NHS - Welcome to the Team

7/31/2019 NHS - Welcome to the Team

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Welcome to the

medical team

Join the team and

make a difference


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Contents

Your employer 3

Your working life 6

Your career 23

Key contacts 28

Glossary 30


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2 Welcome to the medical team www.nhscareers.nhs.uk

The National Health

ServiceHaving successfully completed the first

stage of your medical training, youre

now part of an organisation that serves

nearly 52 million people in England.

For the NHS, a typical day includes:

836,000 people visiting their GP

practice or practice nurse

over 50,000 people visiting accident

and emergency departments

124,000 outpatient consultations

114,000 people admitted to hospital

as an emergency admission

344,000 people in hospital for

planned treatment

73,000 patients receiving dental

treatment

26,000 calls to NHS Direct.

From day one of your career you are

a crucial and valued part of the team.

This brochure aims to give you more

information about what its like to

work in the NHS and tell you where

you can get extra support and advice.

The structure of the NHSAs a foundation doctor (F1), you arelikely to be starting work at a hospitaltrust or foundation trust. Acute hospitaltrusts provide medical and surgicalcare and are run by a trust board.

Mental health trusts and ambulancetrusts have a similar structure buttend to cover wider areas. There arealmost 250 hospital, mental healthand ambulance trusts, 51 primary caretrust clusters and a growing number ofclinical commissioning groups or CCGs(previously referred to as GP consortia).CCGs are groups of GP practices andfrontline clinicians working together tomanage local budgets and buy servicesfor patients direct.

As healthcare providers, all hospitaland mental health trusts are dependenton primary care organisationscommissioning and paying them

for patient services such as electivesurgery, outpatient visits and othertreatments. Primary care organisationsalso commission or may run communitybased hospitals themselves. Theyprovide local services such as districtnursing and health promotion andorganise the provision of generalpractice, dental, ophthalmic andpharmacy services. Patients increasingly

www.nhscareers.nhs.uk Welcome to the medical team 3

Your employer

The NHS wants to be the best UK employer.Youve joined an organisation committed todeveloping and valuing its staff.

Your next two years will be spent as afoundation doctor undertaking a nationaltraining curriculum to help you become fullyequipped for a career in medicine.

Welcome to the NHS.


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also have a choice of where theirtreatment is carried out, includingindependent sector treatment centresrun by private companies.

Strategic health authorities currentlycover large geographic areas, and areresponsible for overseeing organisations

in their area and leading on issues suchas workforce development and trainingcapacity.

CASE STUDY

In his first year as a junior doctor, Alex Jewkes worked at a large teachinghospital, rotating around several departments every few months, includinggeneral surgery and cardiothoracic.

My first year in medicine was like going from 0 to 60mph in 2 seconds flat.No amount of hard work and perseverance in medical school could have

prepared me for my first night on call.

Alex studied medicine at Imperial College in London and worked at theManchester Royal Infirmary. He says that putting theory into practice is no walkin the park but support is there. The experience I gained in those first fewmonths from my peers and senior colleagues was more valuable than six years atmedical school. I have learnt how to take the situations I read about at universityand actually put them to use in the real world thats no easy thing.

He also has some advice for new junior doctors. Try not to worry. This job isdaunting, but you really learn a lot in a short space of time.


Find out moreThe DH published A Junior Doctors Guide to the NHS in 2009. Writtenby two trainee doctors, it explains current NHS structures and howhealthcare policy is developed. Visit www.group.bmj.com and searchjunior doctor guide

Academy of Medical Royal Colleges (AoMRC) has produced a FoundationProgramme curriculum and the UK Foundation Programme Office hasproduced a reference guide which guides you through induction,placements, the curriculum, assessments, your study time, how to useyour Foundation e-portfolio, as well as a host of other useful informationwww.foundationprogramme.nhs.uk

Your NHS organisation will have its own website, which can be found onthe NHS Choices websitewww.nhs.uk
http://www.group.bmj.com/http://www.foundationprogramme.nhs.uk/http://www.nhs.uk/http://www.nhs.uk/http://www.foundationprogramme.nhs.uk/http://www.group.bmj.com/


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6 Welcome to the medical team www.nhscareers.nhs.uk www.nhscareers.nhs.uk Welcome to the medical team 7

tasks such as putting in IV lines andinterpreting ECG read-outs on acardiology team

writing up patients notes and drugscharts and organising tests for patients

assisting in theatre and preoperativeassessment clinics you may beasked to do minor procedures such assuturing wounds under supervision

taking part in an audit

seeing patients both with a GP andon your own with another doctor

available to consult with in generalpractice.

You should also be honing otherskills such as communicating withother staff, patients and their families,explaining available treatment, or beingable occasionally to deliver bad news.You are likely to work closely withnurses and other healthcare workersas well as other trainees and seniormedical colleagues within your specialtyteams. You may find that workingalongside experienced nurses is a goodway of enhancing your knowledge.

