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Taking time out of programme (OOP)

MMC Trainee Information

Time out of programme must 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 PMETB Therefore, trainees are advised to discuss their plans for OOP with their TPD as early as possible.

1. Time out of programme for approved clinical training (OOPT)

The term "OOPT" refers to posts that have been prospectively approved by PMETB before the start date. PMETB must prospectively approve any clinical training period out-of-programme not already in a recognised training slot if it is to be counted towards the CCT. 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. Please note that PMETB 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 PMETB prospective approval.

For OOPT in un-approved training slots, PMETB 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 PMETB prospective approval. All applications for support should be sent to the relevant SAC and include the following:

  • Offer letter;
  • Educational contract;
  • Timetable;
  • Name of supervisor;
  • Copy of signed OOP Request form or letter from the Programme Director or Postgraduate Dean if the form has not yet been completed.

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

  • A formal covering letter from the deanery to PMETB 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 PMETB requirements.

If the OOPT is in a post outside of the normal deanery training rotation, but is in a post that already holds PMETB approval, further PMETB 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 PMETB-approved slot;
  • Offer letter;
  • Copy of signed OOP Request form or letter from the Programme Director or Postgraduate Dean if the form has not yet been completed.

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
  • ISCP QA survey
  • Consolidation sheets

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 PMETB 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 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.

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2. Time out of programme for clinical experience (OOPE)

OOPE is classified as clinical experience undertaken outside the training programme in an unapproved post, and therefore it will not count towards the award of a CCT. 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.

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3. Time out of programme for research (OOPR)

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

PMETB 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 PMETB 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 PMETB 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 PMETB 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.

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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.

Page last updated: 01 July 2008