Header Image

Taking time out of programme (OOP)

STR Trainee Information

OOP (Out of Programme) is a generic terminology which refers to all posts undertaken outside a trainee’s original rotation. Time out of programme must be agreed by the Deanery and the SAC and, if the time is to count towards the CCT, it must also be prospectively approved by the General Medical Council (GMC). Therefore, trainees are advised to discuss their plans for OOP with their Training Programme Director (TPD) as early as possible.

Please be aware that changes have been made to the NHS pension scheme which will directly affect trainees undertaking out of programme training. For further information, please contact your local deanery or visit the following link on the NHS: Business Services Authority website: www.nhsbsa.nhs.uk/Documents/Pensions/TN7_-_2010_-_Employer_Newsletter.pdf

Following current guidelines, when referring to specific OOPs the below terminology should be used:

  1. Out of Programme Training (OOPT) should be used for all posts that will count towards CCT. This includes both overseas and UK posts - The JCST may recognise up to a maximum total of 24 months of OOPT towards training but restricts overseas OOPT recognition to a maximum of 12 months.
  2. Out of Programme Experience (OOPE) refers to posts that are not intended to count towards CCT.
  3. Out of Programme Research (OOPR) refers to research posts that trainees wish to undertake. At the moment MMC trainees are not allowed to have research counted towards CCT because it is not part of the new surgical curricula and is not a competence they need to gain to become a consultant in the UK – the exception to this rule is Trauma & Orthopaedics trainees and Academic Clinical Fellows (ACFs) who can have the time they spend undertaking academic work counted towards CCT.
  4. Out of Programme Career Break (OOPC) refers to career breaks for personal reasons and will need to be agreed by the local deanery and the SAC should be informed for accuracy of records.

Below you will find further details regarding the different types of OOP and how you can apply for SAC support. For an overview on how the JCST OOP process works please click here

1. Time Out of Programme for Clinical Training (OOPT)

OOPT may take three forms: 1. a period of approved training in an approved training programme in the same specialty in the UK; 2. a period of training in an un-approved or other specialty slot in the UK; or 3. an overseas training post - for the latter please see here JCST guidance. Please note that the GMC will recognise training in a post approved by the statutory authority in the EEA/Switzerland as approved and no additional approval is needed.

Please note that un-approved training posts require both SAC support and GMC prospective approval.

For OOPT in un-approved training slots, the GMC requires evidence that the SAC supports any periods of OOPT, and the process for prospective approval is two-tiered. First, a separate application must be made to the SAC for its support and a decision must be made before seeking GMC prospective approval. All applications for support should be sent to the relevant SAC and include the following:

  • Offer letter;
  • Educational contract (which should include details of learning agreements and objectives, and a timetable) - PLEASE NOTE THIS IS MANDATORY;
  • Name and contact details of supervisor;
  • Updated CV;
  • Copy of signed OOP Request form or letter from the Training Programme Director if the form has not yet been completed. (Please note that we also require confirmation that the Deanery is aware of the out of programme.)

Please note that T&O trainees are required to submit further documents and therefore are advised to contact the specialty team.

The GMC application for prospective approval should be made by the home Deanery and must include the following:

  • A formal covering letter from the deanery to the GMC seeking prospective approval of the OOPT post and confirming that the post has deanery support;
  • Confirmation that the OOPT post has the explicit written support of the SAC/JCST (i.e. a copy of the decision letter from the SAC offering support of the OOPT);
  • A statement detailing the purpose and structure of the post including confirmation that the post is subject to quality management in line with GMC requirements.

If the OOPT is in a post outside of the normal deanery training rotation, but is in a post that already holds GMC approval, further GMC approval is not needed. However, SAC support is still necessary before starting the post. An application should be sent to the relevant SAC and include the following:

  • Documentation from the Deanery or Trust indicating that the training is in a GMC-approved slot;
  • Offer letter;
  • Updated CV;
  • Educational contract (which should include details of learning agreements and objectives, and a timetable) - PLEASE NOTE THIS IS MANDATORY;
  • Name and contact details of supervisor;
  • Copy of signed OOP Request form or letter from the Training Programme Director if the form has not yet been completed. (Please note that we also require confirmation that the Deanery is aware of the out of programme.)