What you are likely to beasked to doBeing a foundation doctor meanssupervised on-the-job learning acrossa variety of settings. It is a bridgebetween academic learning as astudent and the working world ofthe doctor. You can expect to getsome teaching, both on the ward andin formal taught sessions, a lotof hands-on experience and thechance to enhance your diagnosticand treatment skills. Importantly, youwill be assessed for both clinical andprofessional skills as set out in theFoundation Programme Curriculum,which can be accessed throughwww.foundationprogramme.nhs.uk

The programme is based on competenceand experience. Once you successfullycomplete your first foundation year (F1)and gain all the required competences,

you will move to the second year of theFoundation Programme (F2).

You should not be left to do anythingyou dont feel capable of and helpshould always be available. Your clinicalsupervisor (consultant), educationalsupervisor and foundation programmetraining director/tutor are likely to beimportant figures throughout bothyears of the programme.

Obviously, the day-to-day details of howyou spend your time will vary accordingto the hospital or community practiceyou are working in and the rotation youare on. Whatever your rotation, therewill be learning objectives to measure

competence in areas such as:

taking a patients medical history

making a differential diagnosis,organising appropriate tests andprescribing the correct treatment

clerking in patients on admissionand writing discharge letters

Your working life
http://www.foundationprogramme.nhs.uk/http://www.foundationprogramme.nhs.uk/


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You are likely to have regulardiscussions with both clinical and

non-clinical colleagues.

Your local employer will have policies

and initiatives in place covering all

of these areas. You will be able tofind out more about these from yourhuman resources department.

Health and well-beingat workThe NHS is committed to maintaining

a healthy work-life balance for all NHS

staff. There is a real a focus on specificareas that are designed to make your

life easier at certain times during your

career. These include:

flexible working and flexible retirement

childcare provision and support for

carers in the workplace

creating a healthier work environment

training and development

tackling discrimination, bullying

and harassment

investing in diversity

staff involvement and

communication.

Looking after yourwell-beingStressStress and stress-related illness can be aserious problem for some doctors and

can jeopardise safe medical practice.But theres now more open recognitionof these conditions, efforts to minimisesome of the main causes of stress, andbetter channels of support and advicefor staff.

It is important to treat yourself as wellas you treat your patients. If you arenot registered with a GP, you shoulddo so and avoid corridor consultationswith colleagues, self-diagnosis andself-treatment. There are also severalnational organisations offering adviceand support to doctors when theybecome ill.

You need to bear in mind the General

Medical Councils (GMC) requirementin Good Medical Practice that youact quickly to protect patients if youbelieve you are no longer fit to practise.The GMC suggests that if you knowyour judgement or performance couldbe significantly affected by a conditionor illness, you must speak in confidenceto an occupational health doctor oranother colleague.

Burnout preventionBurnout has been defined as anexperience of physical, emotional, andmental exhaustion, caused by long-term involvement in situations that areemotionally demanding.

Although it can occur in a range ofoccupations, burnout has been foundto occur most amongst professionalpeople in the caring professions ofmedicine, nursing or social work. It istypically associated with the prolongedand cumulative effects of emotionalstress and pressure that arise frompersonal interaction with members ofthe public often vulnerable themselves on a daily basis. Studies have estimatedthe prevalence among healthcareworkers could reach 25 per cent. Howcan you take steps to avoid burnout?

Belief in yourself

Unconditional positive regard for others

Regular social support and exercise

Never lose your sense of humour

Outings breaks and holidays

Understand and develop resilience

Time management

Seasonal flu

NHS staff are on the frontline when it

comes to the spread of infection. This is

particularly true in respect of influenza.

Every year, your employer will make a

vaccine available to its staff to prevent

them contracting influenza themselvesand from passing it on to patients who

may already be in a weakened state.

You are advised to take up the offer of

an influenza jab when it is offered and

also to remember the use of standard

infection control measures.

Standard infection control measures

are the first line of protection against

any infectious disease and should be

followed routinely. These not only help

to protect patients but also visitors

and staff.

Measures include:

hand washing and antisepsis

the use of personal protective

equipment when handling blood,

body substances, excretions and

secretions

appropriate handling of patient care

equipment and soiled linen

the prevention of needlestick/sharps

injuries.


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The right worklife

balanceOngoing reductions in junior doctors

hours have had a considerable impact

on their worklife balance. The days

of the 80 plus hour week with lengthyon-call periods have passed. All NHS

staff, including junior doctors, are now

required to comply with the maximum

working hours and rest periods set

out in the Working Time Regulations,

although limited individual opt-outs

may be available where there is a

well-founded service need. Flexible

training is also an option.

Medicine can be a demanding andstressful career. That is why there

have been other changes in the NHS

to help doctors deal with some of

these factors.

Find out moreYour trusts occupational health department, local staff counsellingservice or postgraduate deanery will be able to help you access adviceand support.

Open your mind, an NHS Employers campaign to raise awareness amongemployers of the benefits of employing and retaining staff with mentalhealth conditions through guidance and good practice. Seewww.nhsemployers.org/openyourmind

The final report of the independent NHS Health & Well-being Review(the Boorman Review) was published in November 2009. The reportprovides a comprehensive set of recommendations for improvement inprovision of health and well-being across the NHS. Seewww.nhshealthandwellbeing.org to download the report.

Further details on the NHS Employers seasonal flu campaign can be foundat www.nhsemployers.org/flu

Find out moreNHS Employers information on improving working lives -www.nhsemployers.org/iwl

BMA members have access to a 24-hour counselling service which coverspersonal, emotional and work-related problems. Call 08459 200169.

