The FPAS made easy
Updated: Jun 28
The Foundation Programme is the 2-year transition from graduating as a medical student and becoming a doctor. The programme 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 practise 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 onto 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, your 3rd and 4th year exam results count towards your EPM. This can vary 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)
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)
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 (AFP - 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 Academic Foundation Programme (AFP)
The difference between the standard Foundation Programme and doctors on the AFP is that AFP doctors have time set aside for academic activities (such as research projects, but this will depend on the AFP itself). This means that AFP doctors essentially work 'part-time'. AFPs vary significantly between foundation schools. Applying to the AFP may be for you if you want have an academic medical career.
All applicants have the option to apply to a maximum of 2 Academic Foundation programmes once they have submitted their standard FPAS. The format of the AFP application form is based on the standard FPAS but additional items are included such as an ‘Evidence’ section and a ‘Supporting’ section. When completing the AFP application form, you must demonstrate your interest in, and aptitude for the programme for which you are applying - i.e. you could do an AFP in medical education, medical management and leadership, surgical research and much more! Demonstrating academic excellence provides a distinct advantage.
This can be demonstrated though the following:
Academic papers i.e. publications
National/international presentations i.e. presenting abstracts at conferences
Prizes i.e. national essay competitions
Courses that you have attended i.e. leadership courses
Intercalated BSc or other degrees
Additional experiences that you have organised e.g. your elective, student selected components, running your own conference, mentorship, owning a tutoring business etc.
Applying for an AFP is a competitive process 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. This is where extra-curricular activities matter, 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, it will be your teaching, leadership and mentoring experience that will be very attractive on your CV and points are calculated in different ways. Consider drumming up these types of experiences too and most of all: do things that you are passionate about! It's not all about the points!