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Guidelines for GMC
and HETV Approval for
Periods Out of
Programme
Updated June 20!
GUIDELINES FOR GMC AND HEALTH
EDUCATION THAMES VALLEY APPROVAL
FOR
PERIODS OUT OF PROGRAMME
This guidance explains Health Education Thames Valley (HETV) and
The General Medical Council (GMC) requirements for approval of any
ut of !rogramme (!) periods for "pecialty Trainees# including
overseas experience and research$ This advice is NOT for %oundation
Trainees &ho should read the 'nal section of the (ppendix$
General Principles
There are a num)er of circumstances in &hich a trainee may see* to
spend time out of training$ This may )e in order to+
Train outside HETV in a particular specialty# to&ards CCT (!T)
Gain additional clinical experience &hich &ill )ene't the ,H" as
&ell as the individual (!E)
-nderta*e a period of research (!.)
Have a career rea! for &ell/founded reasons (!C)
Ac" Up as a C#ns$l"an" % Trainees in many specialties &ill gain a
lot of experience )y acting up as a consultant in their 'nal fe&
months of specialty training$ This can generally count for up to 0
months training and can usually only )e underta*en in the last 1
months of specialty training (consult individual College guidelines)$
Please n#"e "ha" "rainin& 'hich r#"a"es as par" #( "he
pr#&ra))e *# NOT re+$ire OOP appr#,al-
(n a)solute minimum of "hree )#n"hs n#"ice must )e given in order
to ta*e time out of program# and many schools &ill require at least 1
months notice$ Therefore it is advisa)le to )egin the process a full
year prior to the proposed date of the start of the ! experience$ 2t
is recognised that requests for a career )rea* may require a more
urgent interruption of training in exceptional circumstances$
Please note: Application for a period Out of Programme
(during specialty training) cannot be made until the
applicant has been in post for at least 12 months
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All applica"i#ns (#r O$" #( Pr#&ra))e )$s" e si&ne*
an* re"$rne* "# Vic!. /eal in "he Ox(#r* PGMDE
Dean0s O1ce THREE MONTHS in a*,ance #( in"en*e*
*a"e #( lea,e-
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Cri"eria (#r Heal"h E*$ca"i#n Tha)es Valle.
Appr#,al (#r "i)e O$" #( Pr#&ra))e %
ut of !rogramme Trainin& (!T) and Research (!.) should+
3$ 4e pr#spec"i,el. approved )y the relevant "chool5"pecialty
Training Committee
6$ %orm part of the trainee7s !ersonal 8earning !lan (!8!) 5!ersonal
9evelopment !lan (!9!) &hich should )e documented at each
(.C!5.2T( assessment
0$ Count to&ards the trainee7s CCT to the maximum allo&ed )y the
"pecialty (dvisory Committee ("(C)
:$ 4e adequately supervised# including the completion each year of
a "upervisor7s report
;$ 4e su)<ect to an annual (.C! outcome = or .2T( %$
ut of !rogramme Experience should+
3$ %orm part of the trainee7s !ersonal 8earning !lan (!8!) 5!ersonal
9evelopment !lan (!9!) &hich should )e documented at each
(.C!5.2T( assessment
6$ 4e adequately supervised# including the completion each year of
a "upervisor7s report
0$ 4e su)<ect to an annual (.C! outcome = or .2T( %$
ut of !rogramme Career 4rea* should+
3$ 4e agreed )y the Head of "chool and HETV
6$ 4e su)<ect to an annual (.C! outcome = or .2T( %$
Note:
Only under very exceptional circumstances ill the !ean
consider re"uests for Out of Programme hich do not fall
ithin these guidelines#
Cri"eria (#r GMC Appr#,al (#r "i)e O$" #(
Pr#&ra))e %
>our Head of "chool# .egional (dviser# or Training !rogramme 9irector
(may di?er according to specialty) &ill act on )ehalf of your College
and assess the training component of the time ! (if any) that can
)e applied to&ards o)taining a CCT# and advise the !ostgraduate 9ean
accordingly$ 2f any amount of time is going to contri)ute to&ards your
CCT# the ! must then )e pr#spec"i,el. appr#,e* )y the GMC$
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Ac"in& Up as a C#ns$l"an" / The period counting to&ards CCT
should also )e agreed in the same &ay and this &ill also require
prospective GMC approval$
GMC Guidelines state @%or an out of programme training or research
post or an acting/up consultancy post to contri)ute to&ards a
Certi'cate of Completion of Training (CCT) it )$s" e appr#,e* .