Please note that T&O trainees are required to submit further documents and therefore are advised to contact the specialty team.

Trainees keep their NTN while in an OOPT, as long as this has been agreed by the Postgraduate Dean and the trainee has satisfied the requirements for the annual review. OOPT will normally be for a period of one year in total but it can, exceptionally, be up to two years.

Trainees who undertake an OOPT must complete the assessments required by the specialty curriculum and the completed OOP form to the home Deanery's annual outcome panel, as well as to the SAC. This ensures that trainees keep in touch with their Deanery and the relevant SAC and that their progress is reviewed. This process allows trainees to keep their NTN and provides information on the trainee's likely date of return to the programme as well as an estimated date for completion of training.

In order for a period of OOPT to count towards the award of the CCT, on completion of the post an application must be made to the SAC to determine whether educational objectives have been met. Please note that no OOPT will be counted without this decision from the SAC. All applications should be sent to the relevant SAC or notification should be sent to the SAC that all components have been completed online via the ISCP. Applications should include the following, or advise the JCST office of their existence so they can be retrieved via the ISCP system:

  • ISCP assessments for the entire period or satisfactory trainer's report;
  • ISCP QA survey;
  • Validated consolidation sheets;
  • Evidence of GMC approval (as appropriate for non-approved posts).

Taking place near the end of training time, 'acting up' as a consultant can also be classified as OOPT. Trainees can act-up only if they are in their final phase of training, have passed the Intercollegiate Specialty Exam, and the post does not exceed 3 months in total. The post must be defined as 'acting up' for an absent consultant, and cannot be used to fill a new locum consultant post or to fill service needs. Although SAC support is needed, further GMC prospective approval is not required as the competencies gained in 'acting up' posts are embedded in the curriculum. An application to the SAC requires:

  • The name of the consultant supervisor (this individual must work in the same hospital, but can be in a different surgical specialty);
  • The exact dates of the acting-up post;
  • Written confirmation that the post is a substantive NHS consultant post;
  • A letter of support from the Training Programme Director.

Once the acting-up post is completed, a report must be submitted from the consultant supervisor; the CCT can not be recommended until this report is received and the training is deemed acceptable by the SAC.

Return to top

2. Time Out of Programme for Clinical Experience (OOPE)

OOPE is classified as clinical experience undertaken outside the training programme. Any out of programme training which is not intended to be counted towards CCT will be clasified as OOPE. This time out needs to be agreed by the Postgraduate Dean. The OOP Request form should be used to make the request and should be returned on an annual basis to the Deanery and the SAC whilst the trainee is out of programme.

Such posts might benefit trainees who are seeking to enhance / gain clinical experience in different areas of practice.

OOPE may also be used to take time out of programme to gain experience as a Locum Consultant, which cannot be counted towards the CCT. This may, however, be used to support an application for entry to the Specialist Register through the CESR route.

OOPEs are usually for a period of one year, but can be up to two years with the agreement of the Postgraduate Dean.

Although these posts will not count towards training, the SAC must still be notified when these posts are undertaken, and trainees / Deaneries are required to forward the relevant documentation (i.e. a copy of the OOP Request form) for information.

The JCST encourages trainees to undertake time out in developing countries but would normally view this as experience not training. Time spent in a developing country* will therefore normally be treated as Out of Programme Experience (OOPE), which would not count as part of the CCT. The Specialty Advisory Committees (SACs) will, however, consider a maximum of three months to count towards training if a satisfactory application for SAC support is submitted. They may also consider longer periods on a case by case basis.

*Please visit the NHS Employers website here for a current list of developing countries.

For further details on documentation you are required to submit please see above under the OOPT section.

Return to top

3. Time Out of Programme for Research (OOPR)

Trainees are encouraged to undertake research if and when they have an interest in doing so.

The GMC has made it clear that time spent out of programme to do research will be recognised towards the award of a CCT only if the relevant specialty curriculum includes research as an optional element of training. Where this is the case GMC will not be approving research per se, but approving training that is relevant to the CCT curriculum in question.

