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The Foundation Programme is a 2-year training programme for newly graduated doctors. It is a structured, supervised workplace-based training programme, typically made up of 6 four-month placements in a range of specialties and settings over 2 years so you can put what you have learned at medical school into practice, whilst giving you the additional skills, knowledge, and experience needed to practice safely as a doctor.
After graduating from medical school, the first foundation placement will usually commence in early August. Over the 2 years, you will build up a portfolio of recorded supervised learning events (we do a lot of SLEs during our medical school clinical years) and achievements as you gain more experience and acquire competence in new areas. This portfolio will then be used to apply to Core Medical Training, Surgical Training, GP Training, and beyond.
All UK medical school graduates will be enrolled in the Foundation Programme Application System (FPAS) called Oriel to begin applying for their desired Foundation Programme placements across the country. There are a few different programme types to choose from with slightly different application criteria and deadlines, so I will break them down in this blog post, starting from the earliest deadline to the latest.
Pre-allocation
Deadline: early October, will see option to apply on Oriel account (less than 2 weeks from being registered onto the system so make sure you have everything you need in advance) Outcomes given: November
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 means you will be able to be a doctor in the area you live in (your official home postcode) OR where you went to university (your university postcode). You and your university are required to provide evidence for these applications. You should let them know you are applying for pre-allocation as early as possible.
Personal Circumstances are based on 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.
The Specialised Foundation Programme (SFP)
Deadline: mid-October, will see option to apply on Oriel account. Outcomes given: January
The Specialised Foundation Programme (SFP) (which used to be called Academic Foundation - AFP) is the same 2-year training programme as every other junior doctor apart from 5 clinical rotations and 1 academic rotation as opposed to 6 purely clinical rotations. It is an optional EXTRA application AS WELL AS your application to the standard foundation programme. The 4-month block for academia (which is usually at the end of F2 when you've accumulated clinical experience) is time set aside for these junior doctors to complete academic activities such as research projects, conference presentations, education and extra training, but this will depend on the type of programme you apply to).
Specialised units of application (SUoAs) are the different locations in the UK where you can complete an SFP. They provide 3 main types of programmes: academic/research, medical education, and leadership & management. SFPs vary significantly between SUoAs and have slightly different criteria. For example, all of London SFPs are research whilst other regions have more Med Ed and Leadership options.
Research
Suitable for doctors who want an academic career in medicine (clinical work alongside research) and may go on to do a PhD and lead projects in their respective specialty. The SFP in research can also be a springboard to apply for an ACF (academic clinical fellowship - find out more in my blog post on academic careers in medicine).
Examples of academic activities:
Research courses
Dedicated time off to undertake research, attend conferences, and present work in specialties of your choice
Examples of expected achievements:
Complete a piece of academic work in 4-month placement
Literature review
Practical project in a lab
Data collection
Write a paper
An outline of the Surgical Research SFP and typical week timetable in Southampton SUoA can be found here
Examples of possible achievements:
Publish papers
Achieve research degree e.g. part-time Master's
Get ready to apply for ACF / future PhD
Examples of research projects:
Education
Suitable for doctors who see themselves teaching at universities and other institutions. Often SFPs combine education and research if you like a bit of both!
Examples of academic activities:
A systematic review of the literature
Lesson planning
Data collection - lesson feedback, interviews, surveys on teaching
Teaching students and healthcare colleagues
Examples of expected achievements:
Bedside and ward-round teaching
Critically appraises major pedagogic theories in teaching.
Teach in different professional settings.
Present abstract at a conference
Examples of possible achievements:
PGCert
Get involved with medical school admissions & OSCEs
Run an SSC
Previous projects:
Technology-enhanced learning and its use in healthcare settings
Career support for undergraduate medical students
Example of expectations and potential achievements based on medical education SFP programme based in Kent, Surrey & Sussex SUoA.
Leadership & Management
Examples of academic activities:
Attend leadership faculty group meetings
Mentor management and leadership
Plan and run a service improvement project
Expected:
Complete masters-level modules in Leadership & Commissioning
Teach medical students
Possible:
PGCert
Complete an NHS Leadership Academy qualification
Shadow chief executive for a half-day
Become CQC specialist advisor
Recent project examples (from Kent, Surrey, Sussex SFP leadership programme):
Developing an electronic handover tool
Building a business case for expansion of the Acute Oncology Service to the Princess Royal Hospital site.
Example of expectations and potential achievements based on academic management & leadership SFP programme based in Kent, Surrey & Sussex SUoA.
All applicants have the option to apply to a maximum of 2 Specialised Foundation programmes along with their standard foundation programme application. The format of the SFP application form is based on the standard FPAS but additional items are included such as an ‘Evidence’ section and a ‘Supporting’ section including white space questions. When completing the SFP application, you must demonstrate your interest in and aptitude for the programme for which you are applying. You will also be invited to interview if successfully shortlisted. Demonstrating academic excellence provides a distinct advantage.
