Read the accounts, hints and tips of Foundation Doctors who took take a year out of training in 2011/2012.
- Helena Barton's guide to working in Australia
- Ruth Dodwell - Locuming and Studying
- Chris Goes - Medicine in Zanzibar
- Marie O'Sullivan - If you don't get a training post
- Pete Torrance - Studying, Locuming and Travelling
- Vicky Smith - New Zealand
Helena spent her year out in Australia and wrote a guide to help others with the process of getting there and getting all the paperwork done.
Ruth Dodwell - Locuming and Studying
I decided that I wanted a year out of training to gain a broader skill base for GP and to have some time without a portfolio! I started planning the year at the beginning of F2.
I did a 4 month locum Psychiatry job in Lancaster which I organised through emailing consultants that I knew from medical school. It was a valuable experience and has meant that I can now focus on other specialties during my GP training. Since then I've studied a Postgraduate Diploma in Palliative Care at Kings College London. This has been a brilliant experience of learning from the world experts on a multi-cultural and multi-professional course. I'm hoping that this qualification will enable me to become a GP with a specialist interest in Palliative Care. I found this through internet searches and you can find details of this course here http://www.csi.kcl.ac.uk/msc-pg-dip-pg-cert.html. I did self-fund the Diploma - although I must admit it helped that the psych job I found was Band A plus the weekly locum rate!
Overall my year out of training involved a lot of careful planning but was well worth it. It enabled me to have more free time during the GP application process to ensure I got the training post I wanted and has allowed me to gain experience in more areas than is possible during GP training alone.
Deciding to take a year out of training and work in Zanzibar was one of the easiest decisions of my life, and has paid off in more ways that I imagined. It started with my indecision regarding my career path, and ended with me working for a NGO called Health Improvement Project Zanzibar, trying to make a real and sustainable difference to the healthcare system there. This came about through working for the urology team in Musgrove Park during my F1 year, where I met the chairman of HIPZ.
Working in a low resourced setting is so much more challenging than working in the NHS, and has given me a new perspective on the NHS and the UK. I’m sure my clinical judgment and skills have improved, but the public health and management decisions I’ve been exposed to have also made a lasting impression. I’ve had experiences that a CT1 trainee in the UK would never be exposed too.
At the beginning it was very difficult seeing premature babies born only to die soon afterwards, I had frustrations at not being able to offer simple treatments, and I found working in a hospital that has a choice of four intravenous antibiotics and regularly runs out of two of them a real challenge. I’ve attempted to treat tetanus, only to have the patient self-discharge to a traditional healer.
Yet only four months later I saw premature babies surviving and being cared for appropriately because of a protocol I have designed and introduced. I've had the experience of working with the Ministry of Health to help find a solution to the drug shortages, and saw children I thought were going to die, happily eating breakfast the following morning, just by giving them antibiotics, oxygen and fluids. It’s the most rewarding work I’ve ever done. I also now know what it is to be the most senior person in a team, and have had to make decisions about when to stop resuscitations, when to treat strokes with aspirin and no CT scan, and when to start anti-retroviral medication, when HIV tests are not available; decisions that are well above an ST1 responsibility in the UK.
Taking a year out of training is something I would recommend to any trainee, and taking time out after F2 is certainly not too early. The general experience and skills that your foundation jobs teach you are invaluable when you are faced with a ward round that can include any specialty. The experience I have gained from my time in Zanzibar will no doubt hold me in good standing for the rest of my career and has already helped me obtain my first choice CMT job back in the UK.
I undertook my Foundation programme in Gloucestershire. I knew I wanted to train in Obstetrics and Gynaecology and I was keen to stay in the Severn Deanery. Unfortunately, I did not achieve a training post on my first attempt, and this led to me having my year out.
I found the prospect of not being in a training post very daunting, I wasn’t entirely sure of the options that I had. Moreover, I was concerned with how this year out would look on my CV and the implications for my future applications for a training post.
