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SFP to become randomised in 2025 - what do I do now?

The recent announcement from the UK Foundation Programme Office (UKFPO) regarding the integration of Specialised Foundation Programme (SFP) positions into the standard foundation programme has elicited disappointment among medical students and professionals. This decision, which removes the separate application process for SFP jobs, has raised concerns about its impact on the selection of the most suitable candidates and the overall effectiveness of these programmes.

The BMA released a statement on behalf of medical students acknowledging this and I agree with their sentiment. In light of ongoing changes within the UK medical profession, primarily the imminent introduction of apprenticeships, adjustments to the allocation process were bound to happen to ensure equitable distribution of students across regions, particularly in underserved areas. However, instead of incentivising people to apply to these places with bonus wage packets or training opportunities, ALL incentives are being removed across the board, which are unlikely to fix the broader problems in workforce distribution and retention.

Furthermore, there were a huge number of applications to SFP programmes this year as applicants wanted geographic certainty due to the introduction of preference-informed allocation (PIA) for the standard foundation programme. London, for example, had record numbers of applications, and criteria were changed for shortlisting just to get through the numbers of applications (i.e., doing a first pass of applications based on number of publications alone). This was foreseeable and a shame that instead of ironing out potential kinks in the PIA system, SFPs have been lumped into the random mess. However, they have yet to specify if there will be certain 'extra requirements' to rank these jobs which could be based on the typical SFP application that included white space questions and prizes/publications.

So what does this mean for the next generation of doctors?

The basic human psychological principle that we exploit every day is the reward system. The bottom line is: incentives get results and we have to recognise the role incentives play in motivating individuals to excel. The SFP incentivised candidates who enjoyed research to go above and beyond to 'score points' to get a research job they wanted in a place they wanted. Education Performance Measurses (EPM) incentivised candidates to want to do better in exams so they could, again, have their first choice job. The competitiveness it bred was unnecessary and damaging to medical students, so do I think we should go back to EPMs and SJTs? Absolutely not. But do I think motivated individuals should have their motivation encouraged/fostered instead of stamped out? Yes.

So, what would I advise you to do going forward if you still want to apply to the SFP?

Continue what you're doing

Continuing to pursue research, academic achievement, and seizing opportunities remains essential for building a robust skill set and enhancing future career prospects.

It may not feel like it, but research, doing well in exams, and taking advantage of opportunities around you will put you in good stead for specialty applications and if you're keeping your options open, a career abroad or a career pivot. Having more skills and accolades under your belt gives you more freedom to go where you are 'celebrated not tolerated'. You have more things on your CV that can give you an edge and that you can manipulate into suiting a variety of job roles. This will avoid you feeling trapped in the NHS.

Hard work is never done in vain and you need to be thinking about the long game with all the great things you've probably achieved so far. Don't let this get you down!

Put SFP programmes as your top ranked options

With the introduction of Preference Informed Allocation this year, my advice is to put where you really want to live and the jobs you really want to do FIRST. Don't try and be strategic. If you have had your heart set on the SFP, still put the jobs you wanted to do as your top-ranked choices - you're a lot more likely to get one of them (but I'll get back to you with the stats from the system this year).

Consider if this is the type of employer you want to work for long-term

The UKFPO is the first national application you will have to do in a LONG list of future applications for specialties via the same system. As the NHS landscape evolves in response to various factors, including political and financial considerations, individuals must consider whether it aligns with their professional aspirations and values. The goalposts will change as often as politics and finance do!

Ultimately, maintaining awareness of these dynamics and actively planning for contingencies can empower individuals to make informed decisions about their future within the medical profession. If you do not see yourself working for the NHS long-term, I recommend you start thinking and working towards a plan B in medical school.

Those are my thoughts so far. I wanted to keep this short and sweet. Some extra sources:

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