White space questions:
These are up to 6 competency-based questions about your career goals and interest in the programme you've chosen (some question examples are here). It's important to draw on when you have done research, taught, or led a project - as these are the themes of the SFP - and spend time writing these as you would for any job application. Some deaneries do not use white space questions as part of their application (e.g. London and Oxford).
Educational achievement:
SUoAs are very specific about what they deem as an educational achievement or not and this will vary depending on where you want to apply. For example, this year, London still counted extra degrees as an educational achievement whereas the North West of England School of Foundation Training did not. London also used a '2-stage' system whereby Stage 1 was based on the number of publications you had. If you hadn't published, you did not move to the second stage.
Educational achievements can be demonstrated through the following:
Publications (more points for being the first author, must be peer-reviewed and have PubMed ID, book chapters and named collaborations do not count)
Conference presentations (more points for international conferences)
Prizes - i.e. for presenting abstracts at conferences, essay competitions
Courses that you have attended i.e. leadership courses
Intercalated BSc or other degrees
Applying for the SFP is a competitive process (very few spaces are available) so it is essential that your CV/portfolio highlights why you are suited to your chosen post and what you can bring to the role as well as your interview performance. This is where extra-curricular activities can come in, for example:
Have you been a President of a student society? Have you started your own society?
Have you been published? Have you demonstrated a research interest? What projects have you been involved in?
What did you do for your elective?
Have you attended conferences? Have you presented your work at them?
Have you won national or international prizes?
Therefore, although it is important to start thinking about how you can accumulate points early for your FPAS, it is equally important to remember that once you finish your Foundation years as a junior doctor and want to progress in your career, teaching, leadership and mentoring experience will be very impressive on your CV and at interview regardless. Do not overlook these types of experiences and most of all: do things that you are passionate about! It's not all about the points!
It is important to note that specialised units of applications (i.e. foundation schools or groups of foundation schools that offer Specialised Foundation Programmes) determine the scoring criteria for SFP selection locally. Some collect and use information about additional achievements in the SFP section of the application form whilst others will not consider them. Therefore, you need to refer to the scoring criteria available on individual foundation school websites.
Foundation Priority Programmes (FPP)
Deadline: February (same as standard programme), will see option to apply on Oriel account. Outcome given: February
FPPs have been developed to support specific areas of the UK that have historically found it difficult to attract and retain doctors through the foundation and specialty recruitment processes (underserved places). The main aim is to maximise the opportunity for applicants who wish to be in less popular areas and therefore improve the supply for specialty training and beyond.
Many FPPs are specifically designed to attract and retain doctors in remote, rural, and coastal geographies, under-doctored geographies, and shortage specialties, and offer a range of incentives including higher pay. A list of what Foundation Schools offer can be found on their respective webpages under 'Foundation Priority Programmes'
The standard Foundation programme (FP)
Deadline: February (same as standard programme), will be automatically entered into the allocation process by your medical school. Outcome given: March.
Your medical school will register your Oriel account for you to be entered into the Foundation Programme -the 2-year training programme for newly graduated doctors.
You will rank all 20 regions in the UK where you could see yourself working and have until February to do so.
You will be allocated at random in March. Applicants will not be told their randomised rank in advance and this rank will remain the same when choosing the specific jobs/specialties within the region you get allocated to.
This new process was decided in 2024 - see full blog post of changes here.
The Psychiatry Foundation Fellowship programme (PFFP)
Deadline: May, separate application to Oriel (through RCPsych)
This two-year fellowship is open to people commencing foundation training in August 2023 and will provide support throughout your foundation training. An information evening is usually held in March.
What are the benefits?
The PFF aims to improve exposure to psychiatry for foundation trainees and to support them in understanding and exploring careers in psychiatry. As part of the fellowship, trainees will have access to a range of benefits:
Development days - network, meet peers and senior psychiatrists and discover more about research, education and broader careers in psychiatry.
Career Development fund of £1,500 to use over the two years in foundation training
Free registration to attend RCPsych International Congress including accommodation and travel costs will be covered.
Access to the Royal College of Psychiatrists' eLearning hub, journal subscriptions and other learning resources to support trainee psychiatrists prepare for MRCPsych exams.
Opportunity to network and collaborate with PFFs across the country.
Applying for a PFF
PFF positions are subject to confirmation of funding. You apply via RCPsych and must answer white space questions:
What aspect of psychiatry do you find most challenging?
Give an example of where you have had to innovate. This does not need to be work/ professionally related and can be an example from another area of your life.
Describe a situation where you have failed to achieve a desired objective and what you learnt.
At the point of application, you will need to confirm which Foundation School you have been allocated to and have been / will be offered a UK Foundation Programme commencing in August.
You do not need to have been allocated a psychiatry placement as part of your foundation programme.
Late applications will not be accepted under any circumstances.
Eligibility criteria
You must have been allocated to and have been / will be offered a UK Foundation Programme commencing in August.
You must be a Student Associate member of the College.
Please note: popular UK locations are often not offered e.g. London
Extra sources:
