Out of Programme Experience

Out of Programme Experience

Have you identified something that you would like to do for six months, a year or longer, that will mean you need to take time out of your current training programme?

The overall purpose of time Out of Programme (OOP) is to allow trainees to take up opportunities that their training programme would otherwise prevent.

 

Tell me more about time Out of Programme

There are four types of OOP (which can also all be referred to by the one name, Out of Programme Experience OOPE):


OOPT Out of Programme Experience for Training - has approval from the GMC and will contribute towards obtaining your CCT.
OOPE Out of Programme Experience for Clinical Experience - has not received approval from GMC for contribution towards a trainees CCT.
OOPR Out of Programme Experience for Research - including a registerable higher degree) can be up to three years.
OOPC Out of Programme Experience for a career break - e.g. to work in industry, for domestic responsibilities or for ill health reasons.
OOP options explained

To get the full details on OOPEs, you should refer to the Gold Guide (if you started your training after August 2007) and the Orange Guide (if you started your training before August 2007) in detail as they set out the rules for undertaking time OOP. The Gold Guide contains more specific details on the process and most Deaneries/LETBs follow this process.

You should also review your Deanery/LETB website for guidance specific to your region.

 

Will my time OOP contribute towards my Certificate of Completion of Training?

The decision about which OOP to apply for, and eligibility for accreditation to CCT, must be clarified by applicants with their educational supervisor in advance of any application.

If the time out of programme is to count towards CCT, the Deanery or LETB will submit the application to the GMC on the applicant's behalf for their approval.

If the period of OOP does not require approval, then the medical Royal College should also be informed in order to amend the trainee's completion of training.

Once the application has been approved, the educational supervisor and employer (current or next) need to be given notice of the proposed absence in writing as soon as possible.

The process varies slightly between specialties so ensure to check the approvals pathway. The GMC does not retrospectively approve training for the Certificate of Completion of Training (CCT) or CESR CP.

 

How do I apply?

To apply for an OOP experience, you will need to follow the process described on your Deanery website for guidance specific to your region.

If you are undertaking an OOPT, your Deanery will apply for approval to the GMC. The GMC is the only body which can give, amend or withdraw training approval for any OOP intended to lead to the award of CCT. The GMC will not accept applications for OOP directly from the trainees or the respective colleges.

You do not need to consult with the GMC if your time OOP is not to count towards the award of CCT. Full details of the GMC approval process is available on their website. 

Review the application process for OOP

 

When should I apply?

On average, trainees are expected to have undertaken at least a year of training prior to making a request for OOP. Each individual case will be considered on merit and all plans for taking time out of training, and its impact on the individual trainee’s progression, should be discussed with educational supervisors.

Exclamation markIt is recommended to seek advice from those familiar with your specialty, such as experienced colleagues or the Royal College postgraduate clinical tutor on the best time to take time out during training. 

Exclamation markTrainees who wish to take time out of work with a humanitarian or charitable organisation should note that most agencies require a minimum of two to three years’ postgraduate clinical experience and training. 

Year Best time to go Considerations
FY1 / FY2
Timings most often after completing core training You will not be protected by a NTN and your continuation of service would be affected. 
ST1 / ST2 / ST3
Timing most often between ST2 - ST3 
There may be local variation and competing pressures on approvals due to capacity and post availability.    

 

Deferral of training

Deferring the start of your training programme is slightly different, and Deans will not normally agree to deferment except on statutory grounds like maternity, or for time to complete a higher degree, though you may have to be in a programme and apply for OOPR to do this, rather than deferring. 


Applicants currently being allocated to higher specialist training (ST3 level or above)
In order to take time out of training, trainees will need to defer their start date.

It is important to give as much notice as possible to your educational supervisor and dean prior to ST3 (ST4 in psychiatry and paediatrics) allocation.
Applicants for higher specialist training (ST3 level or above) 
Trainees who do not have a National Training Number (NTN) and are applying for a new post, will need to clearly state that they wish to defer their start date when applying.

Your deanery or LETB may not accept applications a year in advance, but consulting with the Deanery or LETB is recommended before applying as successful candidates may be allocated with an NTN with a delayed start date.
Deferral with regard to research
It is recommended that trainees seek guidance from Deanery or LETB regarding deferrals for research purposes. Where training programmes are of short duration, such as in general practice, deferrals for OOP may be less likely to be agreed, and discussions with educational supervisors prior to applying is recommended.