The Doctors Support Network offers self-help for doctors with mentalhealth problems such as stress and burnout. Call 0844 395 3010 or visitwww.dsn.org.uk

The National Clinical Assessment Service helps healthcare practitioners

to prevent, understand and resolve any performance concerns. Visitwww.ncas.npsa.nhs.uk/home

Doctors who have problems with an addiction to drink or drugscan contact the Sick Doctors Trust on 0370 444 5163 orwww.sick-doctors-trust.co.uk

If you have a mentor within a trust, they may be an appropriate personto talk to if you feel stressed or unwell.
http://www.nhsemployers.org/openyourmind%20http://www.nhsemployers.org/fluhttp://www.nhsemployers.org/iwlhttp://www.dsn.org.uk/http://www.ncas.npsa.nhs.uk/homehttp://www.sick-doctors-trust.co.uk/http://www.sick-doctors-trust.co.uk/http://www.ncas.npsa.nhs.uk/homehttp://www.dsn.org.uk/http://www.nhsemployers.org/iwlhttp://www.nhsemployers.org/fluhttp://www.nhsemployers.org/openyourmind%20


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www.nhscareers.nhs.uk Welcome to the medical team 1312 Welcome to the medical team www.nhscareers.nhs.uk

that enables you to complete yourprogramme. However, this maymean reviewing the length of yourtraining period. Flexible trainingoffers an equivalent access to studyleave and clinical experience as full-time colleagues in order to meet

the requirements of the FoundationProgramme Curriculum, and offersthe same statutory employment rightsenjoyed by full-time equivalents.

Taking a break from trainingAs you progress through your training,you may need to take a career breakfor personal reasons but still want tokeep up your clinical skills. In someareas, employers can make individualarrangements for members of staff tokeep in touch or continue or return totraining on less than full-time hours.However, as working reduced hourswill affect your time spent progressingthrough the training programme, thesearrangements must be formalised inadvance between your employer andyour local deanery. It is also advisableto discuss any proposed break in trainingas early as possible with your educationalsupervisor and employer. Moreinformation is available in the FoundationProgramme reference guide.

Flexible working beyond thetraining gradesMany qualified doctors in the NHSchoose to work less than full-time andthe opportunities to do so may expandonce you have completed your trainingand moved into a career post, as aconsultant, specialty (or SAS) doctor, orin general practice. You may also wantto consider a career break, perhaps totravel and work in overseas healthcaresettings, or experience a spell inresearch or academic medicine.

It may be possible for you to take upa less-than-full-time post within yourown trust, or to job share, and therehas also been a growing trend towardspart-time GPs. If you go on a GP careerbreak, you may wish to maintain orupdate your knowledge and skills byworking as a locum or for one of theout-of-hours providers. You will needto talk to your employer about the

options that are available to you.

Flexible trainingFor all sorts of reasons, you may wantto work or train flexibly at some stagein your career. Flexible working, whichis now more commonly known as lessthan full-time training, is often

associated with women with youngchildren, but an increasing number ofother doctors are expressing otherwell-founded reasons for wanting it.Childcare responsibilities are not theonly reason for wanting to work lessthan full time. For example, manydoctors may have elderly relativeswho need care, or may want tobecome involved in medical politics ornational bodies, or pursue a sport orvoluntary activity.

The NHS is committed to supportinga good work-life balance for all NHSemployees, including trainees. Today,flexible training can be performedthrough a reduction in your workinghours or perhaps sharing a trainingpost (sometimes called a slot share).To train flexibly or in a slot share,you must first discuss these optionswith your postgraduate deanerywhere you have been allocated. It isusual for deaneries to prioritise flexibleopportunities including slot sharesbased on individual need and localavailability. You may not be able totake up flexible training straight away.

When training flexibly, you will still beable to access the necessary training

CASE STUDY

Not long into her first foundation year, Rachel Voller found out she was expectingher second child. As with the majority of mothers, she did not want to spend alot of time away from her children, and thanks to flexible working she was able tocombine her duties as a mother with her foundation training.

Flexible training allowed me to spend time with my very young children while

keeping my practical skills and knowledge base current.

Rachel currently works 20 hours a week in general surgery at the Airedale GeneralHospital but has also worked in several medical specialties and in urology. Forthose considering training flexibly, she says organisation is really important.

Try to arrange your timetable so you get some continuity and get most out ofyour rotation. Acute medicine can be done for one day and then forgottenwhereas your consultants patients and their families need you to be aware oftheir plans and progress.

Find out moreDoctors in training: contact yourlocal postgraduate deans office.Visitwww.copmed.org.ukorwww.foundationprogramme.nhs.ukfor local contact details.
http://www.copmed.org.uk/http://www.foundationprogramme.nhs.uk/http://www.foundationprogramme.nhs.uk/http://www.copmed.org.uk/


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Raising concerns in theworkplaceOccasionally, you may see somethingin the workplace which you regard asunacceptable or dangerous. This can bean ethical dilemma. Should you informsomeone of what is happening? And ifso, who? Or should you keep quiet out

of loyalty to the organisation or yourcolleagues? If you inform, will there berepercussions for you and could yourfuture career be affected?

