Key point: Communicate with your training programme director as early as possible (at least 6 months before) if you are considering applying for an OOPE, even if only provisional at that stage. This allows the school to plan ahead and give you conditional approval pending confirmation of your OOP plans.

Introduction

This guidance document is designed to explain the current OOP application process for the London School of Paediatrics & Child Health. This guidance has been divided into sections that explain each step of the process from the different OOP types, submitting documents and the OOP panel to receiving an approval outcome. It also details the process of applying for OOP time to count towards training.

Please note that this guidance is specific to the School of Paediatrics and Child Health and relates solely to the decision making process leading to the approval or rejection of applications for time OOP. It is designed to be read in conjunction with guidance issued by Health Education South London and the Gold Guide and does not replace either, but is supplementary to them.

Full details of out of programme guidance can be found in sections 6.66 to 6.88 of the ‘Gold Guide’ June
2010. This can be downloaded from the MMC website – www.mmc.nhs.uk.

The 4 OOP types:

Out Of Programme Experience – OOPE

Time out of programme for clinical experience in a post. This OOP type will not count towards the award of a CCT

Out Of Programme Training – OOPT

Time out of programme for approved clinical training in a post which already has prospective approval from the GMC

Out Of Programme Research – OOPR

Time out of programme for research

Out Of Programme Career – OOPC

Time out of programme for career breaks. This OOP type will not count towards the award of a CCT

What to Submit to Make an Application

All of the application forms and up-to-date information can be found here: https://www.lpmde.ac.uk/training-programme/training-matters/out-of-programme

A. For OOPE / OOPC – (cannot count towards CCT) the following documentation must be returned to the Operations Department of Health Education South London:

1. OOP Application Form confirming support of Educational Supervisor and
TPD/STC Chair.

2. Job Description (and Statement of the post or research timetable where
applicable) or other relevant supporting documentation

3. OOP Application Checklist completed and signed by the trainee
B. For OOPT / OOPR – (may count towards CCT where prospective GMC approval is obtained) the following documentation must be returned to the Operations Department of Health Education South London:

  1. OOP Application Form confirming support of Educational Supervisor and TPD/STC Chair.
  2. Job Description and Statement of the post/timetable
  3. Letter of confirmation from Royal College/Faculty that the post has College/Faculty Training Committee approval OR Letter of confirmation from the host institution / Deanery that the post has GMC approval.
  4. A statement detailing the purpose and structure of the OOPT or OOPR placement, including confirmation that the placement is subject to quality management in line with GMC requirements
  5. OOP Application Checklist completed and signed by the trainee

The letter from your Regional Advisor / Academic Regional Advisor (bullet point 3 above)

In order to make an application to the GMC for time to count towards training, the GMC ask that we submit a letter of support from your Regional Advisor, along with your OOP application form. For OOPR trainees wishing to count some of their research time, the GMC also ask for a letter of support from the Academic Regional Advisor.
Both Regional Advisor and Academic Regional Advisor letters must be on headed paper and contain the following information:

• Your full name

• You GMC number

• Whether this is an OOPT or an OOPR

• The location of your OOP

• The exact to and from dates of your OOP

• The amount of time your Regional Advisor is happy to support to count towards your training, in words.

The details in these support letters must be exactly the same as on your application form. Any discrepancies in information will cause a delay in processing your application.
Contact details for Regional and Academic Advisors can be found on the RCPCH website: http://www.rcpch.ac.uk/training-examinations-professional-development/training-contacts/london/london-draft

Process for Applying for Time to Count towards Training

Once the above documentation has been received, reviewed and approved, an application for prospective GMC approval will be made by The Paediatrics Team at Health Education South London. Approval for time to count towards training can only be granted once GMC approval has been received.

Additional notes for trainees who wish for time to count:

It is worth noting that the GMC have recently issued very clear guidance that as of 28th April 2014, all training must be prospectively approved if it is to count towards the award of a CCT or CESR (CP) and this is a requirement of the EU Directive.

You must therefore submit your signed OOP application form, proof of appointment to post and/or funding and your letter(s) of support from your Regional Advisor(s) at least 3 months in advance of your start date. Any delay in providing these documents could result in the GMC not approving
your application and your CCT date being extended by the duration of your OOP.

The School OOP Panel

Currently, OOP applications submitted by the published deadline are reviewed by an OOP panel which meets 4 times a year; 2 main panels per year with one ‘tidy up’ panel after each. This has been in effect since November 2009. The idea of the OOP panel is to have a structured and transparent decision making process with set criteria for judging each application. The panel will be comprised of the following:

• Head or Deputy Head of School

• STC Chair or representative from each region of the training programme

• Training Programme Director/s

• College Tutor/s

• Trainee Representative (observer capacity)

The Trainee Representative on the OOP panel (or senior trainee i.e. ST5-8) is invited to sit in on each of the main panel meetings as an observer. The trainee rep should not, however, be involved in the actual decisions, or be present during the discussion of any potentially confidential information about the applicant (such as progress in training or confidential reasons for requesting OOPC).

