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Beyond Foundation

We know that many doctors in training choose, for a wide variety of reasons, to take a break from Foundation in Specialty training. Many will continue to work in the NHS, others may take up clinical opportunities overseas or in a voluntary capacity, whilst others may simply wish to take a break or take time to gain new experiences.

We are keen to support these doctors during this time and provide practical help when they decide it is time to return to their training programme. Options available include Less Than Full Time training and Supported Return to Training.

HEE’s E-Learning for Healthcare portal also provides a wide range of online learning.

To access support and information you can contact your local HEE office via the links below.

For the latest information on recruitment and to apply to a specialty training programme, please visit the Medical and Dental Recruitment Service website.

Careers Planning

We understand that planning your career can be challenging at times. There is a range of resources to help you, via your Trust, such as careers fairs, expert guidance from senior colleagues and taster weeks. Your HEE local office will also be able to provide advice and guidance.

Having a pause in training

We hope that if you have a training pause - it is for a positive reason; such as spending time abroad, developing a broader experience in a particular specialty or research or a new family . 

However, If you are considering having a training pause because of exhaustion or stress, difficult decisions, negative feelings about the future, then we want to hear from you. Start with your FTPD and talk through your worries and issues. If this is due to a problem with your training programme, we will want to try and fix the situation as well as signposting you to other supportive resources.

The F3 phenomenon report

In February 2022, we published a new report called "The F3 phenomenon: Exploring a new norm and its implications". Over recent years we have seen an increase in the number of junior doctors choosing to take a break from training following completion of the Foundation Programme. This is often to work in a non-training post and the vast majority have returned to training at a later date. As this report identifies, there are numerous factors in why doctors choose to take this break, and the reasons are shaped by the interaction between different personal and professional circumstances.

This programme of work, run jointly with the Royal College of Physicians was commissioned in order to build our understanding of what has been referred to as “the F3 phenomenon”, and what it means for individual doctors and for postgraduate training.

This report confirms what we have observed; taking a break from training post foundation is becoming increasingly common. The increased understanding the report brings will help us in the HEE Medical Education Reform Programme to ensure doctors are adequately supported in their careers and attracted into training programmes through our work to individualise training and to increase training flexibility.

Read the F3 report here.

Revalidation - What you need to do about your GMC registration after finishing your Foundation Programme

In order to continue practising as a doctor, you will need to keep your GMC registration and licence to practise.

If you’re going straight into a training programme (GP or specialty) you can find all you need to know on those webpages.

If you’re one of the many Foundation Doctors who are not going straight into a training programme, then the information below is very important!

As a doctor, you are responsible for ensuring that you do everything needed to revalidate and maintain your licence to practise medicine.

The below FAQs will hopefully be helpful in answering any questions you have. If you still have further questions, please ask someone at your employing organisation about who can help you with arranging the appraisal you need.

Revalidation FAQs

What is Revalidation?

The General Medical Council explains revalidation as “the process by which all licensed doctors are required to demonstrate on a regular basis that they are up to date and fit to practise in their chosen field and able to provide a good level of care.”

How do doctors in training revalidate?

For doctors in a training programme, this is achieved through the training curricula and the ARCP process, so nothing extra to the usual training requirements are required.

If I’m not in a training programme, how do I revalidate? (e.g. ‘F3’ posts, trust grade posts, anything post-Foundation that’s not a training programme)

Every doctor not working in a training programme MUST:

  • Log onto your GMC Online account
  • Know your designated body and responsible officer
  • Collect supporting information
  • Have an annual appraisal

How do I find out my designated body & Responsible Officer (RO)?

Your designated body is usually the Trust you’re working at, and the RO is usually the Medical Director of that Trust. However, this varies between different Trusts – there is an online GMC tool that will help you identify your designated body.

What sort of supporting information should I collect?

You are responsible for collecting supporting information. There is no defined set of evidence required, but anything that demonstrates how you’ve practised will be helpful. Getting feedback from more senior colleagues will help you develop as a doctor, and can be used for your appraisal, so ask consultants, more senior trainees, non-consultant grade doctors, senior nurses and AHPs to document what they think of you and your work.

Your designated body should help by giving you access to complaints, compliments, feedback from patients and colleagues etc.

How do I arrange an annual appraisal?

Many Trusts have a medical appraisal team to ask, or if not, try the Director of Medical Education. It is up to you to ensure that you have an appraisal.

What if I decide to work overseas?

If you are planning to work overseas you are unlikely to have a designated body. In this situation the GMC will usually advise you to keep your registration but relinquish your licence to practice. This means you won’t have to participate in revalidation and will pay a reduced annual retention fee, but you also won’t be able to carry out any of the duties for which you need a licence to practise.

To put this last statement in context, if a doctor relinquishes their licence because they are spending a year working abroad, then they won’t be able to carry out locum shifts or voluntary work in the UK if they come back to the UK for a few weeks. Similarly, if a doctor relinquishes their licence during a career break, they will need to reinstate it before working again.

What if I want to keep my licence whilst working abroad – “just in case”?

This is possible, but you will need to collect supporting information about your practice and have an annual appraisal with an appropriately trained UK appraiser, just as you would if you were working in the UK.

With grateful thanks to Maisie Shrubsall, Severn Foundation School Manager, and Dr Clare van Hamel, Severn Foundation School Director, for their help with these FAQs

Support you could receive may include:

To find out what is available in your area, please contact your local HEE office.