The FPAS made easy

Updated: Feb 22

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. 43 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 - 43 points

Top 20% of the year 42 points

30% - 41 points

40% - 40 points

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

60% - 38 points

70% - 37 points

80% - 36 points

90% (bottom 10%) - 35 points

100% (bottom of the year) - 34 points

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

Additional degrees (max. 5 points) - will NO LONGER COUNT from 2023

You score extra points for any additional degrees, hence why lots of medical students intercalate.

5 points - Doctorate (e.g. PhD, DPhil)

4 points - Postgraduate Master's degree (MSc, MA), Bachelor's of Dental Surgery (BDS), Bachelors of Veterinary Medicine (B Vet Med), M Pharm Distinction, 1st Class Honours Degree (e.g. 1st class in your intercalation BSc, BA)

3 points - 2:1 class honour's degree, MPharm Merit, 1st class BMedSci at University of Nottingham

2 points - 2:2 class honour's degree, MPharm Pass, 2:1 class BMedSci at University of Nottingham

1 point - 3rd class honour's degree, 2:2 BMedSci at University of Nottingham

0 points - No extra degrees, 3rd class BMedSci at University of Nottingham

Tip: You may consider intercalating in a Master's degree instead of a BSc if you are up to the challenge! Bear in mind, you may have to sacrifice the summer between this year and when your 4th year starts (so I have been told).

Publications (max. 2 points) - will NO LONGER COUNT from 2023

Applicants earn up to 2 points for 2 publications (x1 point each). These are desirable but NOT necessary. Publications must have a PubMed ID number by the time you submit the application and you must be a named author. You do not have to be the first author.

Tip: Get published by starting early. Check out my blog post on how to get published.

Please be aware that there is a reason this section is only 2 points. It is more important that you are a competent doctor than one with publications. Publications, however, are slightly more important for the Academic Foundation Programme (now called the Specialised Foundation Programme, see below).


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 Academic Foundation Programme (AFP) - called the Specialised Foundation Programme (SFP) from 2022


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). Specialised units of application (SUoAs) will fall into a few main categories: academic/research, medical education, and teaching and/or leadership and management.


This means that SFP doctors essentially work 'part-time'. SFPs vary significantly between foundation schools. Applying to the SFP may be for you if you want an academic medical career.


All applicants have the option to apply to a maximum of 2 Specialised Foundation programmes with their standard FPAS. 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.


This can be demonstrated through the following:

  • Publications

  • National/international 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).

Sources:


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