Acquiring Foundation Competences outside the UK 

Working Abroad

The Peninsula Foundation School was advised in February 2018 of the changes below

F2 Abroad in Australia / Changes to the Australian immigration laws: 

The Foundation School has been notified that it will unfortunately no longer be possible for Foundation doctors to undertake their F2 training in Australia (if they require a work visa).  This is due to new Australian immigration laws which begin soon. The new Temporary Skilled Shortage visa (TSS) will be replacing the current work visa (457) in March 2018.  Under the new TSS visa, overseas candidates must supply evidence of two years employment experience to be nominated under this visa category.  Foundation Year 2 candidates are not eligible for nomination under the TSS (having only completed one year of work as an F1) and therefore will not be in a position to accept employment in Australia at this point in their career. 

Individuals who hold Australian citizenship are advised to contact prospective employers or the Australian authorities to discuss this further if required.

Background

On qualification, graduates from UK medical schools are provisionally registered with the General Medical Council (GMC).  To become fully registered with the GMC they must then satisfactorily complete one year as a Foundation Year 1 doctor (F1) in posts approved as meeting the requirements set by the GMC.

If a graduate completes their F1 experience successfully, this information is passed by the relevant Foundation School to the Medical School from which they graduated and the doctor is then able to become fully registered with the GMC.

The GMC devolves the responsibility for approving F1 posts to local Universities, which in turn usually devolve this to foundation schools. The Peninsula Foundation School has responsibility for inspecting and approving posts in Devon and Cornwall.

According to the Reference Guide (2016), the medical school in partnership with the local foundation school may, in exceptional circumstances, prospectively approve training as a provisionally registered doctor outside of the UK and upon satisfactory completion support an application for full registration with the GMC. Medical students wishing to undertake their first postgraduate training year (training as a provisionally registered doctor) outside of the UK should seek the advice of their medical school as soon as possible. Not all Universities allow their graduates to undertake F1 experience outside the UK.

The Reference Guide (2016) also states that not all foundation schools will support F2 abroad. Foundation doctors wishing to undertake F2 outside of the UK should contact their foundation school in which they are completing their F1 year. Prospective approval must be granted if the training outside of the UK is to count towards the requirements for satisfactory completion of the Foundation Programme. It is the foundation doctor’s responsibility to arrange a suitable placement and confirm that the unit has agreed to provide training, assessment and support in accordance with the requirements for satisfactory completion of the Foundation Programme.

Doctors are not eligible for full registration with the GMC if they have not had prospective approval of their F1 posts from the University to undertake F1 outside the UK. The GMC does not accept retrospective approval and does not allow UK graduates to undertake the Professional and Linguistics Assessments Board (PLAB). 

UK graduates who do not have right of residency are allowed to undertake both F1 and F2 placements in the UK. For further postgraduate training, such graduates will come under the same restrictions as International Medical Graduates.

Policy

We will consider applications to acquire foundation competences outside the UK from Peninsula Medical School Graduates (for F1) and Peninsula Foundation School trainees (for F2).

Applications from Peninsula Medical School graduates to undertake F1 outside the UK will only be considered if supported by the Undergraduate Dean. Applicants will need clear, verifiable and exceptional reasons as to why they cannot undertake the foundation programme in the UK.  F1s completing their training abroad must have Provisional GMC Registration with a licence to practice in place prior to commencing in post.

Applications from Peninsula Foundation School trainees to undertake F2 outside the UK will only be considered if supported by the Trust Foundation Programme Director.

 In order to complete a programme outside the UK, both the individual and the proposed post require approval.

It will not be possible to complete both years of a foundation programme abroad.

It is the responsibility of the applicant to secure a post outside the UK that meets all criteria for approval and to supply the relevant evidence to the Foundation School within the timescales required.

Once an application for F2 abroad has been accepted (and before it is approved), the trainee will not be able to simultaneously hold their F2 place in a Peninsula trust.

There is no process for managing trainees undertaking foundation programmes outside the UK who do not complete the year satisfactorily.  Any trainee who does not complete their programme abroad who wants to continue training, will have to undertake an appropriate placement on return to the UK and apply in open competition for such a post.

Process of prospective provisional approval

The student must notify the Undergraduate Dean as soon as possible of his/her wish to undertake F1 outside the UK. This should be done by discussion and completion of the form “Application for Approval to undertake F1 outside the UK” available from the Foundation School.

