UK Foundation Programme Research Articles

Foundation training programme is oversubscribed for 2014

The UK Foundation Programme Office (UKFPO) has confirmed that the foundation training programme is once again oversubscribed. Applications for foundation trainee placements starting in August 2014 closed at midday on 18 October. There …

Simulation for foundation year survival skills (SIM-FYSS) – Using simulation to teach medical undergraduates to care for elderly inpatients before entering the UK Foundation Programme

Simulation for foundation year survival skills (SIM-FYSS) – Using simulation to teach medical undergraduates to care for elderly inpatients before entering the UK Foundation Programme

All foundation programme reserve list applicants placed for 2013

All the remaining applicants who failed to get a place on the foundation programme for 2013 have now been allocated to a foundation school, the UK Foundation Programme Office (UKFPO) has announced. The foundation programme had more eligible applicants than places when the …

General practice makes perfect

Around half of medical students will end up training to become GPs. Yet this career pathway is viewed by many students as a “soft option”—consigning you to a lifetime of colds and ingrown toenails. I recently heard a fellow medical student remark to another: “Don’t take this offensively, but I think you’d make a really good GP.” Where does this disregard for general practice as a career stem from, and why do some medical schools produce disproportionately fewer GPs? In the latest UK Foundation Programme Office national F2 career destination survey,1 medical students from Bristol …

All doctors on foundation reserve list are now placed

The last group of newly qualified doctors on the reserve list for the start of this year’s foundation year training programme have been allocated a place, the UK Foundation Programme Office has announced. In October last year it emerged that there were more applicants for this year’s foundation programme than places available at that time, prompting 295 applicants to be placed on a reserve list on 8 March this year.1 A total of 236 reserve list applicants were allocated in the first three batch allocations between May …

A third of reserve list candidates have been allocated to foundation programme

A third of the 295 applicants on the reserve list for the UK foundation programme have been allocated to schools for August 2013. The UK Foundation Programme Office (UKFPO) has announced that the first 54 applicants on the reserve list were …

Independent review criticises procedures and timescale for SJT marking

An independent review has criticised the marking process and timelines used for the Situational Judgement Test (SJT) sat by foundation programme candidates this year. In March, 148 medical students had their foundation school allocations changed after marking errors were identified in the SJT papers of more than 350 candidates.12 In response, Health Education England commissioned an independent review by John McLachlan, professor of medical education and associate dean for undergraduate medicine at Durham University. The review sought to understand what went wrong with the marking process. McLachlan’s report 3 criticised the UK Foundation Programme Office (UKFPO) and the …

Ways in which healthcare organisations can support overseas-qualified doctors in the UK

Objectives: To identify what healthcare organisations, including medical regulators, can do to address the issues and concerns faced by overseas-qualified doctors when moving to the UK. Methods: Qualitative interviews were conducted with sixty-six doctors who had qualified outside the UK and who were entering the first year of the UK Foundation Programme (FY1, equivalent to the intern year). Doctors were interviewed three times at different points in that year. In addition twelve telephone interviews were conducted with educational supervisors. A grounded theory approach was used to analyse the findings. Results: Issues and concerns were found to relate to: practical and logistical difficulties; gaps in declarative knowledge relevant to the UK, for example, use of equipment and drug names; structural differences, for example, organisational elements of working in the NHS, and differences in the relational aspects of professional work and clinical care, stemming from training in different models of healthcare. Conclusions: Agencies at different levels - government, regulator and employer - have a role to play in supporting overseas-doctors in their transition, and it is suggested that a co-ordinated approach would have benefits for doctors and patients.

Errors found on 350 foundation scheme papers, but effect on allocations is still unknown

Scanning errors have affected the test papers of over 350 medical students, but the number of students whose foundation school allocation will now change remains unknown, the UK Foundation Programme Office (UKFPO) has said.1 Over 7200 medical students have had their situational judgment test (SJT) scores rechecked by medical schools after an error in the marking of …

Workplace‐based assessments in Foundation Programme training: do trainees in difficulty use them differently?