All NHS employers should have in placeeffective policies on how to raiseconcerns and the appropriate action tobe taken. This is sometimes referred toas whistleblowing. The NHS expects aclimate of openness and dialogue whichencourages all staff to feel able to raiseconcerns about healthcare matters in areasonable and responsible way

without fear of victimisation. In the firstinstance, you should report or discussconcerns with your manager. If youdont feel able to do so, or areunhappy with the response, you canreport an issue to a more senior

manager, such as the medical director.You should usually try and resolveissues internally.

In some cases, you may feel the needto take further action because a seriousissue is not being dealt with. ThePublic Interest Disclosure Act 1998gives significant statutory protection toemployees who disclose informationreasonably and responsibly in the publicinterest and are victimised as a result.

If you want to seek independentadvice before taking action, Public

ChildcareMany junior doctors find gettinggood, affordable childcare a problem,especially if they are working shifts, ormoving between hospitals on rotation.However, the NHS has invested heavily

in childcare over the last few years andmany hospitals now have an on-sitenursery and may subsidise places forstaff members children.

All NHS employees should have accessto a childcare co-ordinator who can giveinformation about a range of childcareoptions such as childminders, after-schoolclubs and holiday clubs for older children.Some NHS childcare co-ordinators arelooking at childcare support to meet thespecific needs of junior doctors, such asemergency childcare in the childs ownhome, emergency places in nurseries orarranging flexible child-minding servicesto cover shift working and on-call. Anumber of NHS organisations offer

childcare vouchers in lieu of your salary.These can be cost effective for parentsas you do not have to pay NationalInsurance contributions or tax on them.They can be used to pay for a widerange of childcare.

Violence, harassmentand bullyingUnfortunately, some NHS staff areassaulted or threatened by patients ortheir families, while other staff may feelharassed and bullied by fellow employees.You may spend your entire careerwithout this happening to you, but if itdoes happen, support is available. TheNHS takes action against patients ortheir families who assault NHS staff,including refusing to treat them unlessspecial measures are in place. All front-line NHS staff are offered conflictresolution training to help them dealwith these potentially serious situations.

Trusts will have different policies onwhat to do if an incident occurs but allshould offer you support. Ensure you fillin an incident reporting form if you arethreatened or assaulted. This helps assessrisk and safeguard your interests if thereis further action. The trust has a statutory

responsibility to protect you. If you findyourself being bullied, it is importantto take steps to remedy the situation.Hospitals should have a policy in place fordealing with bullying and harassment inthe workplace and will be able to suggestsuitable action and someone for you totalk to. In some cases, you will be ableto speak to your manager. Some NHSorganisations have a network of trainedharassment advisers and/or mediatorswho are available to support you indealing with incidents of harassment.

Find out moreYour trust may have a localchildcare coordinator who can helpyou plan your childcare provisionwww.nhsemployers.org/childcare

Find out moreNHS Protect tackles violenceand promotes other securitymanagement measures acrossthe health service -www.nhsbsa.nhs.uk/security

For information on staff welfareissues, visit www.nhsemployers.org/staffwelfareissues

For information on bullyingand harassment, visitwww.nhsemployers.org/bullying
http://www.nhsemployers.org/childcarehttp://www.nhsbsa.nhs.uk/securityhttp://www.nhsemployers.org/StaffWelfareIssueshttp://www.nhsemployers.org/StaffWelfareIssueshttp://www.nhsemployers.org/bullyinghttp://www.nhsemployers.org/bullyinghttp://www.nhsemployers.org/StaffWelfareIssueshttp://www.nhsemployers.org/StaffWelfareIssueshttp://www.nhsbsa.nhs.uk/securityhttp://www.nhsemployers.org/childcare


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how they are meeting the requirementsof the act. This is monitored by theCare Quality Commission (CQC).

Outside of the NHS, the Equality andHuman Rights Commission (EHRC) isresponsible for ensuring all public bodies

meet the duties of the Equality Act.NHS Employers works with the CQCand the EHRC to help NHS trusts meettheir statutory and non-statutory duties.

Your working hoursWhen many of your older medicalcolleagues were training as juniordoctors, they could have been on dutyfor long periods of time and withinadequate rest, spending much of their

time exhausted, and posing a potentialrisk to patient safety and their ownwell-being. This has changed significantlyand most trainees will now work regularshift patterns. This change is due to twoseparate but related developments:

The New Deal, a concordat betweenthe BMA and the Government,gradually reduced junior doctorshours to no more than 56 hours ofactual work a week.

The Working Time Regulations wereextended to all doctors in trainingfrom August 2009. This UK legislationsets a maximum average workingweek of 48 hours, although individualscan opt-out of this requirement up

to the New Deal limit should theywish and their employer agrees. Theregulations also established designatedrest periods and maximum periods ofduty, and there is no opt-out fromthese rest requirements.

Compared with a junior doctor often years ago, you are less likely tospend time on call or work overnights.You are more likely to work a full shiftsystem and you shouldnt be asked towork for very long stretches at a time such as being on duty throughouta weekend.

