Foundation programs - a breakdown

[Will Watson]

I was just about to send out this to my 2nd years who've been asking me about MMC - I've adapted it from a very good article in the MSC conference guide with a bit of my own knowledge and stuff off the NHS webbie - although I think it might do for a quick guide to anyone on this form too. If anyone notices any inaccuracies, please let me know.

-=/o/=-

Some people have been asking about how medical careers are changing, so this outlines foundation programs as best as I can figure them out. I’m sorry if some of it is a bit vague in places but a lot of Modernising Medical Careers is still up for debate. Further information can be found on the NHS MMC website http://www.mmc.nhs.uk/foundation_programmes.asp?m=3 and the Manchester postgraduate deanery site http://www.pgmd.man.ac.uk/

F1
Foundation programmes last for 2 years, the first of which being F1. This includes 4 month rotations in General Medicine, General Surgery (which are compulsory) and the third 4-month rotation in another speciality (e.g. Paediatrics, A&E, Psychiatry, Obs and Gynae, etc). Registration with the GMC takes place at the end of the F1 year (similar to the present system where it takes place at the end of the PRHO year). Pay will be at the same rate as PRHOs.

F2
This will also involve 3 4-month rotations, although what they will be in is less clear, and there is some debate as to whether or not they will involve a general practice rotation. F2 placements will be advertised in journals like the BMJ and will be paid at SHO rate or similar.

Specialist Training
These will be followed by a specialist training program of 5-8 years which will end in a certificate of completement of training (CCT), thereafter making you a consultant. Alternatively, you may enter GP training at this stage.

Teaching, Supervision and Assessment
There will be a generic teaching program for the duration of the foundation program, also incorporating time for case discussions, problems and peer support. A monthly formal teaching session will be given.
Learning is centred around ‘core competencies’ rather than being based on the time spent in a specific discipline – these are also supposed to be generic competencies, so which specialities F2 and the third rotation of F1 are spent in should not influence future career prospects as the skills learned should be the same (although if this will work in practice or not is dubious).
You will be given a logbook and a dedicated educational supervisor (ideally the same one for the whole two years) and a nominated trainer for each 4-month rotation. Your assessments will come from this logbook and you will also be ‘encouraged’ to have a portfolio of learning under constant review. At the end of F2 there are probably going to be a national assessment process to validate your competence, enabling you to move onto specialist training (which will be far less supervised).

Applications
You will submit an anonymous application (the system is an attempt to ensure that you can’t get into a particular program by knowing the right people, although there’s a great deal of scepticism about whether or not that will work in practice) with several choices of program within a certain postgraduate deanery (the one containing the medical school you graduate from – the North Western Deanery in the case of Manchester). You will then be shortlisted for interview, after which the interview panel will rank candidates in order of preference. You now rank your choices in order of your own preference and the form is thrown into a computerised matching program. Any unmatched students will enter a clearing system.
The postgraduate deans are working towards standardising the admissions system across all deaneries in order to make it easier for students to apply for jobs outside their own deanery, although students are still recommended to apply within their own deanery, and I imagine this will still be the case when we qualify. If you’re considering other clinical schools (e.g. Edinburgh etc) do remember that this will go a long way to dictating where you can work for F1.

Transfers
It’s still unclear as to how a transfer from an F1 program in one deanery to an F2 program in another will work, although the NHS are encouraging the programs to be flexible. A case of wait and see I’m afraid.

[DrPie]

Hey- the Foundation Fair was recently run at Manchester where a little more information was given with regards to the Foundation programme.

The application process is now through a Multi-deanery application process which means you can apply OUTWITH the North Western Deanery and have the same opportunity of getting a position at a hospital as anyone else. The same applies in that students outwith the North Western Deanery can apply for jobs here and have the same chance of getting the job as anyone who studied within the deanery.
I think with this current year of applications, there will be a number of deaneries involved (not necessarily all yet) but the aim is that the application process will be National.

The application form is still anonymous. However they will no longer take in to account academic achievements i.e exam results, intercalated degrees. This is because not all the medical schools are standardised with regards to exams, not all offer the opportunity to intercalate- even prizes will probably have less weighting cause not all med schools offer them.
There is no longer a section for these (as far as i know) but it probably will be worth putting them in the personal statement sections.
This has, unsurprisingly p*ssed a lot of people off.

The application form will basically consist of BS questions such as give an example of where you were directly involved in someones care (similar q appeared on last years application form). Its possibly there will be up to 6 questions or so, and you have to chose 3 to answer (with word limits)
It favours students who can write creatively and articulately and probably havent done well academically.

Then there is a section for a Personal Statement.

You can apply to as many hospitals as you want. AS MANY as you want. So long as you dont mind ending up at any of them.
Whatever your first choice is (e.g if its Wythenshawe then the North Western Deanery will receive your application form) will be who marks you application form.
It is sent to one place only, and you get a mark from one place only.

Your score then goes in to a computer. Again if wythenshawe is your first choice then it will find all those who put wythenshawe as their first choice and allocate the place to whoever got the highest mark. If you didnt get the highest mark it will move down to your second choice e.g Hope. Again- whoever gets the highest mark between people who have Hope as there second choice gets the place. If it isnt you it moves down to your third choice and so on and so forth- until it finds you a hospital.

The tracks you apply to (for example one hospital may offer a number of tracks. A track consists of a number rotations 4 months in a variety of areas) include your F2 rotations too (however not all trusts are able to tell you what their F2 rotations involve yet which is ludicrous).
You cannot apply for F2 posts, as far as I know. When you apply for a track, you are applying for the F1 and F2 years- you will be based within the same hospital/trust.

[DrPie]

Forgot to say

They dont hold interviews anymore

Yup- they offer jobs to people they've never met!!!

[brboy]

Does anyone have an opinion of whether a year or so out after graduation would prejudice FP applications?

[rjm]

How can they not take into account prizes and intercalated BSc's. That is ridiculous, this is what has previously made people stand out. Surely you just end up having to put them into the boxes rather than there being a specific box for them. When we had a talk from our Deanery a few weeks back, they didnt really seem to know what was going on with this nationwide process.

[DrPie]

Little bits of information regarding the application for FP this year is coming out here and there. The new application form will be online is going to appear in July- you access it using a PIN number that applicants will be given.

Im afraid it is the case that there wont be a specific box for prizes, extra degrees, etc- for reasons mentioned above.

[DrPie]

Dont know whether your deanery is currently part of our Multi-Deanery Application ... as i said they're planning to make it national- so if it isnt already sooner or later it will be.

[DrPie]

brboy.

wouldnt recommend taking a year out after graduation as at the end of the fifth year you spend a few weeks shadowing the junior doctor whose position you are going to take over. Plus all the medicine you've just learnt will be fresh in your memory for when you start work.

[rjm]

We were told by our deanery (Wessex) that prizes and other degrees were "desirables" on the person specifications (as part of the national matching scheme), which is why I am shocked it isnt specifically on the application form.

[Jake]

The westmidlands deanery (which also incorporates Leicester, Nottingham and Leeds aswell as Birmingham Keele and Warwick) has a very similar application to the one DrPie has described, and was successfully last year. The application includes examination results (each medshool has a different page that shows the exams for that medschool) aswell as intercalated degrees.