What is OOP and what is it for?

Every paediatrician is different, and many will want to spend time doing things outside the programme during their time training for CCT. In order to stay part of the training programme while this is happening, trainees can apply for and may be offered Out of Programme time. Full guidance around OOP is to be found in the Gold Guide.

The overall purpose of OOP time is to enhance training and the lives of trainees, so they can be fulfilled, balanced and effective consultant paediatricians. There are many benefits to OOP time, but also some downsides, and this should be carefully discussed with your educational supervisor and TPD before applying.

OOP time is also discretionary – and the School is not under obligation to grant OOP time. This is especially relevant as HEE acknowledges that when a trainee moves to go OOP, this creates a rota gap and affects the training experience of the rest of the trainees at a site. Where a large number of trainees all want to go out at the same time, the panel has to make difficult decisions about who should best go out, ensuring consistency and fairnees, thinking also about those still in programme posts.  This page outlines the principles and processes around OOP application and consideration.

OOP Guidance, Application Windows & the form

Find the deadlines for OOP and the form you need to fill out on this link: https://lasepgmdesupport.hee.nhs.uk/support/solutions/articles/7000019131-oop-application-form-and-guidance

Previous OOPs

The  innovation subgroup has put together a guide to OOPs that trainees have previosuly taken.

OOP panel

The OOP panel is where the school makes decisions around OOPs, so as to ensure consistency. It consists of the Head and/or Deputy Head of School, TPD’s and a trainee representative who will review each application. They will come to a consensus on whether to approve, not approve or give “conditional” approval to the application. Often it is not clear for OOPR, OOPT and OOPE applications at time of submission that the trainee will be successful in the application for their prospective job or funding offer, and in this case the School is happy to grant “conditional” approval, subject to future information. We have a second 'wash-up' panel to review what has happened to the conditionally approved OOPs and discuss discrepancies identified by trainees whose OOPs have not been approved.

Overally, you cannot have more than a total of 4 years OOP. Also you cannot go from one type of OOP straight to another other than in exceptional circumstances. In paediatrics, we have also learnt that breaks in training before completion of MRCPCH are often detrimental to progression. OOPEs are unlikely to be approved before the clinical is completed.


What are the different OOP types?

There are five different types of OOP’s that you can apply for which are: -


Experience related to training that is not available within the London programme, but is relevant for the trainee’s bespoke career aims and interests. It will not be granted for more time undertaking a post that is already available in the programme. OOPEs can be useful to explore or test an area of medicine or working life that is important to career objectives.

With posts that mix something different with a service role e.g. education fellow, it is expected that at least 40% of time (2 days/week) is devoted to the additional opportunity. Trainees will not normally be granted more than 12 months OOPE in their run through programme.


Accredited research time relevant to the career aims of the trainee. Again, this should be discussed with the TPD before application, and is granted for specific research projects. Normally the OOPR will be expected to lead towards a goal such as a PhD, MD etc. Research experience without such a goal is better suited to OOPE application.

The maximum OOPR usually granted to a trainee within the entirety of their run-through training programme is 3 years WTE. Exceptionally, in order to complete a higher degree, this may be extended to 4 years.


Training experience that is to be counted towards the CCT and directly relevant to the CCT to be obtained, but not available within the programme. Examples might include overseas training, working in a different region for a period of time or undertaking training not readily available within the current training programme. Again, this will normally be for a maximum of 12 months.

Trainees undertaking an OOPT must complete the same requirements as for a clinical ARCP (ESTR, WPBAs, MSF....).

Trainees intending to undertake an OOPT abroad must ensure that their named educational supervisor/s have access to the RCPCH eportfolio and can complete the required supervision reports and WBPAs.


Time taken out of the training programme to pursue other interests or deal with other responsibilities.

Although time on career breaks can be very useful for trainees, it is often better to consider going LTFT (less than full time)  in order to find a sustainable lifestyle if the issue is other commitments or health issues limiting time at work. This also keeps the 'NHS continuous service years', which is broken on OOPC when not employed by an NHS-affiliated body.


Trainees ‘pause’ their training to undertake an NHS other patient-facing roles with a UK registered organisation outside of the training programme. Advantages include gaining extra/additional skills, taking stock of their training, working in a related speciality, concentrating on wellbeing etc.

Whilst this time cannot count formally as training time, it may give trainees the opportunity to gain capabilities and competencies that can count towards reducing their training time following demonstration of the accrued capabilities and competencies in the workplace subsequently.