Many trusts have adopted the Hospitalat Night approach where a team ofdoctors, including consultants andjuniors, will cover several specialties oreven a whole hospital rather than eachspecialty having its own team of juniorson duty. This has greatly reduced thenumber of juniors on duty overnight although those who are there may findthemselves kept busy!


Concern at Work runs a helpline forNHS staff on 020 7404 6609 or [email protected]

Promoting equality andvaluing diversityThe NHS puts equality and diversity atthe core of everything it does: equalityof access for patients and equality ofopportunity for staff.

The Equality Act 2010 is a majorpiece of legislation seeking to protectstaff and patients in the UK fromdiscrimination and unfair treatment onthe basis of their age, race, gender,disability, sexual orientation, religion orbelief. It places significant duties on allpublic sector bodies to produce clearequality action plans to demonstrate

Find out moreSee more on equality and diversityat www.nhsemployers.org/equality

Find out moreFind out more atwww.nhsemployers.org/EWTD

Find out more

Public Concern at Work

www.pcaw.co.uk

NHS Employers www.nhsemployers.org/whistleblowing

The Social Partnership Forum(SPF) search whistleblowing onwww.socialpartnershipforum.org
mailto:[email protected]://www.nhsemployers.org/equalityhttp://www.nhsemployers.org/EWTDhttp://www.pcaw.co.uk/http://www.nhsemployers.org/whistleblowinghttp://www.nhsemployers.org/whistleblowinghttp://www.socialpartnershipforum.org/http://www.socialpartnershipforum.org/http://www.nhsemployers.org/whistleblowinghttp://www.nhsemployers.org/whistleblowinghttp://www.pcaw.co.uk/http://www.nhsemployers.org/EWTDhttp://www.nhsemployers.org/equalitymailto:[email protected]


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fall into Band 1 due to the EuropeanWorking Time Regulations limit of 48hours work per week.

In addition, bands are subdividedinto A (high intensity of work, mostunsocial time), B and C (less intensity,less unsocial hours). The bands attractadditional weighting and are attachedto each job, so as you move through arotation, your banding, and thereforeyour pay, may change.

Band 1C attracts a 20 per centweighting, Band 1B 40 per cent, Bands1A and 2B 50 per cent, and Band 2A80 per cent. So, if you are starting outas an F1 doctor in Band 1B, for example,you will be paid 31,377 per annum. Ifthe band of your next training post isnot 1B, your total pay in that postmight go up or down accordingly.

Your basic salary will rise as youprogress through the grades.

Currently, as an F2 doctor, you willstart on a basic salary of 27,798. Overtime, this basic salary could rise to asmuch as 46,708 as you move into andthrough specialty training.

There are several career avenues thatcould be pursued after your training:

specialty doctor posts attract a basicsalary of between 36,807 and70,126 and offer an attractive

career and continuing professionaldevelopment for those who want towork in hospital medicine

if you become a consultant, youwill have a basic salary of between74,504 and 100,446. In addition,depending on your job plan and NHScontribution, you could be consideredfor a clinical excellence award whichwould increase your salary further

you may consider a career ingeneral practice. A salaried generalpractitioner will earn between53,781 and 81,150. Generalpractitioners can also becomeself-employed partners in generalpractices and share earnings roughlysimilar to those of consultants.

Pay is normally determined each yearin line with government decisionsfollowing recommendations from theindependent Doctors and Dentists Pay

Review Body.

HolidaysAs a foundation doctor, you will beentitled to five weeks of holiday a year.Your entitlement rises to six weekslater in your training, normally after fiveyears service.

Sick payIf you are unlucky enough to becomeill, the NHS has a comprehensive andgenerous sick pay system. As you start

Your payAs a full-time F1 doctor, you will bestarting your career on minimum of22,412 per annum for a basic 40hour week. In addition, there is asupplementary system to reflect theintensity of the work you are asked todo and the hours you are expected towork, which can boost your pay. If youwork in the London area you will also

get a London weighting.

Unbanded postsF1 doctors who work no more than 40hours per week on average and takes

place wholly between 7am-7pm onweekdays currently receive a five percent pay supplement. This supplementonly applies to F1 doctors and is notavailable when you move into F2.

Banded postsIf your working week averages over40 hours or includes work outside7am-7pm on weekdays, pay bandingsupplements will apply. Jobs are classedas Band 1 if they involve work between40 and 48 hours a week, or Band 2 ifthey involve up to 56 hours a week.Many F1 posts are now unbandedand most remaining banded posts will


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You are entering your postgraduate medicaltraining years at an exciting time. Over thelast few years, doctors training has been

radically redesigned to meet modern trainingand patient requirements. You will enter atwo-year foundation programme which willprepare you for competitive entry into yourspecialty.


Your career


Training numbersIn 2010, there were over 140,000doctors practising in the NHS or intraining in England in either a primaryor secondary care setting. Nearly51,000 were in the training grades:

6,240 F1 doctors

6,101 F2 doctors

38,158 in secondary care specialtytraining (excluding trust doctor posts)

3,718 GP registrars.

Your postgraduatemedical education yearsThe Foundation Programme aims todeliver better, more effective patient

care within the NHS and also to help thedoctors of tomorrow receive a focused,relevant and high standard of training. Ithas recently undergone a strategic reviewof its effectiveness and recommendationsfor future years are being considered.