Trainee-led workplace-based assessment (WPBA) is increasingly used in postgraduate medical training. Trainees in difficulty are known to behave differently from their peers; these differences may be reflected in their use of WPBAs and may give new insights into the behaviour and assessment of struggling trainees. Data were extracted for 76 115 assessments, completed by 1900 UK Foundation Programme (FP) trainees. Of these 1900 trainees, 95 (5%) were FP trainees in difficulty (FTiDs). We analysed aspects of the use of WPBAs, using multiple logistic regressions, to compare the behaviours of FTiDs with those of their peers. Of 48 possible comparisons, only two (i.e. the rate expected to occur by chance) showed statistically significant differences: relative to their peers, FTiDs were more likely to choose nurse assessors in direct observations of procedural skills (odds ratio [OR] 7.05, 95% confidence interval [CI] 1.23-40.43) and more likely to choose non-clinical assessors for assessments using the mini-peer assessment tool (OR 30.44, 95% CI 1.34-689.29). Key features of assessor choice for FTiDs are familiarity and likelihood of receiving a positive assessment. This analysis has not demonstrated that FTiDs use WPBAs any differently from their peers who are not in difficulty, although it does suggest associations and trends that require further exploration. These null results are interesting and raise hypotheses for prospective confirmation or disproof, and for further qualitative work investigating how struggling trainees use WPBAs in order to guide the future implementation of WPBAs in postgraduate training.

Foundation programme oversubscription is higher than in previous years

The level of oversubscription to the 2013 foundation programme is higher than in previous years, although the exact number of applicants can’t yet be confirmed, the UK Foundation Programme Office has said. Nevertheless the health minister Dan Poulter has committed the government to guaranteeing all graduates of UK medical schools a place on a foundation training programme in 2013. In October …

Situational judgement tests: the role of coaching

who hold that it isfeasible to construct situationaljudgement tests (SJTs) that are notsusceptible to coaching. With theintroduction of SJTs into UKFoundation Programme (UKFP)selection, candidates and commer-cial organisations are likely to seekways to improve scores. This issueof coaching is likely to be contro-versial in this high-stakes selectionprocess.Questions in SJTs relate to profes-sional behaviour that is under-pinned by values encapsulated inguidelines such as the GeneralMedical Council’s ‘Good MedicalPractice’.

Psychiatry experience in foundation years is linked to higher rate of application to specialty training in the discipline

Junior doctors who undertake a placement or a taster session in psychiatry during the foundation programme are almost 10 times as likely as those who don’t to apply for specialty training in the discipline.1 The UK Foundation Programme Office sent a questionnaire …

Foundation Programme psychiatry placement and doctors' decision to pursue a career in psychiatry

Aims and methodThis study analyses whether there is a relationship between a psychiatry placement during the UK Foundation Programme and appointment to psychiatry training. A survey was distributed to all foundation year 2 doctors in the UK to determine how many have exposure to psychiatry before specialty applications and whether such exposure correlates with choosing psychiatry as a career.ResultsThe study showed that 14.6% of foundation doctors had exposure to psychiatry prior to specialty applications. Of these, 14.9% chose psychiatry as a career in contrast to only 1.8% of those who did not have psychiatry exposure (χ2P = 0.0008; risk ratio 8.19).Clinical implicationsThis study adds weight to calls to increase the proportion of psychiatry posts in the Foundation Programme as part of a broader strategy to improve recruitment. To answer this question categorically, we suggest a prospective cohort study looking at how attitudes and career preferences change with exposure to psychiatry posts.