Please note that any reduction in training time must be retrospectively approved by the trainee’s educational supervisor and ratified by and ARCP panel. Trainees cannot be on an outcome 3 to undertake an OOPP. The maximum duration of an OOPP is 12 months WTE.

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.

The dates for the windows and panel meetings will be sent around by email from HEE with an OOP guide with further information and a copy of the signatory form that must be submitted with all applications.



Process for all OOP Applications

  • Decide on type of OOP/Post
  • Discuss with your ES and agree suitability depending on level of training, career aspirations, well-being etc.
  • Download Application form from trainee portal, complete form and obtain ES signature. https://lasepgmdesupport.hee.nhs.uk/support/home?trainee
  • Discuss planned OOP with TPD (ideally relevant programme TPD) and obtain signature
  • Upload Completed OOP application form together with outline of planned OOP/Job offer
  • Supported Return To Training (SupporTT)

All trainees going out on OOP are required to complete SupporTT paperwork as part of the application process.  Details on the Supported Return to Training process can be found here: https://london.hee.nhs.uk/professional-development/supported-return-training

For OOPE / OOPC – (cannot count towards CCT) the following should be completed:

-OOP Application Form confirming support of Educational Supervisor and TPD

-Job Description (and confirmation of post offer if available applicable) or other relevant supporting documentation.


-OOP Application Form with brief outline of reasons for requesting career break e.g.travel abroad and signed by ES and TPD

For OOPT – the following documentation must be completed and returned:

-OOP Application Form confirming support of Educational Supervisor and TPD

-Job Description

-Letter of confirmation from Royal College that the post has College approval OR Letter of confirmation from the host institution / Deanery that the post has GMC approval.

-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

For OOPR: (may count towards CCT where prospective GMC approval is obtained)

-OOP Application Form confirming support of Educational Supervisor and TPD

-Job Description and description of research project/proposal as well as name and location of research supervisor/s

-Confirmation of funding  (if available at the time. If not, please indicate where funding is being sought from)

-Confirmation of registration for higher degree (if relevant)

-Letter of confirmation from Royal College that the post has College approval (if part of OOPR counting towards training. Please note that a maximum of 12 months WTE can count)


-OOP Application Form confirming support of Educational Supervisor and TPD http://londonpaediatrics.co.uk/wp-content/uploads/2021/08/Out-of-Programme-Pause-Scope-of-Practice-and-Initiation-Document.docx

-Job Description and confirmed job offer by the time of the OOP wash-up panel, 6 weeks after the main OOP panel.

-Complete the Out of Programme Pause-initiation and Scope of Practice Monitoring form

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:


  • 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:

-Applicants should have completed ST1 before the start of the proposed OOP

-Applicants should be not less than 12 months 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


  • 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

Frequently Asked Questions

I’m due to start a GRID sub-specialty at the same time I wish to start and OOP. Am I able to do this?

Deferral of commencement of grid training has to be discussed and agreed by the RCPCH. This is usually only available for OOPR leading to the attainment of a higher degree or for statutory leave (Parental or longterm sick leave). If you are already a GRID trainee, you will need to let the CSAC know about any changes in your plans.

Can I apply for an OOP outside of the rotation dates?

Some trainees are offered posts that they wish to take up as an OOPE/OOPP that do not fit well with the September/March rotation dates. Taking these up is very messy for the trusts who are hosting the trainee and whose service provision may be derailed by losing a trainee from the rota. So wherever possible, OOPs will follow the September/March pattern. In exceptional cases where this really is not possible, this will have to be agreed with the HoS and the employing trust.

I wish to take an OOPC for 12 months. Am I able to do so?

Yes, however OOPC’s are only approved for 6 months at a time. It is possible to extend your OOPC for more than 6 months but you will be required to submit an OOPC extension form after 6 months for this to happen. If you are extending your OOPC then you do not need a signature from an Educational Supervisor but will still need a TPD signature for your application. 12 months is the usual maximum for OOPC.

Do I need to get the Postgraduate Dean to sign my OOP form before submitting it?

No. The process is under the overall scrutiny of the PG Dean, but it is clearly unrealistic for the Dean to manage all of the OOPs in London.

The educational supervisor and TPD will need to sign the form and then it goes before the OOP panel. This sits at the cut off time, so late applications will not be looked at. Should the OOP panel review and approve your application, it will be signed off by the Postgraduate Dean or a representative. The completed form and your approval letter will then be sent to you by the operations team.

