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

Updated: Feb 8

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.

Prior to this change, UK applicants were 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. The 2024 applicants’ guidance explains what will be happening for myself and many other medical students this year.

So how will preference-informed allocation work?

The Specialised Foundation programme and Foundation priority programmes have separate applications and candidates find out their jobs in January.

Every eligible applicant who remains in the Foundation Programme application process after allocation to SFP or FPP programmes, will be given a computer-generated rank by the Oriel system. The ranks will be generated when the allocation algorithm is run in Oriel and candidates will NOT be informed of their rank until after they receive their job offers.

The allocation process takes place in March (after Foundation School preferencing closes in February) and applicants are allocated to Foundation School, also known as Unit of Application (UoA).

The Oriel application system will allocate everyone within two passes through the system:

Pass 1 - First choice Foundation School allocation only
  • The algorithm will work through the applicant list in computer-generated rank order. If there are places available in an applicant’s first choice Foundation School, they will be allocated to it. If no places are available in their first choice Foundation School, that individual applicant will be skipped over and the algorithm will continue to work through the full list of applicants, giving as many as possible their first preference. It will do this until it reaches the end of the applicant list.

  • Example: Out of 6000 medical students this year, let's say 1500 want to work in London and put it as their first choice deanery. The algorithm will only consider these 1500 people in the first pass for London because they put it as their TOP choice. If there are only 999 places available in London, around 500 people will be left disappointed and this depends on their randomised rank. Once all London places are filled, nobody else will be able to be allocated to London - no matter where it is in their list. So I'd advise putting where you TRULY want to work first.

Pass 2 – Allocating unplaced applicants
  • Next, the algorithm will again work through the applicant list in computer-generated rank order. Any unplaced applicants will be allocated a place in their highest preferenced Foundation School which still has available places. It will do this until it reaches the end of the applicant list.

  • Therefore, you must think carefully about your ranking list because the higher up something is on your list, the more likely you are to get it.

  • Very popular deaneries are likely to be completely filled on first pass.

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.

Once allocated
  • Applicants will be invited to preference the specialties/jobs they want to do within their Foundation school once allocated and this will take place from March onwards.

  • Applicants will then be confirmed for their choices from April onwards. This process will be managed locally by foundation schools.

  • The same computer-generated rank will be used when allocating applicants to the specialties/jobs they want. You will NOT receive a new rank.

What about '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. This will remain the same as it has always been.

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.

My pros and cons of the new system:



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

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

Allows for a better spread of doctors across the UK

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

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%)


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May 03

Absolute rediciulous decision made by little minds who really need to get out more. Yes I'm talking to you idiots at the Medical school councils, BMA and the so called four UK governments. Have you not learnt from the dangerous mistakes your stupid algorithms have made with the Covid A level results and the Post Office cock ups? When a candidate misses out on his or her's first choice they are completely shafted by being placed right at the bottom of your S..t pile! You are really meddling with a system that was already working well, your little thick minds can't comprehand. Or is it that you clever clogs are trying to supply jobs for your PA machinery that yo…


Mar 12

No reward for working hard over the 5 years of medical school. If your random ranking is low your going to get the last pick of areas and shafted again as you get the last pick of individual specialities/jobs in the second round.


Jun 09, 2023

Really clear summary and thanks for discussing the pros and cons. Really don’t know how to feel about this change tbf i think its very unfair to do it last minute and for the ppl who have consistently worked hard

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