 

Notice period

National minimums for notice periods are stated below but it is advisable that you give as much notice as possible for approval of application, as this may increase the likelihood of time out being approved. 


Before you go Must do
12 months before you go Inform educational supervisor or training programme director

Inform final approving authority (i.e. Dean) of intention to take time out during following year of training. 
6 months* before you go Submit application form
 3 months before you go Finalise dates and process for return

*As soon as possible or minimum 6 months before you intend to go

 

How long can I be Out of Programme?

This will depend on the nature of the project or task you are undertaking. You will be asked to declare your return date in your application to your Deanery.

As a rough guide, an OOP will normally be up to two years, however, for longer periods and with OOPR, you should discuss this with your Deanery at the time of making an application.

If the nature of your OOP changes you must notify your Deanery as soon as possible. They may be obliged to return to the GMC for approval for contribution towards CCT and therefore you should do this as soon as possible.

At the time of application, your Deanery will be able to confirm if you are to retain your NTN number.

 

Removal of your NTN during time Out of Programme

Those trainees who take a period of OOP retain their National Training Number (NTN), leaving gaps within the rotation. Deans may take into consideration the needs of the service and the impact on patient care and the training of colleagues when assessing OOP applications from trainee doctors.

The Gold Guide mentions the specific occasion where the Deanery may believe that you have breached the conditions under which you have retained your NTN during time OOP or working overseas, for instance. They may write to you to inform you that you have had your NTN removed.

In this situation, contact the BMA on 0300 123 123 3 or use the enquiry form urgently to discuss your situation. In some circumstances, you may be able to appeal this with the Postgraduate Dean. This is a very rare situation and each case will be determined on its individual merits.

 

Gaining Permission

To gain the necessary permission for taking time out of the specialty training programme while retaining a NTN, you must do the following: 

icon blue infoComplete the OOP request annual review form (Appendix 4 Gold Guide 3th Edition), obtainable from Deaneries or LETB. 
This form must be countersigned by the educational supervisor before being submitted to the postgraduate dean and training programme director for approval. Note: Individual Deaneries may require further documentation and evidence in addition to a completed OOP application form.
Trainees must clarify the OOP policy and procedure of the approving Deanery or LETB before submitting an application as practices vary.
Note: In some instances, the educational supervisor may need to provide a supporting statement or record of discussions with the trainee about the application
It is the responsibility of the trainee to ensure that full supporting documentation is sent to the Deanery or LETB within the required timeframe.
Once all the required information is received, the Deanery or LETB will consider the application for approval
icon blue infoContact the relevant body with responsibility for signing off training, such as the training departments of their respective medical Royal College or Faculty.
 All medical Royal Colleges and faculties have procedures in place for reviewing OOP applications, though terminology may differ between colleges.
 Full details about the process for taking time out can be obtained from the training and education departments of the relevant medical Royal College.
 The Deanery or LETB should be kept informed of all correspondence. Trainees should also contact their employer.
 icon blue infoIt is essential that trainees decide whether or not they want the time they are spending out of programme to count towards their Certificate of Completion of Training (CCT) or CESR CP, and discuss this with their educational supervisor.
If the time out of programme is to count towards CCT, the Deanery or LETB will submit the application to the GMC on the applicant's behalf for their approval.

If the period of OOP does not require approval, then the medical Royal College should also be informed in order to amend the trainee's completion of training.
Once the application has been approved, the educational supervisor and employer (current or next) need to be given notice of the proposed absence in writing as soon as possible.

The process varies slightly between specialties so ensure to check the approvals pathway. The GMC does not retrospectively approve training for the Certificate of Completion of Training (CCT) or CESR CP.
icon blue infoTrainees should ensure that their educational supervisor is aware of the anticipated date of their return, in order to secure their re-entry to the training programme. 
Where the duration of the OOP is longer than a year, the OOP document should be returned on an annual basis to the Deanery or LETB while the trainee is out of programme, and at least six months notice must be given of the intended return date. 
Note that training placements depend on availability and they may have to wait for a placement on their return. If you want to extend your OOP period you will need permission from the Deanery or LETB as if it were a new period of time out, including requesting further approval from the GMC where applicable.
Any extension to the OOP period agreed by the Deanery or LETB should be communicated to the relevant medical Royal College or Faculty as well. 
 All parties should also be informed about any changes to the OOP, such as advising if the OOP is not going ahead, if the start dates, duration or location change, or if the trainee's experiences during the placement differs from the original application. 
Failure to provide information to the relevant authorities could result in the loss of your NTN.