The surgical curricula all require basic knowledge of research, but how this is addressed is up to the programme. A small number of non-Walport trainees may want to undertake significant pieces of research. Generally research for non-Walport trainees would not be recognised towards the CCT.

Although OOPR will not count towards training, the SAC must still be notified when a post is undertaken, and the trainee / Deanery is required to forward the relevant documentation (i.e. a copy of the OOP Request form) to the SAC for information.

All trainees who undertake research must submit the relevant section of the OOP Request form to the annual outcome panel. This ensures that the trainee keeps in touch with the Deanery and registers each year to renew his/her commitment to the training programme. Once again it is the trainee's responsibility to make this return annually.

Some trainees undertaking research retain clinical work which will allow them to maintain their existing competences whilst out of programme. However, at least 50% of the total amount of time must be spent in approved clinical training if it is to count towards the award of a CCT, and prospective GMC approval must be sought if the clinical work is being done in a non-educationally approved post. Trainees should liaise with their Training Programme Directors to ascertain if the proposed clinical timetable is appropriate for recognition. If the clinical element is prospectively approved by the GMC and has been supported by the SAC, the trainee is required to provide formal assessments to the annual review panel with copies sent to the SAC.

Please note that the approach to research may be different depending on the surgical specialty you are in. Please contact the relevant specialty team for further information (please use the ‘contacts’ tab to see where you should direct your query to).

Return to top

4. Time Out of Programme for Career Breaks (OOPC)

Trainees are allowed to take career breaks if and when agreed by all involved, including the TPD, the Postgraduate Dean and the relevant SAC. This will permit long periods of out of programme for several possible reasons, as listed below, and gives trainees the security of having a place available when they decide to re-enter training.

The OOPC will permit trainees to step out of programme for a designated and agreed period of time to pursue other activities, such as domestic responsibilities, working in industry, or developing talents in other areas. It can also be used to deal with long periods of ill health. However, OOPC is not training and can not count toward the CCT.

An OOPC must be agreed by the Postgraduate Dean, and the SAC also needs to be informed, usually via the OOP Request form. Occasionally OOPC requests may be turned down - for example: if programme is not able to fill the resulting vacancy (in the interest of public care), if the training programme will not be able to accommodate the trainee upon return, or if there is evidence that the trainee is no longer committed nor suitable to train.

When requests for a career break cannot all be accommodated by the programme then priority will be given to the following:

  • Trainees with health issues;
  • Trainees with caring responsibilities for dealing with serious illnesses within the family which cannot be accommodated through flexible training;
  • Trainees with childcare responsibilities, which cannot be accommodated through flexible training;
  • Trainees with a clearly identified life goal which cannot be deferred - as per Postgraduate Dean's discretion

Trainees can take up an OOPC after their training programme has started but it should not be accepted until they have been in training for at least one year. OOPC can not be used to defer a start date. Career breaks are breaks without pay and trainees should take advice from the Postgraduate Dean on their statutory rights. The needs of the service will be considered when agreeing a start date for OOPC.

OOPC is limited to two years in total; however, it can be longer if the Postgraduate Dean has agreed to an extension. Support from the SAC is also required in this instance.

Trainees who undertake OOPC for longer than the agreed period will relinquish their NTN and will need to re-apply in open competition for re-entry to the same training programme or to a different one.

At least six months notice should be given before the planned return to work. Although the trainee will be accommodated in the next available vacancy, it may take time for a suitable placement to arise. There is also no guarantee that the return date will be within the six months; trainees should discuss this with their Postgraduate Dean. A period of refreshment in skills may be necessary; if so trainees need to liaise with the Training Programme Director and the Postgraduate Dean to arrange a training session. Trainees are also encouraged to keep up to date through attending educational events, although there is no entitlement to study leave funding for this.

Trainees need to complete a Form R and the relevant section of the OOP Request form on an annual basis while out-of-programme and submit it to the annual assessment outcome panel in order to continue to register their interest in staying in programme. This should include an update of the date they intend to re-enter training. Copies of these documents should be sent to the relevant SAC.

Trainees should bear in mind that career breaks might affect their ability to maintain a current licence to practise with the GMC.

Return to top

Page last updated: 10 May 2012