Foundation Programme

Here is my promised blog post on the foundation programme and my experience with it. I apologize for the length - but I wanted to be as comprehensive as possible.

Firstly here is the official website: http://www.foundationprogramme.nhs.uk where you will find all the information you could possibly want, and then some more.

So, you are a maltese medical student and you are wondering what to do once you finish the MD course. Well one of the options is to continue training in this field. I emphasize that this is only one option of the variety of things you can do with your life after an MD course. So if you've decided to practice medicine then you need to train. In Malta and the UK this is done with the Foundation Programme. I cant comment about other countries as each have their own system, but I encourage you to check them out, if you are interested in other places.
So the is programme is a two year programme which would teach you all the practical skills for being a basic doctor and helps you decide about your future specialization, be it surgical, medical, GP etc..It also makes you eligible to apply for speciality training posts.

So the foundation application can be quite a daunting task as it is a multi step process and 12months will pass from the start of your application till the day you actually start working. So I will attempt to break down the process into easily understandable steps:

1. Eligibility (sometime in mid summer between 4th yr and 5th yr)

This is where you confirm that you are able to apply to the foundation programme. There are a few documents that you need to get which include:

• Transcript (you can get this from the university administration building)
• Deans statement (there is an official form on the FP website which you need to give to medical school. This would also include your academic ranking eg 15th out of 20 students and your quartile which would be 4th in the case I just mentioned - This does have an effect on your ranking obviously as people in the top quartile all get the same mark, the ones in the 2nd a different mark and so forth. The difference between the very top student and the very bottom is only 4 marks - so don't lose sleep over this.)
• Passport photos (SMILE)
• Proof that you are not required to take the PLAB (Professional and Lignuistics Board) tests (as maltese nationals you do not need to do this, as our training is done in English)
• Photocopy of your ID or passport.
• Eligibility form ( this also contains a tick list that reminds you exactly what documents you need to present)

   2.  On-line Registration and Enrolment (beginning of October)

You will receive an email telling you that you are eligible and then you will have instructions about where to go to register and enrol (on-line link included in email). You will have to put in some data exactly as you did in your eligibility form. After which you will again receive telling you that your account is registered and activated. A few days later you will be able to fill in your actual on-line application.

3. Application (Mid October)

This what freaks most people out, and I cant say that I wasn't anxious about filling this in, but don't worry. Just take time and read everything and fill everything out and get someone to double check your work. There are 8 sections, most are dead easy to fill in, and since you can save each step you do you can fill different sections in at different times.

1. Personal details (name, email etc)
2. Qualifications (there is a list of things which they are looking for which is explained on the site)
3. Clinical Skills (don't worry too much about this - this is just as a self assessment so that you know what you need to work on within the FP and what you need training  in. This section is not going to be graded)
4. Equal opportunities (this section is basically personal details like race, religion, sexual orientation, special needs etc - simple)
5. References (I recommend you get on this asap. Possibly even before you need to fill it in. Basically you need to ask two people - one clinician and one from med school, to be your references. You can ask them in summer so that they will know about you and will be expecting your email. Then when its time to fill in your application, just email them and ask them for the relevant data - which is listed in this section. Its basically their contact info. Make sure to get this information as soon as possible and hunt them down, cos some may take their sweet time and this does nothing for your anxiety)
6. Questions: Ok so this bit is what reallly gets people going, so lemme explain it. Next year this section will be just like mine, which means that my advice can help, but in two years time it is scheduled to change. So for now you have 6 questions. They are quite general questions that are used to gauge how you are as a person and how you handle stress, manage time, ethically correct, learn etc. These questions are the ones that will affect your actual grade in the foundation programme which when added to your academic ranking (mentioned above) will give your total grade. Its impossible to predict which questions will come out but I can give you a few tips. 
• Write the questions down somewhere, and dissect them to see exactly what they want from you. 
• Make sure you answer all the question. 
• Obviously one must use good grammar and spelling so check everything twice and get someone else to read it for you to make sure it makes sense and all that jazz. 
• They are strict on plagiarism so don't use some on-line company to write this for you.
• Also they may want to verify something so be truthful. 
• There is a word limit to these questions so be concise and practical in your wording. 
• So I suggest that you try working on these from day1 of your application so as not to freak out on the last day. 
• One of the questions is also about previous qualifications, where if someone did a BSc course or something of the sort before they will be awarded marks for that accordingly. Most people don't receive anything for this section so chill.
• I think that from 2013 the application process will change and one will need to go to the UK to complete this by sitting for an MCQ style questions. They are easy to do, and quite enjoyable but you need to see what the instructions are then.
7. Preferences: This also gets people confused especially for us non-UK residents. So here you need to decide which Foundation School you want to be in. This is basically the entire UK divided into parts. There are around 23 foundation schools and you need to rank them according to your preferences. This section can be quite confusing for Maltese people. There you have the ENTIRE UK in front of you and you need to decide where you want to work/live/love/play/party. Obviously London is extremely desirable as it is the capital and fabulous but it is also very competitive to get into any of the London Schools (North Central-, North East-, North West- and South- Thames). There is a graph somewhere on the UK FP website about the competition ratios and how many people applied for the deanery and how many actually got in. The London, Oxford and Severn deaneries are ALWAYS oversubscribed. This should serve as a warning, that since you don't know what marking you will get for your application form yet, you have no guarantee that you will get a high mark, and therefore accepted into these schools. The way the places are filled is by giving everyone their first placement by default, and then if a place is over subscribed, the people with the highest marks will be kept in preference to those with lower marks. The problem with this, is that if your 2nd preference is also full, you might end up shuffling down quite low on your preference placements. And this year was the first time that the entire foundation programme was over subscribed, so some people were actually not placed anywhere at first. So how is one meant to choose. 

