Foundation Programme


15 / 12 / 2014 Midnight

The Foundation Programme is the two-year training programme immediately following graduation from medical school. On completion of the Foundation Programme, doctors can apply for Specialty or GP training. This page includes information on:

Foundation Programme shadowing period

Following recommendations made in the Collins Report - Foundation for Excellence, it was agreed that new Foundation Programme appointees should undertake four days’ shadowing immediately prior to the start of their employment. Health Education England (HEE) issued guidance in April 2013, stating that by the end of the shadowing period, newly appointed F1 doctors should:

  • demonstrate that they are familiar with their new working environment
  • describe their responsibilities for safe and effective patient care, including how to seek supervision
  • demonstrate familiarity with appropriate IT systems and procedures
  • understand what their roles and responsibilities are, and their limitations.

See our guidance on how to pay and contract for the shadowing period

Improving selection: the Situational Judgement Test

In 2009, the Department of Health commissioned a review selection to the Foundation Programme, with the aim of recommending a more reliable, robust, valid, feasible and sustainable method for selection which would minimise the risk of successful legal challenge. 

A Situational Judgement Test (SJT) replaced ‘white space’ questions, and a more granular and standardised Educational Performance Measure (EPM) replaced the academic quartile scores. After testing in 2012, the new selection methodology was implemented for students applying for the 2013 Foundation Programme. Reports suggest students find the SJT was fairer in comparison with the previous method of selection.

Foundation Programme Curricula

The Academy of Medical Royal College’s (AoMRC) Foundation Programme Committee revised the Foundation Programme Curriculum to be used from 2012. NHS Employers consulted employers on the key changes to the curriculum including:

  • the inclusion of a definition of the purpose of the Foundation Programme
  • the addition of learning outcome descriptions at F1 and F2 levels
  • the importance of including a section on managing long term conditions throughout the Programme
  • revisions to the assessment process
  • leadership skills for foundation doctors.

NHS Employers sent a summary of employers' views to the AoMRC on 9 September 2011 to inform the development of the curriculum.

Foundation program curriculum resource

The UKFPO has published information for junior doctors on the resources available to improve knowledge and understanding of the 2012 curriculum. Read the curriculum guidance on the UKFPOs web site.

The trainee doctor and provisional registration 

The GMC’s guidance Trainee Doctor, published in 2011, sets out standards for training and the duties expected from doctors in training. The guidance makes it explicit that provisional registration with a licence to practise only allows doctors to participate in programmes specifically for provisionally registered doctors.

In practice, this means that provisionally registered doctors with a licence to practise can only practise in approved Foundation Year 1 posts (successful completion of which is marked by a Certificate of Experience). They may be allowed to undertake Locum Appointments for Training (LAT) posts but only with the approval of their medical school and where the foundation school has been involved in the recruitment of the doctor to that post. A LAT post fulfilling the above criteria is part of a programme and leads to the award of a certificate of experience.

The law does not allow provisionally registered doctors to undertake any other type of post, including trust doctor or Locum for Service (LAS) posts even on F1 rotas. Therefore, employers will need to ensure that the registration status of any doctor appointed corresponds to the requirements of the post they will be undertaking. Further information is available on the GMC website.  

The Shape of Training review published in late 2013, recommended that full GMC registration move to the point of graduation from medical school.

The GMC has published a report on their consultation on regulatory changes to provisional registration. With effect from 1 April 2015, the amount maximum time a doctor can hold provisional registration status is 3 years and 30 days (1125 days). See our web page for further information

Tier 4 sponsorship for UK trained overseas doctors

When successful applicants that fit the criteria are allocated to foundation school programmes, details of Tier 4 sponsorship can be found in guidance documents on the the UK Foundation Programme Office website.


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