top of page

The Foundation Programme application (FPAS) made easy - SFP vs FP

Updated: Mar 26

The Foundation Programme is the 2-year transition from graduating as a medical student and becoming a doctor. 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 or GP Training, and beyond.

All UK medical school graduates will be enrolled on the Foundation Programme Application System (FPAS) to begin applying for their desired Foundation Programme placements across the country. Applicants are allocated to foundation schools based on their total application score, which is made up of the Situational Judgement Test (SJT) score and the Educational Performance Measure (EPM).

The EPM (50 points altogether)

The EPM is a measure of academic performance throughout an applicant’s time at medical school. Points are awarded for medical school performance and any additional educational achievements including additional degrees and publications.

Your medical school performance (max. 50 points)

This will be based on your exam results in medical school. For King's, our 3rd and 4th year exam results count towards our EPM. This varies between medical schools.

The exam results for your year group will be grouped into 10 deciles:

Top 10% of the year - 50 points

Top 20% of the year 49 points

30% - 48 points

40% - 47 points

50% - 46 points (average score of the year group, most people will get 39 points on their EPM)

60% - 45 points

70% - 44 points

80% - 43 points

90% (bottom 10%) - 42 points

100% (bottom of the year) - 41 points

Tip: Find out what exams are worth prioritising by finding out what years your exams count. Work SMART - use your time effectively.

The SJT (50 points altogether):

The SJT is an invigilated test designed to assess the professional attributes expected of a foundation doctor. You will be presented with a series of hypothetical scenarios that a foundation doctor may encounter and asked to choose what course of action you should take. For each question, you may be asked to rank five possible responses in order of most appropriate to least appropriate or to select the three most appropriate actions for a given situation. I like to think of it as the UCAT SJT section on steroids!

Tip: Start attempting questions early.

Total points: 100

The Prescribing Safety Assessment (PSA)

The PSA is an online assessment of competency in the safe and effective prescribing of medications, taken by final-year medical students.

Some medical schools use it summatively i.e. you have to pass it, along with your other exams, in order to get your medical degree. Others use it formatively, but if you do not pass it by the end of F1, you will not be able to continue your training.

The exam is 200 marks in total and takes 2 hours to complete. Geeky Medics has a fantastic post with tips on how to pass.

The Specialised Foundation Programme (SFP) (used to be called AFP)

The difference between the standard Foundation Programme and doctors on the SFP is that SFP doctors have time set aside for academic activities (such as research projects, but this will depend on the subject you apply to). This is usually a 4-month placement in F2. Specialised units of application (SUoAs) provide 3 main types of programmes: academic/research, medical education, and leadership & management.

SFPs vary significantly between SUoAs and have slightly different criteria.


Suitable for doctors who want an academic career in medicine (clinical work alongside reseach) 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 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 lab

  • Data collection

  • Write a paper

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:

Yorkshire & Humber Research SFPs


Suitable for doctors who see themselves teaching at universities and other instutions. Often SFPs combine education and research if you like a bit of both!

Examples of academic activities:

  • 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 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


  • Complete masters-level modules in Leadership & Commissioning

  • Teach medical students


  • 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 & leadershipSFP programme based in Kent, Surrey & Sussex SUoA.

All applicants have the option to apply to a maximum of 2 Specialised Foundation programmes with their standard FPAS (has to be the same TYPE of programme e.g. x2 leadership & management). 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 exampls 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.

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 an interest in research? 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: 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 schools use the EPM decile score and others do not. 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.

Overview of key changes:

  • The UKFPO released an official statement in December 2020 that explained that additional degrees and publications will no longer count as part of the total points for the foundation programme application from 2023 onwards. You can read the BMA article here.

  • Medical graduates will only need to submit one application, which will include the option to indicate if they would like to apply for any specialised foundation programmes. Additional questions for specialised programmes will be shown if this option is selected and you can also request for your application to be considered for priority programmes. Please refer to specific deadlines for each (2021 deadlines can be found summarised here).