• I personally followed advice of other people applying for the UK FP and avoided the over-subscribed places (so London, Oxford and Severn were out). 
• Next I got all the foundation schools and checked what part of the UK they lie in, and what the actual geographical boundaries were and the major cities within it. This allowed me to see the entire UK as an option. 
• Next I decided that I wanted a city life, so I wanted to be somewhere with good commute and cities which I liked when I visited the UK. This directed me towards the North-West Deanery/Foundation School. This is mainly because I loved Manchester as a city when I visited, and its a very metropolitan area which is what I wanted.
• Obviously you need to see what you want. Some people chose East Anglia (most of my class in fact) for reasons which I gather to be; a large number of Maltese doctors are there, and its close to Cambridge (a lovely town), and also close to Luton airport with flights to Malta. Others chose Scotland - from what I gather there are also a large number of Maltese doctors there. But there were people applying to everywhere from the Peninsula to Scotland and from Wales to East Anglia - so don't limit yourself, and try speaking to a few locals regarding life in different parts of the UK, as you will be living there.
8. Submit: this is the page that you need to click on to confirm your submission when you are done from all other sections (obviously before the closing date)

Some people (including myself) get confused with the terminology such as deanery, trust, Foundation school especially since we don't use these in Malta. So here is my version (you can find more here)

• Deanery: this is basically the organizational body that takes care of managing the foundation programme in the UK. All of England is in one, Wales has its own etc. Not that important for you to worry about.
• Foundation School: This is the one that you apply to (e.g. Trent). It is basically the collection of resources within it that include universities, hospitals and health care services which are used by the foundation programme. This is what you need to be concerned with during your actual foundation application.
• Trusts: These are groups of hospitals or one big hospital that offers services to a particular  population. Each trust generally encompasses primary and secondary medical services, some also have tertiary services.
• Programme/Track: this is the one year or two year programme of your clinical placements for the foundation programme. It composes of departments such as general medicine, oncology, GP, psychiatry etc.

4. Allocation to your foundation school (Early December)

Congratulations, you have been accepted into ******* foundation school. This is where you will be training for the next two years, pending you accepting your placement and being offered a job.

So once you are allocated to a school you need to enter in their system of choosing how you will work for the next two years. Each school has its own system. Most will ask you to rank their programmes on the UK FP website. It is recommended that you choose placements based on what you like or are interested in. Be careful because in the same programme/track you will/may have different trusts and therefore be in two different hospitals (you may need to move or commute). In the North-West we had to choose our Trust before we chose our Track meaning that we choose which hospitals we want to work in, before we got to choose what we will be doing in said hospital. Again the competition comes in wrt hospitals; those which are most central, and in the biggest cities only accept students with the highest marks. In our case, all students with the highest mark were placed (according to their preferences and availabilities), and then the bunch of students with one mark lower were placed, and so forth. This is different to the placement in your foundation school preference. In Scotland, they also have a different system where you must choose which part of Scotland to be in (there are four Deaneries) and then rank the tracks/programmes within that deanery.

So by some point in mid-February you should know which hospital you are going to be working in, and what your clinical placements are. From now on you need to follow the specific instructions that come from the foundation school or trust in particular. You will be guided as to which papers you need to fill and what you need to do.

Along side to this application, there is also the Malta Foundation Programme, which follows similar steps and timing (but the questions occur in an interview format). Also the ranking is posted publicly according to local legislation. You are not allowed to accept both the Malta and UK FP as they are in contact with each other and will remove you from their list if you do not accept one or the other. This means making a final decisive stand on weather you want to do your training in Malta or in the UK. These 2/3 days were quite difficult for some people I know as they were on the fence about their decision, but in the end as long as one follows their dreams while keeping their mind and options open, every experience will be a productive one.

I hope this post is helpful for anyone considering applying to the UK foundation programme. And if you have any questions do not hesitate to ask me.

(Disclaimer: this post is not meant as a rule book for the UKFP, please check the official website posted above for the official up to date information)