postgraduate medical
training in the UK
2011/2012
Lydie Fialová
University of Edinburgh
medical training
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medical school - 5 years (29 med schools)
intercalated BSc, MSc - 1 year
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foundation training - 2 years - UKFPO
full GMC registration after FY1
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GP and specialty training - Royal Colleges
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general practice - 3 years
specialty training - 4-7 years
institutions involved
• General Medical Council
• Royal Colleges
• NHS Deaneries
• Universities (Academic Medicine)
• http://www.mmc.nhs.uk/colleges__dean
eries/deaneries.aspx
points of entry
• FY1 (FTAS)
• FY2 (GMC registration)
• ST/GP entry (CCFT – 3 years)
• core training - subspecialty training
• run-through training programs
• CCT (certificate of completion of
training) entry - consultants
FY1 entry
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http://www.foundationprogramme.nhs.uk
national centralized recruitment process
application - October (FTAS)
eligibility - August (UKFPO eligibility office)
provisional GMC registration http://www.gmcuk.org/doctors/registration_applications/s15a_
p1.asp
allocation to FT
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allocation to foundation schools based on
ranking of the application
list of foundation schools
http://www.foundationprogramme.nhs.uk/page
s/medical-students/deaneries-foundationschools
provisional GMC registration http://www.gmcuk.org/doctors/registration_applications/s15a_
p1.asp
FT application
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educational performance measure (EPM)
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Medical school performance, providing a
decile score - 34 – 43 points
Additional degrees (Bachelors, Masters
and Doctorates) – maximum of 5 points
Publications, presentations and prizes –
maximum of 2 points
situational judgment tests (SJT)
situational judgment tests
Situational Judgement Tests are a test of
aptitude and are designed to assess the
professional attributes expected of a
Foundation doctor. There are two question
formats:
1. Rank five possible responses in the most
appropriate order
2. Select the three most appropriate responses
for the situation
example 1
You are looking after Mr Kucera who
has previously been treated for prostate
carcinoma. Preliminary investigations
are strongly suggestive of a recurrence.
As you finish taking blood from a
neighbouring patient, Mr Kucera leans
across and says “tell me honestly, is my
cancer back?”
A Explain to Mr Kucera that it is likely that his
cancer has come back
B Reassure Mr Kucera that he will be fine
C Explain to Mr Kucera that you do not have all
the test results, but you will speak to him as
soon as you do
D Inform Mr Kucera that you will chase up the
results of his tests and ask one of your senior
colleagues to discuss them with him
E Invite Mr Kucera to join you and a senior nurse
in a quiet room, get a colleague to hold your
‘bleep’ then explore his fears
answer: DCEAB
It is not a FY1’s responsibility to break bad news to a
patient and the full results are not available yet. It would be
most appropriate for a senior colleague to speak to Mr
Kucera with regards his diagnosis. Informing Mr Kucera that
you will speak to him as soon as you get the test results
back would still be appropriate as you are giving him some
information, although this may not necessarily mean that
you would be providing him with the diagnosis. It may be
appropriate to discuss Mr Kucera’s fears with him, but by
doing this you may not be attending to other ill patients and
are asking a colleague to take on your responsibility by
holding your bleep. It may also become a difficult
conversation when you do not have full details of the
results. It would not necessarily be appropriate to tell Mr
Kucera that his cancer is back as this has not been
confirmed, however it would be inappropriate to provide
false hope to a patient when preliminary investigations are
strongly suggestive of a recurrence.
example 2
You review a patient on the surgical
ward who has had an appendectomy
done earlier on the day. You write a
prescription for strong painkillers. The
staff nurse challenges your decision
and refuses to give the medication to
the patient.
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A Instruct the nurse to give the medication to the
patient
B Discuss with the nurse why she disagrees with the
prescription
C Ask a senior colleague for advice
D Complete a clinical incident form
E Cancel the prescription on the nurse’s advice
F Arrange to speak to the nurse later to discuss your
working relationship
G Write in the medical notes that the nurse has
declined to give the medication
H Review the case again
answer: BCH
Ensuring patient safety is key to this scenario.
It is important to discuss the nurse’s decision
with her as there may be something that you
have missed when first reviewing the patient.
Therefore it would also be important to review
the patient again. Also relating to this is the
importance of respecting the views of
colleagues and maintaining working
relationships, even if there is disagreement. As
there has been a disagreement regarding
patient care, it is important to seek advice from
a senior colleague.
professional attributes
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Patient Focus
Commitment to professionalism
Coping with pressure
Effective communication
Problem solving and decision-making
Organisation and planning
Working effectively as part of a team
Self-awareness and insight
Learning and Professional Development
FT resources
• http://www.foundationprogramme.nhs.u
k/pages/home
• academic programmes
http://www.foundationprogramme.nhs.u
k/pages/academic-programmes
• selection for FT http://www.isfp.org.uk/
GMC resources
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Trainee Doctor
http://www.gmcuk.org/Trainee_Doctor.pdf_39274940.pdf
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Good Medical Practice (2006)
http://www.gmcuk.org/guidance/good_medical_practice.a
sp
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GMC interactive cases
http://www.gmcuk.org/guidance/case_studies.asp
FY 2 entry
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must hold GMC full registration and licence
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http://www.gmcuk.org/doctors/registration_applications/s3_p1.
asp
stand-alone FY2 jobs - rare and competitive
‘locum appointment’ jobs - LAT (training) or LAS
(service); portfolio
advertised through http://www.jobs.nhs.uk;
http://www.jobs.scot.nhs.uk and other national
websites
specialty training
• run-through specialties - ST
• GP, paediatrics, OG, opthalmology,
microbiology, pathology, public
health...
• core training and specialties - CT + ST
• acute care, surgical specialties,
medical specialties, psychiatry
• Royal Colleges and GMC
ST/CCT entry
• GMC registration
• Royal Colleges - individual specialties
• certificate of eligibility for ST/GP
registration - http://www.gmcuk.org/doctors/registration_applications/
certification_college_contacts.asp
• ST application - November
ST selection
• application - person specification
• interview / situational judgment
• portfolios and certificates
• appraisals and recommendation letters
• certificate confirming eligibility for
specialty registration
• academic medicine
specialty training
• England http://www.mmc.nhs.uk/
• Wales
http://specialty.walesdeanery.org/
• Scotland http://www.scotmt.scot.nhs.uk/
• Northern Ireland
http://www.nimdta.gov.uk/
• http://www.gprecruitment.org.uk/
STx entry
• fixed term specialty training
appointments
• FTSTA and locums advertised through
• http://www.jobs.nhs.uk
• http://www.jobs.scot.nhs.uk
• http://careers.bmj.com/careers/hosp
ital-medical-healthcare-doctorsjobs.html
GMC registration
• provisional/full registration and license
to practice
• specialist registration
• GP registration
GMC registration
• documents
• ID documents
• medical training
• certificate of good standing
• fee
• identity check - London
GMC registration info
• http://www.gmcuk.org/doctors/medical_register.asp
• http://www.gmcuk.org/doctors/applications.asp
• http://www.gmcuk.org/doctors/registration_applications/
s3_p1.asp
key links
• http://www.gmc-uk.org/
• http://www.medicalcareers.nhs.uk/
• http://aomrc.org.uk/
• http://careers.bmj.com
• http://www.jobs.ac.uk/