advisable to confirm your status with the Home Office before applying.

I am coming to live in Britain with my non-EEA spouse or civil partner who has permission to work in the UK. Will I be able to apply for specialty training?
 You can apply and will be assessed against the eligibility criteria set out in the person specifications. However, it would be advisable to confirm your status with the Home Office before applying. If you do not have sufficient leave to complete the programme for which you are applying, your application may not be considered if there are sufficient suitable UK or EEA candidates.

If I have passed PLAB, am settled in the UK and have house officer experience, can I apply to F1, rather than F2 training posts? No. Only doctors who have not completed an internship (or equivalent training) are eligible for F1 posts. As you’ve had house officer experience and are entitled to register with the GMC, it is likely you have already gained competences comparable to the F1 year. You will be able to apply for F2 posts when they are advertised. These standalone posts are not recruited to through MTAS, but will be advertised locally.

What is the impact of changes to the Immigration Rules [April 2006] on overseas nationals with UK medical degrees?
Graduates from UK medical schools who are not EEA or UK citizens, can apply for permit-free training within a year of graduation and upon having been accepted to a Foundation Programme. It is likely they will be eligible for permit-free training in this instance. In order to remain in the UK after completing their Foundation Programme, they will need to ‘switch’ to another part of the Immigration Rules such as the work permit or HSMP provisions.
 

Useful links

• The Home Office - www.homeoffice.gov.uk - for information on eligibility to work in the UK
• NHS Employers - www.nhsemployers.org - for the latest on policy and guidance
• PMETB - www.pmetb.org.uk - for information on applying for registration via Articles 11 and 14
• MMC - http://www.mmc.nhs.ukhttp/www.mmc.nhs.uk/ - for information on applying to foundation and specialty training
  programmes

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