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offer run-through programmes whereyou will be recruited for the fullduration of your specialty programme.Others, such as medicine or surgery,will begin with core training wherecore training lasts for two years, butin emergency medicine, paediatricsand psychiatry it runs for three years.Successful completion of core trainingcan contribute, but will not leaddirectly, to the award of a CCT. Furtherinformation on these models can befound on the Medical Specialty Training(England) website at www.mmc.nhs.uk

Once you are in a run-through,specialty or GP training programme,

you will have the opportunity togain a CCT, subject to satisfactoryprogress. After you receive a CCT,you are eligible for entry to thespecialist or GP Register and can applyfor an appropriate senior medicalappointment. If you do not go throughthe traditional training route, but workinstead as a specialty doctor, you maybe able to apply to the General MedicalCouncil for a Certificate of Eligibilityfor the Specialist Register (CESR), citingyour past training and experience.The specialty doctor contract wasintroduced in April 2008 and providesnew developmental opportunities fordoctors working in the NHS.

The first year of your foundationtraining will ensure that you can putinto practice the knowledge, skills andattitudes learned as a student as wellas gain new generic knowledge andskills. Your F1 year typically comprises

three four-month placements althoughsome schools include shorter or longerplacements. In most cases, you willundertake placements in medicine,surgery and another specialty. AllF1 rotations are designed to enableyou to acquire and demonstrate theoutcomes and competences set out inthe Foundation Programme Curriculum.After satisfactorily completing 12months of training in F1 placements,demonstrating that you have achievedthe required F1 outcomes, and meetingall of the other requirements, you areeligible to apply for full registrationwith the GMC.

The second foundation year

enables you to take on increasingresponsibility for patient care underclinical supervision. This will prepareyou for the next steps in your medicalcareer as you enter specialty training.The F2 year typically comprises threefour month placements in a range ofdifferent specialties including generalpractice. Inevitably, not everyonesplacement preferences can be met butyou should have a good chance ofspending at least part of the time in afield which particularly interests you.There are also opportunities for you to

explore different career options throughtasters. To be eligible for the FoundationAchievement of Competence Document(FACD), you must complete 12months in approved F2 placements,demonstrate that you have achieved therequired F2 outcomes and meet all ofthe other requirements.

Full details of the FoundationProgramme curriculum, a list of freeonline resources to assist you meetingthe outcomes of the curriculumand information on keeping yourFoundation Learning Portfolio up todate can be found atwww.foundationprogramme.nhs.uk

There is also information on theassessment tools youll be asked to useand examples of each assessment form.

If you successfully complete yoursecond year, you are likely to makea choice about where you want yourcareer to go. You may wish to leavetraining and switch to a specialty, trustor other type of locally recruited post.If, however, you wish to continueto train towards full qualificationthrough the award of a Certificate ofCompletion of Training (CCT), you willneed to apply through a competitiveprocess for training as a specialtyregistrar, which currently starts inthe autumn/winter of your F2 year.Specialty training programmes nowcome in a variety of models, dependingon the specialty. Some specialties

Find out moreVisit www.foundationprogramme.nhs.uk for full details of theFoundation Programme Curriculum and other useful information.

Visit www.medicalcareers.nhs.uk for help and support on your careerdecisions.

Visit www.mmc.nhs.ukfor detailed information on recruitment tospecialty training programmes and career progression as outlined in theSpecialty Training Gold Guide.

Visit www.nhsemployers.org/sas for information about careers as a trustspecialty doctor or associate specialist.

Your local postgraduate deanery will be able to give you moreinformation on training and career options and will offer careers advice.Visitwww.copmed.org.uk for local contact details.

Visit www.gmc-uk.org and search CCT

Visit www.nihrtcc.nhs.uk/intetacatrain for information about integratedacademic training programmes.
http://www.mmc.nhs.uk/http://www.foundationprogramme.nhs.uk/http://www.foundationprogramme.nhs.uk/http://www.medicalcareers.nhs.uk/http://www.mmc.nhs.uk/http://www.nhsemployers.org/sashttp://www.copmed.org.uk/http://www.gmc-uk.org/http://www.nihrtcc.nhs.uk/intetacatrainhttp://www.nihrtcc.nhs.uk/intetacatrainhttp://www.gmc-uk.org/http://www.copmed.org.uk/http://www.nhsemployers.org/sashttp://www.mmc.nhs.uk/http://www.medicalcareers.nhs.uk/http://www.foundationprogramme.nhs.uk/http://www.foundationprogramme.nhs.uk/http://www.mmc.nhs.uk/


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Other key bodiesThe medical royal colleges and facultiesdevelop specialist and general practicetraining programmes, which are qualityassured through the GMC. Once youstart concentrating on your specialty,

you are likely to be in regular contactwith your appropriate college or faculty.

The postgraduate medical deaneries areresponsible for managing the deliveryof postgraduate medical education andensuring standards are met. Foundationschools oversee appointments totraining programmes and providedirect support to you duringyour training via your foundationtraining programme director/tutors,supported by postgraduate educationmanagers. These individuals are therepresentatives of the postgraduatedeans within your trust. Foundationtraining programme director/tutors arealso a good source of careers advice

throughout your training.