Foundation programme is oversubscribed third year in a row

The foundation programme for newly qualified doctors is oversubscribed for the third year running, the UK Foundation Programme Office has confirmed. It has, “as predicted,” received more applications to the foundation programme …

Foundation programme for 2012 is oversubscribed by 81 applications

The UK Foundation Programme Office has received 81 more applications than the number of places available for the foundation programme in August 2012. All fully eligible applicants will now be ranked on the basis of their foundation programme application system score. The top 7089 will be allocated to a …

Foundation programme is oversubscribed for second year running

The number of eligible applicants for the foundation programme has outstripped the number of places available for the second year in a row, the UK Foundation Programme Office (UKFPO) has confirmed. “As predicted earlier this year,” there are more applicants to the foundation programme starting in August 2012 than places currently available, the organisation has said. To remedy the situation, applicants who did not provide proof of their right to work in the United Kingdom by 7 October 2011 will now be withdrawn from the process. All applications from people with the right to work and remain in the UK will be ranked according to the Foundation Programme …

Workplace-based assessments of junior doctors: do scores predict training difficulties?

Workplace-based assessment (WPBA) is an increasingly important part of postgraduate medical training and its results may be used as evidence of professional competence. This study evaluates the ability of WPBA to distinguish UK Foundation Programme (FP) doctors with training difficulties and its effectiveness as a surrogate marker for deficiencies in professional competence. We conducted a retrospective observational study using anonymised records for 1646 trainees in a single UK postgraduate deanery. Data for WPBAs conducted from August 2005 to April 2009 were extracted from the e-portfolio database. These data included all scores submitted by trainees in FP years 1 and 2 on mini-clinical evaluation exercise (mini-CEX), case-based discussion (CbD), direct observation of procedural skills (DOPS) and mini-peer assessment tool (mini-PAT) assessments. Records of trainees in difficulty, as identified by their educational supervisors, were tagged as index cases. Main outcome measures were odds ratios (ORs) for associations between mean WPBA scores and training difficulties. Further analyses by the reported aetiology of the training difficulty (health-, conduct- or performance-related) were performed. Of the 1646 trainees, 92 had been identified as being in difficulty. Mean CbD and mini-CEX scores were lower for trainees in difficulty and an association was found between identified training difficulties and average scores on the mini-CEX (OR = 0.54; p = 0.034) and CbD (OR = 0.39; p = 0.002). A receiver operator characteristic curve analysis of mean WPBA scores for diagnosing 'in difficulty' status yielded an area under the curve of 0.64, indicating weak predictive value. There was no statistical evidence that mean scores on DOPS and mini-PAT assessments differed between the two groups. Analysis of a large dataset of WPBA scores revealed significant associations between training difficulties and lower mean scores on both the mini-CEX and CbD. Models show that using WPBA scores is, however, not a valid way of screening for trainees in difficulty. Workplace-based assessments have value as formative assessments that prompt supervision, feedback and reflection. They should not be relied upon to certify competence and their use for such ends may reduce their effectiveness in training. Their results should be interpreted in the context of multiple other methods of assessment, with the aim of achieving a genuinely holistic and representative assessment of professional competence.

General practice and the Foundation Programme

The reform of postgraduate medical education and the inception of the Foundation Programme in 2005 saw the creation of new opportunities for junior doctors in the community setting. The target was to allow 55% of foundation trainees to have a placement in general practice. Five years on, in October 2010, Medical Education England (MEE) published Foundation for Excellence -An Evaluation of the Foundation Programme . This included data from the UK Foundation Programme Office report 2009 showing that we are far from meeting those targets. At the time of writing, only 16% of rotations included a community placement.2 How these figures can be improved and, in fact, whether there is value in doing so, is a key issue for debate. For many trainees, the shorter working hours and close supervision of general practice …

Choosing your career path

You wouldn’t buy a car without taking a test drive so why choose a career without trying it out first? The days when a senior house officer could sample a variety of specialties before deciding on one are gone. Just 16 months after qualifying junior doctors must decide which of the 59 medical specialties in the UK to follow.1 The UK Foundation Programme Office has introduced taster weeks. These give the trainee a glimpse into life as a doctor in that …