"he GMC )efore the post is startedA$ (ny clinical training that has not
)een prospectively approved &ill not contri)ute to&ard the a&ard of a
CCT$
2f the ut of !rogramme period is "# c#n"ri$"e to&ards a Certi'cate
of Completion of Training (CCT)# the GMC 'ill re+$ire the follo&ing
documentation+
3$ ( formal covering letter from HETV to the GMC see*ing
pr#spec"i,e approval of the ut of !rogramme Experience
and con'rming that the period out of programme has HETV
support$ The GMC &ill not accept applications from individual
trainees or Colleges5"(C5%aculties &ithout the HETV support$
6$ Con'rmation that the ut of !rogramme period has the explici"
'ri""en s$pp#r" #( "he rele,an" R#.al Me*ical C#lle&e
#r Fac$l". representative (s)$ 8ocal College or %aculty
representatives must act in accordance &ith the national policy
of their College or %aculty and should see* advice &here
necessary from their College or %aculty to ensure consistent
standards across the -B$
0$ ( &ritten statement detailing the purpose and structure of the
out of programme period including con'rmation that it is su)<ect
to quality management in line &ith the GMC requirements$
2f prospective approval is not given then the trainee &ill no longer
legally )e a)le to )e a&arded a CCT$ The GMC can no longer accept
retrospective requests given clari'cation received over the legal
o)ligations around the requirements for the a&ard of a CCT$ Therefore
if prospective approval has not )een given the trainee &ill need to )e
moved to a CE".(C!) programme
Note: $f the Out of Programme period is not to count
toards the aard of %%& (usually OOP' and OOP%)( the )*%
does not need to be consulted#
Please note: $ncomplete paperor+ ill not be submitted
by ,'&- to the )*% and could a.ect your %%& date
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%urther details on GMC (pproval can )e found on &&&$gmc$org$u* or
your .oyal College5%aculty &e)site$
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F$r"her P#in"s
Trainees planning on ta*ing time ut of !rogramme of any type
must discuss this &ith their Educational and Clinical "upervisors
and Training !rogramme 9irector as soon as possi)le so that plans
can )e considered for covering their post if the application is
successful$
Chen it is agreed that ! &ill count to&ards CCT to the maximum
allo&ed )y their "(C# (esta)lished in advance) trainees7 CCT date
&ill# nonetheless# )e re/assessed on return to the programme in the
light of their current educational progress and the time left in the
programme$
2f the period ! is n#" to contri)ute to&ards the CCT# then the
CCT date &ill )e delayed )y an equivalent amount$
!.# even if clinically )ased# &ill not contri)ute full time to&ards
the CCT# therefore &ill result in a delay to the CCT$
There are limits on the amount of !. time allo&ed )y HETV$ (ll
an individual7s time in !. counts cumulatively to&ards this limit#
including !. ta*en during any "t.5"p. posts in other Health
Education or 8ET4 organisations$ Currently the limit is three years
for a higher degree (M9 or !h9)# up to #ne extra year may )e
granted at the discretion of the !ostgraduate 9ean and Head of
"chool# provided a &ell su)stantiated request is made at least three
months )efore the planned return to the trainee7s clinical
programme$ There &ill )e NO further extensions granted$
(ny request for an Extension of an ! must )e made on the
Extension to ! form and accompanied &ith all necessary
supporting paper&or*$
2n their 'nal year of training# trainees &ill not usually )e granted
any ! period# except !C especially if this results in a delay to
their CCT date$
( trainee &ith an (.C! 650 or a .2T( 95E# or &ith unmet
o)<ectives identi'ed at their penultimate year assessment# &ill not
usually )e granted a period ut of !rogramme unless it can )e
demonstrated that their speci'c training o)<ectives have )een5&ill
)e met$
Trainees must comply &ith College regulations (e$g$ the .oyal
College of (naesthetists requirement that the last six months of