Appraisal, assessmentand medical revalidationRegular appraisals and assessmentapply to all doctors. The aim is togive you regular feedback on yourperformance and help you identifyyour training and development needs.As an integral part of foundationtraining, you will be assessed onspecific competencies throughout thetwo years you spend on rotations.Your appraisal will dovetail with thedocumentation and processes usedto assess your progress. Your deaneryand foundation school will have moreinformation on your appraisal.

Since November, 2009 all doctors intraining who become registered withthe GMC are also required to belicensed to practise in the UK. To retainyour licence, you will be subject tomedical revalidation based upon a

recommendation made by your localresponsible officer who is normally youremployers medical director or thepostgraduate dean in the case of doctorsin training. The recommendation willconsider evidence based on your clinicalknowledge skills, safety and quality ofyour performance, your communicationsskills, and your honesty and probity. Visitwww.gmc-uk.organd searchrevalidation for more information.


Declarations on yourfitness to practiseAs a junior doctor progressing throughtraining, you will be asked periodicallyfor details of your GMC registrationand licensing status, proof that youhave received occupational healthclearance and have no relevant criminalconvictions.

If you are working in a hospital, thisinformation is stored securely on theNHS Electronic Staff Record (ESR)operating within your trust. Detailsshould be transferred when you movefrom job to job to satisfy your nextemployer that you continue to be fit topractise safely in the NHS.

Data held on the ESR is covered underthe Data Protection Act and is heldsecurely and confidentially. You can atany time request a print-out of yourdata, but be aware that some trusts

may charge an administration fee forthis service.

Under the GMCs Good MedicalPractice, it is your responsibility toensure that you keep your employerup to date on any relevant changesin circumstances which may have abearing on your continued fitnessto practise.

Find out moreAcademy of Medical RoyalColleges - www.aomrc.org.uk

Conference of PostgraduateMedical Deans of the UnitedKingdom - www.copmed.org.uk

National Association of ClinicalTutors -www.nact.org.uk

Find out moreEmployment checks - www.nhsemployers.org/employmentchecks

Good Medical Practice visitwww.gmc-uk.org and searchgood medical practice.
http://www.gmc-uk.org/http://www.aomrc.org.uk/http://www.copmed.org.uk/http://www.nact.org.uk/http://www.nhsemployers.org/employmentcheckshttp://www.nhsemployers.org/employmentcheckshttp://www.gmc-uk.org/http://www.gmc-uk.org/http://www.nhsemployers.org/employmentcheckshttp://www.nhsemployers.org/employmentcheckshttp://www.nact.org.uk/http://www.copmed.org.uk/http://www.aomrc.org.uk/http://www.gmc-uk.org/


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This section brings together contactsand links which you might find helpful

as you get to grips with the NHS, itsstructures and the initiatives which will

benefit you. Others will be more useful

as your NHS career progresses.

Equality and diversitywww.nhsemployers.org/equality

Personal development andcareers advice.BMJ Careerswww.careers.bmj.com/careers/welcome.html

NHS Medical Careershttp://www.medicalcareers.nhs.uk .

General Medical Councilwww.gmc-uk.org/education/index.asp

Medical Specialty Training

(England)www.mmc.nhs.uk

Training bodiesAcademy of Medical Royal Collegeswww.aomrc.org.uk

Conference of PostgraduateMedical Deans of the UnitedKingdomwww.copmed.org.uk

National Association of Clinical Tutorswww.nact.org.uk

The Foundation Programmewww.foundationprogramme.nhs.uk

Pay, contracts and pensionswww.nhsemployers.org/juniordoctors

NHS Pensionswww.nhsbsa.nhs.uk/pensions

Clinical support and quality of careGMC guidance on good practicewww.gmc-uk.org/guidance

Care Quality Commissionwww.cqc.org.uk

National Institute for Health andClinical Excellence (NICE)www.nice.org.uk

NHS Revalidation Support Teamwww.revalidationsupport.nhs.uk

Professional bodiesBritish Medical Associationwww.bma.org.uk

General Medical Councilwww.gmc-uk.org

Your wellbeingAlcoholics Anonymouswww.alcoholics-anonymous.org.uk Tel: 0845 769 7555

BMA Counselling Servicewww.bma.org.uk/doctorsfordoctors


Key contacts

Doctors Support NetworkAnonymous, confidential peersupportwww.dsn.org.ukTel: 0844 395 3010

Royal College of PsychiatristsInformation on depression andother mental health issueswww.rcpsych.ac.uk/mentalhealthinfoforall.aspx Tel: 020 7235 2351

Royal Medical BenevolentFund Financial help for sickdoctorswww.rmbf.orgTel: 020 8540 9194

The Samaritanswww.samaritans.org.ukTel: 08457 90 90 90

Sick Doctors Trustwww.sick-doctors-trust.co.uk Tel: 0370 444 5163

The Boorman review of NHS Health& Well-beingwww.nhshealthandwellbeing.org/FinalReport.html