How do I ensure my return to training?

Trainees should ensure that their educational supervisor is aware of the anticipated date of their return, in order to secure their re-entry to the training programme.

Where the duration of the OOP is longer than a year, the OOP document should be returned on an annual basis to the Deanery or LETB while the trainee is out of programme, and at least six months notice must be given of the intended return date.

Note that training placements depend on availability and they may have to wait for a placement on their return. If you want to extend your OOP period you will need permission from the Deanery or LETB as if it were a new period of time out, including requesting further approval from the GMC where applicable.
Any extension to the OOP period agreed by the Deanery or LETB should be communicated to the relevant medical Royal College or Faculty as well.

All parties should also be informed about any changes to the OOP, such as advising if the OOP is not going ahead, if the start dates, duration or location change, or if the trainee's experiences during the placement differs from the original application.

Failure to provide information to the relevant authorities could result in the loss of your NTN.

 

What if my application for time Out of Programme is refused?

If your application for time OOP is refused or the GMC will not approve your time OOP for contribution towards your CCT you should:

  1. Write to your Deanery to request written confirmation of the reasons your application for OOP was refused and written confirmation of the amendments to your application that would satisfy their criteria for an Out of Programme request
  2. Upon receipt of the letter from your Deanery, see if you are able to amend your application for time OOP to fulfil the criteria they set. If you are able to make suitable amendments, write to your Deanery to explain the amendments and request approval
  3. If you have any problems, contact BMA on 0300 123 123 3 or use the enquiry form

It is important to note that an appeal against an OOP can only be against the way that the decision was taken rather than the actual decision.

Before beginning the full appeals process, trainees and deans must first jointly attempt to resolve the issues of concern through informal discussion. A professional representative or colleague may also participate in these discussions.

If, after due consideration, the matter can be resolved without recourse to the appeals procedure, then this agreement should be confirmed in writing by all parties.

 

Wait! I am on a visa - does this affect whether or not I can participate in OOP?

If you are subject to the immigration rules you will need to consider your visa status when planning any time out of programme. For example if you are on a Tier 2 visa , which is your permission to stay in the UK, the visa is attached to your job.

If you leave your current employer to go on an OOP your employer must tell the Home Office you have left your job.

For more detailed information on how your visa status might impact on time out of programme contact the BMA Immigration Advice Service which is available to all BMA members.

Check the Immigration section FAQ's

 

OOP Top Tips

Some of our trainees who've taken time Out of Programme have offered their top tips for trainees who are considering applying:

  • Plan ahead and let your deanery know plans promptly - be aware of early cut-off dates for obtaining deanery approval
  • Start thinking about what you want to do with regards to a fellowship around 9-12 months in advance. This will give enough notice to your parent school and makes it easier when you do get a job offer.
  • Do as much preparation work as possible before starting your time out (eg. start organising ethical approvals).
  • Sort out your visa early on, as there is a lot of paperwork to sort out and it can take a lot of time to organise.
  • Think carefully about what you personally want to achieve during time out and set realistic, clear goals which you should review carefully. Also consider how what you learn would benefit your department when you return.
  • If taking OOP in a non-clinical post, do some locum work, but don't worry too much about de-skilling. Try to choose something you are passinate about, not necessarily within your specialty. Also, be diverse in taking up opportunities while doing OOPE - try everything once to widen your horizon.
  • Be very discerning about reserach supervisors and projects (if at all possible - it isn't always)
  • Try to look for a banded OOPE (most of them are not). Some posts were not banded initially, but this changed after negotiation. Banded posts are usually related to your speciality.
  • Keep your e-portfolio subscription to maintain access to it while not in training.
  • Look for personal contacts: speak to your consultants and colleagues, and see if they've done fellowships and can offer any sort of introduction.
  • Make contact with the consultants in the department you're going to be working in - ideally face-to-face.
  • Think hard about the training you've had so far in the NHS and what skills and knowledge you're able to bring to them.
  • Get a PAYG SIM card with plenty of data when you first arrive in the country - so many forms want a phone number so it makes a big difference.

 

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