The F1 doctor must notify the Head of Foundation School within the advertised timeframe of his/her wish to undertake F2 outside the UK. This should be done by discussion and completion of the form “Application for Approval to undertake F2 outside the UK” available from the Foundation School.

A formal application with full post information must be submitted to the foundation school within the advertised timeframe. The application must be supported by the Undergraduate Dean (for F1) and the Trust Foundation Programme Director (for F2).

An applicant wishing to undertake a Foundation placement outside the UK must find and secure a suitable 12 month post, in an English speaking hospital, that meets the criteria set out by the foundation school.

Information about the placement must be obtained by the applicant from an appropriate person at the relevant hospital; in addition the Applicant Checklist must be completed by the trainee (see appendix 1 for F1 and F2) and the Agreement by the Host Institution for an F1 or F2 Programme (see appendix 2) must be completed and signed by the appropriate person at the hospital.  The completed forms (Application form, Application Checklist and Host Agreement) and evidence provided must be submitted together by the application deadline. They will be assessed by the Postgraduate Dean (or their delegated official) and the information passed to the Foundation Programme School Manager.  All evidence required for approval must be submitted to the foundation school by the applicant within the advertised timeframe.

Process on completion of placement

At the end of the year, the trainee must meet the requirements for sign-off and provide evidence to an Annual Review of Competence Progression (ARCP) panel that they have met all criteria in line with all Peninsula Foundation School trainees.

On receipt of information of satisfactory completion of the F1 year, the Foundation School will undertake the process of informing the GMC that the trainee achieved the requirement for full registration. 

Although a placement outside the UK may have prospective approval, neither the Medical School or the Foundation School can be responsible if any aspect of the programme is deficient in such a way that the trainee is unable to complete the necessary experience to allow them to be fully registered with the GMC or to complete F1/F2. 

The placement itself

Prospective approval of a placement outside the UK for foundation training will require the applicant to provide evidence that the hospital: 

  • delivers high quality training programmes for doctors at a similar stage of experience
  • can deliver the Foundation curriculum at the appropriate level
  • will provide appropriate clinical and educational supervision
  • will support the use of the e-portfolio and programme tools
  • will provide the doctor with access to career advice and support

Programmes that will be considered for approval must be for 12 months duration. They must meet the relevant standards set out in the “Promoting excellence:standards for medical education and training (2016)".  These programmes should also include:

  • substantive posts in ideally three but no more than four specialties AND
  • opportunities to achieve and demonstrate the outcomes necessary for satisfactory completion

Whilst in the placement, the doctor must participate in a formal teaching programme that covers the topics outlined in the Foundation curriculum. 

The F2 study leave entitlement and funding is not transferable to posts undertaken abroad.

The F2 doctor must undertake a supervised quality improvement project.

A record must be kept of all annual, sickness and study leave. This should be included with all other information submitted as part of the ARCP.

A report on the Doctor’s progress should be available to the Head of Foundation School at agreed intervals (e.g. 4 monthly if the placements are for 4 months).

The Head of Foundation School must be notified by the trainee and educational supervisor if there are any significant educational or training concerns.

Foundation doctors commitment whilst in a placement outside the UK

The  doctor seeking  approval for a foundation placement outside the UK  must agree

  • to complete their learning portfolio
  • to undertake all assessments
  • to follow the Foundation curriculum
  • to keep in contact with the Head of Foundation School

The doctor must obtain evidence that: 

  • the competencies have been achieved;
  • they have attended regular educational meetings with the Clinical and Educational supervisors,
  • they have completed  360º appraisal, the required number of supervised learning events (SLEs) and other assessments,
  • they have attended teaching sessions and/or any other educational activities.  The trainee should also be assessed in accordance with documentation required by the overseas programme.
  • They have met all the requirements for sign-off expected from all ‘home’ Peninsula trainees

The educational portfolio must be kept up to date during the year and will be reviewed periodically by the Head of Foundation School.

The doctor may also be required to undertake the assessments that are required by the local programme abroad.

The student/doctor needs to be aware that sometimes between appointment to a placement abroad and taking up the post (as well as during the placement itself) fundamental changes – such as to the clinical content of the post, the consultants and educational supervisors, the rota worked, the educational component, even the hospital involved – can occur.  It is the responsibility of the trainee to notify any such changes as soon as possible to the Head of Foundation School.  Failure to do so may threaten the successful completion of the placement.