1. Can you explain what Foundation Training is and how it fits into the training pathways for doctors in the UK?
Emma: Foundation training is what all doctors do in the first 2 years post-qualification from medical school. Foundation trainees are doctors but, as they are just starting out, they get a lot of support and further training in core skills while rotating through a variety of specialties. For the first year, doctors have provisional GMC registration, which means that whilst they are doctors there are strict restrictions on what they can and can't do. After that first year, foundation doctors will be granted full registration and are able to do some extra things (e.g. signing certain legal documents, more autonomy in clinical practice).
Once they have completed the 2 years of foundation training, doctors are then eligible to apply for specialist training (e.g. general practice, surgery, psychiatry etc).
There are different types of foundation training - the standard foundation programme, academic foundation programme (this includes allocated time to work in an area of research, education, or leadership), and priority foundation programmes (these are designed to attract people into areas that are historically less popular. Examples include getting paid a bonus to work in a remote area of Cumbria, or having 1 day a week for the whole 2 years dedicated to working in general practice in order to attract more GP trainees).
Helena: Foundation training is a nationalised scheme for the most junior of junior doctors. In your final year, you apply to foundation training using a combined score of your ranking at medical school and your situational judgement test (SJT) score. Once you have completed your FY1, or first year of training, you are fully registered with the GMC, and can complete your FY2. After this, it's up to you! You could take an FY3 year and travel, or work as a locum, or you could go into specialty training. This includes core medical, surgical, GP and other specialities such as psychiatry.
2. Could you tell us a bit more about the process of applying for the Foundation Training programme?
Emma: Applying to the foundation training programme is a long process spanning from October to April of the final year at med school. It starts with completing straightforward forms on the online platform. These include things like your personal details and references from your medical school etc.
You then rank which rough area of the country you wish to go to (e.g. Scotland, Yorkshire, North West of England, South Thames). Some areas are quite geographically small and others are huge. You have to rank all of them so it can be quite hard to choose the order!
If applying to an academic programme, the process has extra steps like adding details of any med school prizes or distinctions, research presentations and publications, as well as sometimes answering written interview style questions, and then attending an interview (usually face to face but online via video conferencing during Covid-19).
The next step for all programmes is to revise for and sit the situational judgement test (SJT - done in Dec/Jan) which is an online test designed to assess how you would deal with difficult scenarios that arise in clinical practice. When completed, all medical students across the country are given a ranking score based on how well they did in comparison to other students. This score is added to the score generated by your medical school based on how well you did in medical school exams and this gives an overall score which is used to rank all medical students in the country. You can also get ‘bonus points’ for having previous/intercalated degrees, or for your name being on a published research paper.
Once everyone has been ranked, the online platforms sorts people into their "deaneries" (this is the rough area of the country I mentioned you rank early in the process). Academic programmes and priority programmes are confirmed around this time. If on the standard programme, you then pick where in that area you want to be (if a large area - e.g. Yorkshire is split into south, east and west). Then the same ranking score is used to allocate people their smaller areas.Then you get back to ranking again, this time for the actual jobs you will be doing. Some places have more than 300 jobs and you have to rank all of them so this is a very time-consuming task! After this, the rankings are once again used to allocate jobs. Then it's simply a matter of liaising with the HR teams at the hospital where you are placed to finalise details like occupational health, DBS checks, rotas and things like that.
Helena: We use a website called Oriel, where you submit your personal information, and any other degrees or publications you have. The medical school confirms your ranking (from 1-10) in the cohort and allocates you points accordingly. You then sit the SJT, and you have to rank each deanery in the UK (~20) based on where you'd like to go. The likelihood of being placed at your top choice depends on how well you do and how competitive the deanery is, but the vast majority of people get one of their top 5 places, with most getting choice 1 or 2.