training must )e spent in programme)$
! application is not an alternative to an interdeanery transfer$
Trainees must meet the requirement of eligi)ility or apply through
open competition for posts in other 9eaneries$
Trainees are advised not to voluntarily erase themselves from
the GMC register &hilst out on !E overseas or on a career )rea*
D this &ould )rea* their conditions of training approval and &ould
remove them from the training programme$
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Re,ali*a"i#n 'hils" O$" #( Pr#&ra))e 2
9octors &ho are ut of !rogramme# )ut carrying out any type of
medical &or* &ill still need to provide evidence of %itness to !ractise
annually# to&ards their revalidation$ Those having a complete Career
4rea* at the time of revalidation may )e deferred for revalidation$
There is a speci'c information leaEet &hich guides trainees in each
form of ! as to exactly &hat evidence they &ill need to provide to
their (.C!5.2T( panel for revalidation purposes$ This can )e o)tained
from the .evalidation area of the HETV &e)site$
(s every trainee &ill have an (.C! or .2T( annually# even if ut of
!rogramme# the same rules for provision of evidence apply to them as
to all other trainees and revalidation &ill occur every ; years$
NHS Pensi#n Sche)e an* OOP
%rom Fuly 6G3G trainees &ho &ish to underta*e a period of unpaid
leave5! and &ho &ish to remain in the ,H" !ension "cheme are
no& required to maintain their pension contri)utions currently# i$e$
they cannot pay their contri)utions )ac* once they return to &or*$
http+55&&&$nhs)sa$nhs$u*59ocuments5!ensions5T,HI/I6G3GI/
IEmployerI,e&sletter$pdf
M#n"hs 3 2 4 OOP % Trainees &ill )e required to pay their pension
contri)ution &hilst a&ay for the 'rst 1 months$
M#n"hs 5 2 67 OOP % Trainees &ill )e required to pay )oth theirs
and their employer7s contri)utions from months H D 6:$
Thir* .ear % The scheme does not allo& anyone to remain on it
for longer than 6 years !$
$t is the &rainee/s responsibility also to inform
*edical 0ta1ng ithin the &rust of any Out of
Programme experience#
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Re"$rnin& "# "rainin& a("er ein& O$" #(
Pr#&ra))e
2n all cases of agreed time out of program# the anticipated date
of return and date of original or revised CCT5%oundation "ign ?
must )e discussed at the outset and the trainee should give at
least six months notice of the return to &or*$
Chen time is ta*en out of programme for any reason apart form
a 'xed period of !T# although every e?ort &ill )e made to
accommodate the trainee in the next availa)le vacancy in the
programme# there is no guarantee that the return date or a speci'c
rotation can )e accommodated$ &rainees should be aare of
this at the outset hen a re"uest for time ta+en out of
program other than for training is re"uested$
The (cademy of Medical .oyal Colleges has a policy on the
process to )e follo&ed &ith trainees returning to clinical &or* after
more than 0 months ! and can )e found at
http+55&&&$aomrc$org$u*5component5Joo5item5academy$html$
This involves t&o )rief chec*lists / one for Kdeparture from
clinical &or*K to identify the clinical training issues that are current
at the time of leaving the programme and &hich need to )e
addressed on return# and a second Karrival )ac*K chec*list
identifying possi)le clinical shortcomings &hich need to )e
addressed at return$ These should )e completed in consultation
&ith the Training !rogramme 9irector and Educational "upervisor
and put into each traineeLs clinical e!ortfolio$ The emphasis in )oth
cases is for the trainee to ta*e the initiative$
( period of s*ill refreshment and updating may )e necessary for
trainees &ho underta*e signi'cant periods a&ay from training$
This is at the discretion of the !rogramme 9irector and the
!ostgraduate 9ean$
Up*a"e* A$&$s" 6839 :Dr ; E*&e< In"eri) AD
Re,ali*a"i#n=
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(ppendix 3$ G$i*ance n#"es (#r In*i,i*$al Special"ies< 'here
"he a*,ice )i&h" *i>er?