What do I need to have in order for my OOPT or OOPR count towards my training?

If you wish to have any time in your OOP count towards your training you will need to get this signed off by the RCPCH Training & Quality Board (training.services@rcpch.ac.uk). You will need to submit to them your OOP application form and attach a blank RCPCH OOP approval form for them to complete and send back to you. This can be done before or after the OOP panel has met, however your OOP may be given a conditional offer with the stipulation that you need to get your OOP signed off to be approved.

If your OOP will be in a GMC approved training site, then approval from the GMC is not required.

If your OOP will not in a GMC approved training site, then approval from the GMC will be requested by the operations team on your behalf.

If your OOPT is to be undertaken abroad, it is important for you to ensure that you have a named educational supervisor who can access the RCPCH eportfolio and complete the required WBPAs and necessary supervision reports.

What will happen to my future training posts when applying for an OOP?

If your application is approved, then you will be removed from your future training posts. After your OOP you will have to undergo the matching process for when you return.

If your application is conditionally approved, you will have a deadline to submit confirmation of your job or funding offer. If you will still not have confirmation by the deadline then you will either must withdraw your application and remain in your current future posts or stay “conditional” and be taken out of your future posts. If you still do not have confirmation 14 weeks to the rotation date, your application will be withdrawn, and you will be contacted by your TPD to be placed in an available training post.

If your application is not approved, you will keep the training posts you have already been allocated.

Can I appeal the decision if my application is not approved?

There is no appeals process for the OOP process as OOPs are discretionary. Please contact your TPD to obtain feedback about why the application was rejected, if the written information coming from the panel is unclear. In the rare situation where there has been a factual error leading to the OOP not being approved, then the panel may reconsider its reasoning.

If the placement/and or details of my OOP change, is it still approved?

No. You cannot move an OOP from project to project, as the OOP panel looks at the merits of the project on the application provided and approves the OOP on the basis of these details. While there is a little leeway, taking on a very different job/project is not possible.

My OOP was approved but the funding/job fell through. Am I able to reapply for a different OOP?

Unusually yes, but only if the different OOP is essentially the same as the first (approved) OOP. You will have to complete another form with details of your new OOP so it can be reviewed. Please keep your TPD informed of these changes.


After receiving my OOP approval letter and application, is there anything I need to do with them?

Yes. After receiving your approval letter and signed off application, please upload them to your documents on ePortfolio in a clear folder named with the type of your OOP and the start and end dates. For example, “OOPT 06/09/2022 to 05/09/2023”

You will also need to update the training posts section of your ePortfolio to reflect that you’ll be on an OOP.

Other information

Does OOP affect my rights as an NHS employee?

When you go OOP, you go under the regulations and benefits of your new employing organisation. This may potentially have substantial impact on trainees. For instance, a trainee who goes on maternity leave when overseas, or on OOPC will not get maternity benefits. All OOPs will count as a break in continuous NHS service, unless it is within the NHS.

While I am on OOP do I still need to undergo the ARCP process?


All trainees enrolled in the training programme must have an annual ARCP to continue their enrolment irrespective of whether they are in programme or out of programme. This is a statutory requirement of all trainees. All trainees are required to be reviewed annually for revalidation purposes.

Trainees on OOPT will be assessed as per a clinical ARCP and should therefore submit everything outlined in the clinical ARCP checklist, along with a completed “OOP update form for ARCP” and Form R.

Trainees on OOPE should complete an “OOP update form for ARCP” which should be signed by their OOP supervisor in order to demonstrate adequate progress during the time OOP.  This form is available on London School of Paediatrics website via the link provided in your invitation. An Enhanced Form R, Placement Pro Forma and Exams & Courses Pro Forma should also be provided.

Trainees on OOPR (research) should ensure they follow the Academic Trainees Checklist for ARCP.  This checklist is available on the London School of Paediatrics website.

Trainees on OOPC should complete a Form R. No other forms need to be completed.

Trainees on OOPE and OOPR should also complete an “OOP update form for ARCP” which should be signed by their OOP supervisor in order to demonstrate adequate progress during the time OOP.  This form is available on London School of Paediatrics website via the link provided in your invitation. An Enhanced Form R, Placement Pro Forma and Exams & Courses Pro Forma should also be provided.

References/Further Information

Gold Guide 9th Edition August 2022