Time Out Of Training (TOOT)
The most common time to take a year out of training is after the Foundation Programme, an 'FY3' with approximately half of trainees taking this option. Other common times to take time out is after core training, before applying to specialty training.
There are any number of reasons that people make this decision from exciting travel plans to CV enhancing opportunities. Often it is just because trainees feel like they need a break.
There are a range of opportunities for doctors taking time out of training, but for the more competitive fellowships you may need to apply well ahead. If improving your application is your main aim during your time out, remember that applications run across winter so anything you want to do to enhance your application will need to be done in the first half of your year.
Locum Jobs in the UK
Locum jobs are a great way to try a specialty before actually applying and many trainees do some locum work during their FY3 year. This may be in a department you have worked for during your Foundation training – if this is what you are interested in make sure they know early on that you will be available.
As well as ‘ad hoc’ locums, you will see adverts for LAT and LAS posts. LAT posts are Locum Appointment for Training posts. These posts are vacant training posts in GMC approved training placements, they will include all the educational elements of a training post. LAS posts are Locum Appointment for Service posts. These posts are not training posts, you will have clinical supervision to ensure patient safety but without other opportunities associated with training posts.
LAT and LAS posts are advertised on an open market basis but different Trusts will advertise in different places. So it is worth making sure that any relevant hospital departments know you are available and ask medical staffing where they advertise their Trust posts.
FY3 year in ED and ITU
I reached the end of my F2 year without any clue of what speciality training I’d like to pursue. I felt that I needed more experience to make a decision, and wasn’t in any hurry to commit to years of training when I just wasn’t sure. I’d finished F2 working in ITU, so wondered that anaesthetics or critical care might be the right path for me. However, I had nothing on my CV to help with an application, and I’d left it way too late!
I decided to create my own ‘ACCS’ year – luckily through NHS jobs I found a clinical fellow post in the Emergency Department at a busy hospital in central Bristol. I worked there for six months and then moved to a similar clinical fellow post in ITU in a small hospital in Hampshire. Both these jobs were great experience and confidence boosters, and basically served as ‘tasters’ for what anaesthetics or ED training would be like. I'm now an anaesthetics registrar.
Many doctors take time out of training to travel and work abroad. Popular destinations include Australia and New Zealand, but there are a huge range of potential options including voluntary work. These websites provide further information about how you may go about applying for these kinds of jobs.
Non-clinically focussed opportunities
You may want to spend time out of training on a fellowship. These jobs often, but not always, combine academic/research/teaching with some clinical work. Sometimes they are run by universities and some Trusts also run fellowship posts. These posts are advertised on the job market and you will need to apply directly for each post. Adverts can often be found on NHS Jobs but can often be found directly on university or medical school webpages too.
An opportunity to develop skills in writing or editing articles for medical journals
An opportunity to combine travel and leadership development abroad. Run by HEE the Improving Global Health Programme provides a range of opportunities.
A wide range of options including clinical research fellowships, or perhaps taking a further degree like a Masters of PhD.
Develop leadership and management skills. For example the National Medical Directors Clinical Fellows Scheme
Look out of fellowships that also include a PGCert in Leadership
My Fellowship in Medical Education
During my FY2 year I decided I wasn't going to go straight into specialty training, but I wasn't sure which direction to take. I came across a medical education job in Birmingham. I worked with other Education Fellows to provide a range of clinically orientated teaching to the medical students. I also had the opportunity to develop the learning curriculum, train to be an examiner and write assessments and develop mentoring skills. I loved the experience and would recommend it to others; it even gave me a good break from clinical work!
My Fellowship as a Clinical Research Physician
I found a post through NHS jobs, as a ‘clinical research physician’ at a clinical trials unit at a major London hospital. This was a fantastic job – I worked mostly on phase one clinical trials, getting involved with the scientific as well as the clinical side, and was a nice change of pace. I also completed a Masters in Clinical Research alongside my daily job – the curriculum complemented my clinical work beautifully and it made it a highly productive (though exhausting) year!
Taking time of training is great, it wasn’t a break from work but it was all under my own control. I got tons of experience in areas that I never would have achieved just in normal training programmes, which boosted my CV.
Something Completely Different
If you are looking to do something more innovative or unexpected with your medical degree, this is an obvious chance in your training to take a chance on something completely different. Medic Footprints is a good resource to give you some ideas if you have none of your own. Bear in mind that a year will likely go past quite quickly so do not leave your planning until too late to take full advantage or your year. This is often particularly the case for anyone hoping to do something a bit different.
Applying for training after your time out
It is so common for trainees to take a year out of training that it is not going to count against you at interview. However, do be ready to answer a question about how your experiences will contribute to you as a doctor in training in your chosen specialty.
Remember that your application for specialty training may intrude upon your plans for your year out if you are planning on travelling. You will not be able to take part in your selection centre interview from another country. These interviews take place from January to March and you may only be given a few days’ notice of the date.