Ps.chia"r. "rainees 2 Ac"in& Up
!sychiatry trainees ta*ing an ! period to @act upA are entitled to
have this time counted to&ards their CCT date$ The .oyal College of
!sychiatrists and the General Medical Council have agreed that they
do not require a College letter of support
In"ensi,e Care Me*icine "rainees have special arrangements in
place and you are advised to consult &ith the relevant Head of "chool
and appropriate &e)sites for guidance$
Mili"ar. "rainees have special arrangements in place and you are
advised to consult &ith the relevant Head of "chool and appropriate
&e)sites for guidance$
O$" #( Pr#&ra))e Research (#r C#re Me*ical Trainees
Core Medical Trainee (CMT) (C%s &ill )e allo&ed !. after
completing at least 3 full year of core training$ 4oth exit and re/entry
from5to the CMT training programme &ill )e timed around the annual
changeover in (ugust$ 2t &ill not )e possi)le to allo& !. to start at
other times during the year$
Those &ishing to apply for !. must do so )y 3
st
March in the year
that they &ish to go out of programme$ This &ill ensure that posts can
)e 'lled from national CMT recruitment$ 2t may mean that (C%s &aiting
to hear a)out funding applications in May5Fune need to have their
funding under&ritten )y their research group$ 2f they apply for !.
and are not su)sequently a&arded funding they &ill not )e a)le to re/
<oin the clinical training programme for at least a year as their clinical
post &ill have )een 'lled$ They &ill retain the right of run/through to
the higher specialty of their appointment if clinical competences are
met$
4oth )efore applying for !. and during the research the trainee
must stay in touch &ith the academic training programme (-C(G")
and the clinical Training !rogramme 9irector to ensure that they are
follo&ing the policy and *eeping all parties informed$ This &ill ensure a
smooth exit and re/entry to the training programme$ .eturn to the
CMT training programme should )e planned to )e in (ugust as vacant
posts are not availa)le at other times of the year$
Chen returning from !. to the CMT training programme it &ill )e as
a clinical trainee and they &ill )e placed &herever there are CT6
spaces$ This may mean that they are placed outside of xford$ They
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&ill ho&ever retain the right of run/through to the higher specialty of
their appointment if clinical competences are met$
The CMT programme for the purposes of rotation allocation &ill )e
managed as a single group )y the clinical Training !rogramme 9irector
to mitigate gaps in the rota due to (C%s leaving and returning from
!.$
Car*i#l#&. ( maximum period of 0 years of ut of !rogramme is
allo&ed$
Me*ical Onc#l#&. ( maximum period of 0 years of ut of
!rogramme is allo&ed and the "(C &ill recognise up to 36 months
to&ards the minimum training times$
Ti)e #$" #( "he F#$n*a"i#n Pr#&ra))e :TOFP=
(ll %3s considering ta*ing a year out )et&een %3 and %6 must discuss
this &ith their Educational and Clinical "upervisors# the %oundation
Training !rogramme 9irector and the %oundation "chool 9irector$
Chen returning to %6# trainees should )e a&are that &hilst vacant %6
posts are usually availa)le# the %oundation "chool is una)le to
guarantee a place$
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INFORMATION RE@UIRED CHECA LIST
Please note: $ncomplete paperor+ ill not be submitted
by ,'&- to the )*% and could a.ect your %%& date
Please "ic!
#xes el#'
,ame+
"pecialty+
Current Contact address+
Training ,um)er+
GMC ,um)er+
Current CCT date+
Current !lacement+
!roposed leave dates+
Critten details of research5clinical training+
8ocation+
"ource of funding+
"ignature of Consultant "upervisor+
"ignature of !rogramme 9irector+
"ignature of Head of "pecialty "chool+
2f you require your time ut of !rogramme TO
COUNT TOBARDS YOUR CCT &ritten College
con'rmation of education credit for proposed time
to )e spent out of programme MUST ACCOMPANY
THIS APPLICATION-
Please attach a copy of the correspondence
from the %ollege con2rming they approve
your Out of Programme time#
A si&ne* Cpr#,isi#nall. a&ree* c#p. #( "he
OOPE (#r) 'ill #nl. e pr#,i*e* (#r "h#se
C#lle&es 'h# re+$ire a HETV si&ne* (#r)
e(#re "he. can pr#*$ce a C#lle&e le""er #(
s$pp#r"-
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4TH HETV and College approval )$st have )een given in 'ri"in&
)efore "pecialist .egistrar5"pecialist Trainees can leave the
programme$
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