The National Clinical AssessmentServicewww.ncas.npsa.nhs.uk/home

Publications on the webBMJ Careerswww.bmjcareers.com

DoctorsNetwww.doctors.net.uk

Health Service Journalwww.hsj.co.uk

Hospital Doctorwww.hospitaldr.co.uk

The Lancetwww.thelancet.com
http://www.nhsemployers.org/equalityhttp://www.careers.bmj.com/careers/welcome.htmlhttp://www.careers.bmj.com/careers/welcome.htmlhttp://www.medicalcareers.nhs.uk/http://www.gmc-uk.org/education/index.asphttp://www.mmc.nhs.uk/http://www.aomrc.org.uk/http://www.copmed.org.uk/http://www.nact.org.uk/http://www.foundationprogramme.nhs.uk/http://www.nhsemployers.org/JuniorDoctorshttp://www.nhsemployers.org/JuniorDoctorshttp://www.nhsemployers.org/JuniorDoctorshttp://www.nhsemployers.org/JuniorDoctorshttp://www.nhsemployers.org/JuniorDoctorshttp://www.nhsbsa.nhs.uk/pensionshttp://www.gmc-uk.org/guidancehttp://www.cqc.org.uk/http://www.nice.org.uk/http://www.revalidationsupport.nhs.uk/http://www.bma.org.uk/http://www.gmc-uk.org/http://www.alcoholics-anonymous.org.uk/http://www.bma.org.uk/doctorsfordoctorshttp://www.dsn.org.uk/http://www.rcpsych.ac.uk/mentalhealthinfoforall.aspxhttp://www.rcpsych.ac.uk/mentalhealthinfoforall.aspxhttp://www.rmbf.org/http://www.samaritans.org.uk/http://www.sick-doctors-trust.co.uk/http://www.nhshealthandwellbeing.org/FinalReport.htmlhttp://www.nhshealthandwellbeing.org/FinalReport.htmlhttp://www.ncas.npsa.nhs.uk/homehttp://www.bmjcareers.com/http://www.doctors.net.uk/http://www.hsj.co.uk/http://www.hospitaldr.co.uk/http://www.thelancet.com/http://www.thelancet.com/http://www.hospitaldr.co.uk/http://www.hsj.co.uk/http://www.doctors.net.uk/http://www.bmjcareers.com/http://www.ncas.npsa.nhs.uk/homehttp://www.nhshealthandwellbeing.org/FinalReport.htmlhttp://www.nhshealthandwellbeing.org/FinalReport.htmlhttp://www.sick-doctors-trust.co.uk/http://www.samaritans.org.uk/http://www.rmbf.org/http://www.rcpsych.ac.uk/mentalhealthinfoforall.aspxhttp://www.rcpsych.ac.uk/mentalhealthinfoforall.aspxhttp://www.dsn.org.uk/http://www.bma.org.uk/doctorsfordoctorshttp://www.alcoholics-anonymous.org.uk/http://www.gmc-uk.org/http://www.bma.org.uk/http://www.revalidationsupport.nhs.uk/http://www.nice.org.uk/http://www.cqc.org.uk/http://www.gmc-uk.org/guidancehttp://www.nhsbsa.nhs.uk/pensionshttp://www.nhsemployers.org/JuniorDoctorshttp://www.nhsemployers.org/JuniorDoctorshttp://www.foundationprogramme.nhs.uk/http://www.nact.org.uk/http://www.copmed.org.uk/http://www.aomrc.org.uk/http://www.mmc.nhs.uk/http://www.gmc-uk.org/education/index.asphttp://www.medicalcareers.nhs.uk/http://www.careers.bmj.com/careers/welcome.htmlhttp://www.careers.bmj.com/careers/welcome.htmlhttp://www.nhsemployers.org/equality


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PGME Postgraduate medical education

PGMDE Postgraduate medical and dental education

PMETB Postgraduate Medical Education and Training Board [mergedwith GMC in April 2010]

PCT Primary care trustRO Responsible officer

SAC Specialty advisory committee

SAS Staff or associate grade doctor

SHA Strategic health authority

SHO Senior house officer [dental trainees only]

SPF Social Partnership Forum

ST1/2/3 Specialty trainee

STC Specialty training committee

StR Specialty registrar

SpR Specialist registrar (closed training grade)

UKFPO UK Foundation Programme Office

VTC or VT Vocational Training Certificate

WTD or EWTD European Working Time Directive

WTR Working Time Regulations (UK legislation)

ACF Academic Clinical Fellow

AoMRC Academy of Medical Royal Colleges

ARCP Annual Review of Competence Progression

BMA British Medical Association

BDA British Dental Association

CCT Certificate of Completion of Training

CESR Certificate of Eligibility for the Specialist Register

CMO Chief Medical Officer

COGPED Committee of General Practice Education Directors/Deans

COPMeD Conference of Postgraduate Medical Deans of the United Kingdom

CT1/2/3 Core trainee (uncoupled specialties)

DPH Director of public health

DH Department of Health

ESR Electronic Staff Record

F1 First year foundation doctor

F2 Second year foundation doctor

GMC General Medical CouncilGPR General practice registrar

JCHMT Joint Committee of Higher Medical Training

JCHST Joint Committee on Higher Surgical Training

METP Modernising Education and Training Programme (ex-MMC)

MSC Medical Schools Council

NCAS National Clinical Assessment Service

NHSBSA NHS Business Services Authority

NICE National Institute for Health and Clinical Excellence

Glossary


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Documents

NHS - Welcome to the Team