Abbreviations:
OOPT: Out of Programme Training
OOPE: Out of Programme Experience
OOPR: Out of Programme Research
OOPC: Out of Programme Career Breaks

The GP School recognizes that following the Crisp Report (1) and the recommendations of the Gold Guide (2), there will be requests from GP Trainees for OOP that it wishes to support. The specific OOP guidelines and application form are outlined in the linked downloads and should be read in conjunction with this information.

The GP School will be following the Gold Guide’s general recommendation, which emphasizes OOP being used to enhance GP clinical experience and to encounter different working practices. It will also be supporting the recommendation of the Crisp report that encourages educators to facilitate training and work experience overseas. It sees applications for OOP as opportunities for excellence and anticipates that the experience provided by OOP will enhance competencies, improve confidence and equip GP trainees to become future leaders within the profession.

Normally up to 12 months out of clinical training will be considered. We support requests that do not interfere with a training year so it is only between ST2 and ST3 or ST3 and ST4 that we would consider a request for anything other than statutory reasons. Diplomas or other qualifications will not be approved unless they constitute training that precedes relevant clinical experience. MBAs will not be considered as this is a qualification that is more relevant to experience acquired post certification. OOPC will only be considered for compassionate reasons.

Please discuss your application with the OOP Programme Director Dr Patrick Kiernan (patrick.kiernan@nhs.net) prior to submission.

GP School managed OOP posts
To support OOP the GP School is building a menu of overseas OOPE posts in developing countries using in-country partner agencies. These include Africa Health Placements (http://www.ahp.org.za) for posts in Kwa-Zulu Natal South Africa; the Watumull Global Hospital & Research Centre for posts in Rajasthan (www.ghrc-abu.com) and the St Francis Hospital Katete (http://www.saintfrancishospital.net/) for posts in Zambia. The posts are inspected and quality assured  and offered to GP trainees. The aim of such posts is to enable GP trainees to extend their training and enhance their skills and competencies in areas that are difficult to achieve within a three-year programme. It is recognised that GP trainees can gain a great deal from the opportunities provided by working/training in a developing country. Such complicated and challenging environments assist GP trainee’s confidence and consolidate and develop clinical, managerial, leadership, cultural and educational skills, many of which are beneficial and transferable to the NHS.

Job descriptions and GP trainees details who have undertaken these posts are available on the linked downloads. 

Self construct OOP posts
The GP School also supports trainees taking up jobs offered through organisations such as VSO or other similar bodies offering 12 month posts. We also support trainees who construct their own posts in developed countries including the UK.

Information about GP trainees who have undertaken these types of posts are available on the linked downloads. 

Why OOP between ST2 and ST3 or ST3 and ST4 and for 12 months?
The GP School believes the trainee will bring added value to their OOP post through the competencies developed in the ST1 and ST2 years. Experienced trainees committing to jobs for a year is an expressed need particularly of developing countries and aligns with their district and hospital plans to help achieve sustainability. Twelve months is seen as the minimum period necessary in which to benefit from preparation, gain relevant expertise and achieve mutual benefit.

Applications will not be approved if they interrupt secondary care posts as this has implications in relation to certification and funding.

Completing the ePortfolio
During OOP the trainee will provide evidence of maintaining WPBA through the e portfolio, reviewed by the Educational Supervisor at six monthly intervals. It can be logged as additional ST2 reviews and the minimum evidence required will be as per ST2. For OOP posts with reduced clinical contact the assessment tools can be adapted by documenting for example, naturally occurring events and recording any completed audits.  Internet and phone links are generally good so major problems are not envisaged when working overseas. It is the trainee’s responsibility to identify a named in-post clinical supervisor and s/he will be responsible for day-to-day supervision as well as completing their report on the e portfolio. Information from WPBA will help in the monitoring and evaluation of the programme.

Contracts. Pension. Work permits. GMC.
Employment contracts will be with the trust/organization with who you have arranged your OOP not the GP School. For OOP outside the UK, work permits, visas, medical registration etc. will be the responsibility of the trainee, including costs. To prevent difficulties in restarting work back in the UK you are obliged to maintain your GMC registration while overseas. Whilst working abroad your pension contributions will stop when you cease being paid by the NHS and will resume automatically on your return. Further information and guidance is available in the BMA publication Broadening your Horizons (3)

References:
1. Global health partnerships: the UK contribution to health in developing countries. Lord Crisp. 2007
2. Gold Guide Reference Guide for Postgraduate Specialty Training in the UK. Section 6.66 to 6.88 MMC website. June 2010