I was very fortunate to have a supportive and well-informed Educational Supervisor, who guided me through the possibilities. I was keen to look at jobs that would develop other areas of my own skill set, such as teaching. I was appointed as a Clinical Teaching Fellow (CTF) and spent the year teaching the medical undergraduates at the University of Bristol Academy in Swindon.
This role has increased my teaching skill, confidence, organisation, management, leadership and communication skills and has also been thoroughly enjoyable. My knowledge base has grown as I’ve taught across specialties. I’ve also attained a postgraduate exam and diploma, as well as working towards a Postgraduate Certificate in Medical Education.
Following my year out, I applied again and successfully gained my first choice training post.
Obviously, for those who plan to go straight into Specialist Training from their Foundation years, it is a big disappointment to be unable to. However, such time can definitely be used constructively. With the benefit of hindsight I am very glad that I have had a year doing something different. My advice for FY2s who find themselves with a year out of training would be:
- Do not panic. There are plenty of options, whether you choose to do something clinical or academic or to go abroad for the year. Experience is experience and will only make you a better doctor.
- Don’t give up. If you are certain on your specialty choice then keep focussed and apply again. It is not a race.
- Talk to as many people as you can. Supervisors, consultants, trainees, peers and friends. You will be surprised how many people have been in similar situations and they will be able to give you advice and ideas.
- Enjoy it. There’s always a silver lining and it is important to look after yourself and enjoy your work, whether or not you are in a training post.
At the start of my F2 year I decided it was about time I took a gap year so I could do all the things I was finding hard to squeeze round my job.
It was slightly different to your typical medical gap year, with the bread and butter of my time spent doing youth work for my church, studying theology and locuming in A&E. I also spent 4 months in the middle travelling with my wife through India, China, New Zealand and the Middle East. Prior to setting off on my travels I signed up to a few GPST MCQ sites, taking the odd hour here and there to do a bit of revision at internet cafes. I was able to sit my GP Stage 2 exam in New Zealand, before returning for the Stage 3 interview in March.
Tips for F2s
For those applying to GP:
- Make sure you've scanned in all the documents required for applying to GP before travelling
- Practice makes perfect for stage 2 - I used a number of internet–based GPST MCQ. This was my only source of revision, and resulted in a huge improvement form my previous years score.
- Practice for stage 3, it's definitely worth preparing for.
- I signed up for an agency, as well as with 2 local hospitals for internal locums. I personally much preferred internal locums for several reasons: I didn't need to travel miles, I knew the staff and the hospital system, I was informed of the available shifts before the locum agencies, they didn't cancel my shifts last minute and they were less intrusive. I also, bizarrely, found they paid the same, if not better.
Where did I go?
I had a year abroad in New Zealand after my foundation years.
Where did I work?
I worked at Christchurch Hospital as a house officer.
Rotations are 3 months long for house officers and 4 months for registrars (ST1-5 equivalent.) There are a wide range of medical and surgical specialties to choose from.
I had a great year. I got to do a mix of medicine (oncology and cardiology) and surgery (general and orthopaedics) as well as relief posts. There is a lot to do in and around Christchurch, beach hills, mountains and amenities but no city centre. I was also there during Rugby World Cup 2011 which was amazing!!
How I organised it?
- I organised it directly through the hospital Resident Medical Officers Unit.
Details on the http://www.cdhb.govt.nz/ website in careers tab.
- Most UK doctors start in August (end of their 3rd quarter) as their medical year starts November.
Advice to other F2s considering taking time out
- Apply early. I applied in the December of F2. The earlier the better.
- Also remember you will need to time to apply for a visa and the Medical Council application.
- I went on a working holiday visa. You can work on for 1 year only. Friends of mind went on a work visa, which is better if you plan to stay longer than 1 year.
- The visa is straightforward to change if you decide to stay longer.
Things to think about
- How long to go for? 1 year? 18 months?
- Coming back for interviews?
- Things to do to keep your CV alive whilst away? Courses?
- When to go? Between F1/F2? After F2?
Good luck with your decisions!