Criteria for assessing applications

To ensure consistency and transparency of application reviews, the following criteria will be used by the panel to assess the quality of each application. However, due to the variety of reasons for applying for time OOP, each application should be judged on a case-by-case basis:

Essential:

• Application submitted within deadlines

• Clear objectives and learning goals

• Evidence of commitment to OOPE project

• Evidence of appropriate project planning

• Appropriate plans for supervision during time out

• Commitment to return to training number

• Unless clearly exceptional circumstances:

Applicant should have completed ST1 before the start of the proposed OOP

Applicant should be not less than 12m from the end of training

There should be no concerns about the applicant’s progress through training i.e. the applicant should have achieved a satisfactory outcome at their last ARCP/RITA

Desirable:

• Contribution to specialty competencies as set out by RCPCH, especially those difficult to achieve in trainee’s particular rotation

• Contribution to personal development plan/career goals

• Contribution to society/global public good

• Benefit to paediatrics as a specialty

A maximum of 3 years out of clinical training will be allowed. Extensions to this will only be allowed in exceptional circumstances and will require further written approval from the Head of Specialty/Postgraduate Dean and STC Chair / Training Programme Director.

Trainees should plan to start their OOP at the usual changeover times of the clinical training programme – currently the first Monday in September and March. Any reasons for planning to start at other times must be clearly stated in the OOP application, and may not be agreed to by the panel. Trainees must give at least 6 months’ notice of their intended return to the clinical training programme to the Operations Officer and TPD responsible for the allocation of placements at the appropriate level of training.

If a trainee is not granted permission to take time OOP, he/she will receive formal notification of the reasons why their application was unsuccessful.

Special circumstances – OOPC

Trainees with special circumstances likely to require application for OOP for compassionate reasons at short notice should contact their local educational supervisor, TPD and Head of School at the earliest possible opportunity.

Conditional OOP Approval

OOP applications should be made 6 months prior to the intended start date. Please note even if you haven’t finalised your plans, you will still need to submit an application by the 6 months deadline. The OOP panel will then consider giving you conditional approval pending confirmation of the OOP plans. However, the Operations team require confirmation of your plans as soon as possible and certainly no less than 15 weeks prior to the rotation date. Please be advised that you may lose any provisionally approved placements. It is really important to liaise with the relevant Training Programme Director regarding your OOP and future placements plans.

When funding for OOPR is unlikely to be confirmed before the 3 months’ notice period for leaving or not taking up a scheduled training placement, the trainee must provide evidence of agreement to the proposed start date of OOPR from the Trust where they are working or would have been placed at the start of the proposed OOP. This must be countersigned / authorised by the relevant Human Resources Department.

Service Provision/Fairness to other trainees:

While the school believes that appropriate time out of programme should be encouraged and approved where possible, consideration of the effect that granting time out will have on service provision is necessary. Consideration should be made of:

• The ability of the Trust in question to cover the trainee’s service commitments during their time out of programme

• The creation of an ‘uneven playing field’ with regards to applications for higher or subspecialty positions

• In accordance with RCPCH guidance, applications for OOP in order to enhance an individual trainee’s prospects of successful application to National Grid training will not be approved,

as this would be contrary to one of the fundamental aims of the National Grid, namely to provide equity of access to sub-specialty training.
Trainees should ensure that they discuss their proposed OOP with their local Educational Supervisor and TPD at the earliest possible opportunity. This will help to ensure that they are able to make an appropriate decision about whether to apply for time OOP and can do so in a timely manner.

OOP and Exams

The OOP panel does not recommend trainees in ST1-3 taking OOP before MRCPCH is completed as this can create a disadvantage when studying toward the membership exams. Failure to obtain MRCPCH by the end of ST3 may prevent you from progressing through training and may ultimately lead to the withdrawal of your National Training Number.

Although an OOP application will not be refused by the panel solely on the grounds of non-completion of membership (except at the end of ST3 when this is a required competency), applicants should demonstrate that they have considered the consequences of their OOP proposal on their exams and have planned accordingly. For trainees who do choose to go OOP during their Level 1 training, no exceptions will be made in regard to the exam requirements.

Additional information

Please note that once your OOP has been formally approved by Health Education England, any placement that you may already have been allocated will not be guaranteed and will be subject to change. Thus, if for any reason you do not take up your OOP, you will be allocated to a training post at a location which still has vacancies and not the location that you may have gone to had you not applied to go OOP.

Please note if you are on a Tier 2 visa sponsored by West Midlands Health Education England, taking a period out of programme will have implications on your sponsorship and you MUST notify them of your plans by sending an email to tier2@hee.nhs.uk with immediate effect.

Please ensure that Health Education England are given an up-to-date contact address and e-mail address throughout the duration of the OOP placement.

All definitions are as per the Gold Guide to Postgraduate Specialty Training in the UK, as interpreted by
Health Education England in the above policy guidance.