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SJT and EPM removed from Foundation Programme allocation process from 2024 - what it means for you

Updated: Jul 12

Yet another change has been confirmed to how junior doctors will be given their jobs from 2024 onwards, so if you're a 4th-year medical student or earlier, listen up! The UK Foundation Programme Office (UKFPO) announced that the four UK statutory education bodies have agreed on a computer-generated ranking and the removal of the need to sit the Situational Judgment Tests (SJT) for 2024 medical graduates and beyond.

At present applicants are ranked based on a combination of their Educational Performance Measure score (based on how well you've done in your respective medical school exams) and a Situational Judgement Test score, with the highest-ranking applicants being allocated their preferred foundation school first.

The new Preference Informed Allocation (PIA) system is where applicants will not take the SJT and will not be ranked by medical schools. They will instead be given a ranking that is computer-generated (via the Oriel System) and based on NO meritocratic assessment so it should not be associated with any differential attainment according to protected characteristics.

The changes have been backed by the Medical Schools Council, the British Medical Association, and all four UK governments and apply to all medical graduates as part of their allocation to a foundation school in the UK. These proposed changes were open to student feedback from February - April 2023 and two important conclusions were made:

  • Most respondents indicated they would like to move to a Preference Informed Allocation for 2024 (66%).

  • A large majority of respondents (85%) agreed with the statement that the SJT can be very unfair and stressful for applicants and the EPM lacks standardisation within and across schools.

The changes will be applied across England, Scotland, Wales and Northern Ireland and will be implemented for the 2024 Foundation Programme round which opens for applications in August 2023.

Once implemented, the new system will be under constant review to make sure it is working well for applicants and if needed, changes can be made. Applicants’ guidance will be updated to explain the changes and will be available in July (KEEP UP TO DATE WITH THIS BLOG POST WHEN THAT NEW GUIDANCE COMES OUT!)

But for now, how will preference-informed allocation work?

What they've told us so far is that:

  • Applicants will preference their foundation schools / deaneries.

  • The allocation process will allocate as many applicants as possible to their first preference.

  • Where there are no remaining vacancies in an applicant’s first choice foundation school, they will be allocated their next highest available preferred foundation school.

  • Preliminary statistical modelling suggests a higher number of applicants (79.47%) will obtain their first choice Foundation School when compared to the score-based allocation (73.90%).*

* However, this does not take into account that students' attitudes and behaviours towards the process will now change. Since everybody has a chance of getting their first choice deanery, more people will be ambitious with their choices. This may actually result in fewer people getting their first choice.

What's still not clear (and will hopefully be covered in the applicant guide released in July)?
  • How preferencing will work: Will we be able to choose 10 options or 20? Or will we have to rank every deanery and combination of rotations? Will there be a limit on the number of foundation schools we may be able to apply to in the same city/area?

  • How the computer algorithm will generate our 'ranking': What information will Oriel use to give us a 'ranking' and will this be communicated to us before or after we make our choices?

  • What will change about the SFP?: Some deaneries (particularly those in London) that offer specialised foundation programmes used a cut-off EPM score as a measure of who they would invite to interview. If the EPM and SJT no longer count, will SFPs remove their cut-off scores and spread points out across academic achievements and interview performance?

  • What will happen to 'pre-allocation'?: The national pre-allocation (Personal Circumstances) process allows some applicants to apply to be pre-allocated to a Foundation School on the grounds of personal circumstances.

Personal Circumstances on the basis of the following criteria:

Criterion 1: You are a parent or legal guardian of a child or children under the age of 18, who reside primarily with you or for whom you have significant caring responsibilities.

Criterion 2: You are the primary carer for someone who is disabled OR you have significant caring responsibilities for a family member, partner or friend.

Criterion 3: You have a medical condition or disability for which ongoing follow-up for the condition in the specified location is an absolute requirement.

Criterion 4: Unique circumstances (e.g., athlete, armed forces reserves, house adapted for a disability).

Criterion 5: educational circumstances OR widening participation.

It is not clear how the randomised process will take this into consideration - particularly for the London deaneries which now may become even more oversubscribed.



Removes competitiveness between peers as you are not 'ranked' against your future colleagues

Lots of logistics still need to be ironed out and the announcement has come quite late - particularly for 4th years like myself who will have to prepare to apply for the Foundation Programme in the next few months.

Allows for a better spread of doctors across the UK

Lack of autonomy over where you may be based - especially those who have personal circumstances (mentioned above)

Removal of the SJT will allow students to focus more on their medical school curriculum. The SJT was very difficult to prepare for and was weighted far too heavily in the Foundation Programme application (50%)

Preferencing behaviour will change as a result of randomisation due to the fact that everyone has a chance to get a place anywhere. E.g. London and other major cities will become more oversubscribed than they already are.


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