Out of Programme (OOP)
WHAT IS OOP AND WHAT IS IT FOR?
One of the joys of paediatrics is that the speciality can allow for individuals to pursue different interests and career pathways. Residents may want to step off the training programme and pursue other options for either long term career plan, or for their personal wellbeing. In order to stay part of the training programme whilst this is happening residents can apply to take time out of programme (OOP). Full guidance around OOP is found in the Gold Guide.
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 discretionary, and the decision to grant OOP time is made by an OOP panel. The School is not under obligation to grant OOP time. This consideration is particularly important as NHSE recognises that when a resident goes out of programme (OOP), it creates a rota gap and can impact the training experience of other residents at the site. In cases where multiple residents wish to go OOP simultaneously, the panel must make challenging decisions to determine who should proceed, ensuring fairness and consistency while also taking into account the needs of those remaining in programme posts. This page outlines the guiding principles and procedures for OOP applications and their evaluation.
OOP GUIDANCE, APPLICATION WINDOWS & THE FORM
Find the deadlines for OOP and the application form you need to fill out is on this link: NHSE OOP application form and guidance
EXAMPLES OF PREVIOUS OOPs
The innovation subgroup has put together a guide to OOPs that residents have previously taken.
WHAT ARE THE DIFFERENT TYPES OF OOPs?
There are five different types of OOPs that you can apply for which are: -
OOPE (Out of Programme for Clinical Experience)
Time out of training for clinical experience can be used to gain professional skills that would enhance future practice, or enhance clinical experience and skills related to but not part of the curriculum. It can also be used to participate in and experience training overseas. Proposed OOPE’s should not include placements and opportunities that are available within the London programme. OOPEs can be useful to explore or test an area of medicine or working life that is important to career objectives. OOPE will normally be for a maximum of 12 months. 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.
OOPEs will not contribute towards CCT. Residents undertaking OOPE will have their CCT date extended.
OOPR (Out of Programme for Research)
We encourage residents to undertake accredited research where is an interest, aptitude and opportunity to do so. Applications should be discussed with the academic TPDs before submission. OOPR is granted for specific research projects as part of a higher degree (e.g. PhD, MD or master’s degree.) Research experience without such a goal is better suited to OOPE application.
OOPR time can be recognised towards CCT, if the OOPR includes a clinical component. Prospective RCPCH and NHSE approval is needed to make recommendations to the GMC for time to be counted towards CCT. When this is granted, the GMC is prospectively approving the OOPR to be recognised towards CCT, but RCPCH is approving any training (including research) that is deemed to be appropriate and relevant to the curriculum. Achievement of key capabilities should be tagged against the curriculum and pro rata number of mandatory WPBAs must be uploaded to eportfolio for review by the ARCP panel. The ARCP panel will review eportfolio evidence to confirm that training progress has been made and that the training time can be counted towards CCT.
The maximum OOPR usually granted to a resident within the entirety of their run-through training programme is 3 years WTE. Exceptionally, to complete a higher degree, this may be extended to 4 years. Residents in their final year of training will not normally be granted OOPR.
OOPT (Out of Programme for approved clinical training)
There may be circumstances where residents choose to go outside of the training programme for training experience. This time can be counted towards CCT. The training would need to be directly relevant to the intended CCT and have prospective GMC approval. 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. An OOPT will normally be approved for a maximum of 12 months. Residents 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. If prospective approval for OOP is not sought from the GMC, then it cannot count towards CCT. Residents undertaking an OOPT must complete the same ARCP requirements as for a clinical ARCP (ESTR, WPBAs, MSF etc.). ACRP will be undertaken by the London School of Paediatrics.
OOPC (Out of Programme approved for a career break)
Residents may apply to step out of the training programme for a designated and agreed period of time to pursue other interests (e.g domestic responsibilities, work in industry, developing talents in other areas or entrepreneurship) or deal with other responsibilities.
Although time on career breaks can be very useful for residents, it is often better to consider going LTFT (less than full time) to find a sustainable lifestyle if the issue is other commitments. This also keeps the 'NHS continuous service years', which is broken on OOPC when not employed by an NHS-affiliated body.
Periods of ill health should be managed under the guidance of the employer's occupational health services, rather than OOPC.
The duration of OOPC would be for 12 months. A second year of OOPC would be at the discretion of the Postgraduate Dean and only granted in exceptional circumstances.
OOPP (Out of Programme for a pause)
Residents ‘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 residents 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. Residents cannot be on an outcome 3 to undertake an OOPP. The maximum duration of an OOPP is 12 months WTE.
Residents must submit a confirmed job offer when applying for an OOPP (at the point of application).
THE APPLICATION PROCESS
- Communicate with your training programme director as early as possible (at least 6 months before) if you are considering applying for an OOP, even if only provisional at that stage. This allows the school to plan ahead.
- Discuss with your ES and agree suitability depending on level of training, career aspirations, well-being etc.
- OOP applications must be submitted at least 6 months prior to the projected start date of their OOP, during the OOP windows. Applications outside of these windows will not be considered. DISCLAIMER – only in exceptional circumstances OOP applications will be reviewed outside the window i.e. OOPC.
- Residents must discuss their request with their Educational Supervisors and Training Programme Director and ask them to complete the OOP sign off form to support their application. Download Application support form from resident portal, complete form and obtain ES signature. NHSE OOP application form and guidance. You must ensure that you provide full details of your intended OOP to your signatories.
- Complete the online OOP application form ensuring you upload the completed OOP application support form together with an outline of planned OOP/ Job offer (job offer is mandatory for OOPP) and if you are applying for an OOPR, confirmation of funding.
- You will also be asked to complete a SuppoRTT London Pre-Absence Form (link on the form) and submit the SRTT Pre Absence number you will get on completing the form.
SUPPORTED RETURN TO TRAINING (SupporTT)
All residents 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.
Link to the SRTT pre-absence form can be found on the OOP application form (SRTT pre-absence form)
SUPPORTING DOCUMENTS
Please upload the following documents to your online OOP application.
| OOP TYPE | Evidence to be uploaded |
| All | OOP and Acting Up as a Consultant Application Support confirming support of ES and TPD. (There is a single application form which covers both OOP and Acting up) |
| In addition, the following documentation should be uploaded depending on the type of OOP you are applying for. | |
| OOPE |
|
| OOPC |
|
| OOPT |
|
| OOPR
(may count towards CCT where prospective GMC approval is obtained) |
|
| OOPP |
|
APPROVAL PROCESS
OOP Panel
The OOP panel is where the school makes decisions around OOPs, to ensure consistency. It consists of the Head and/or Deputy Head of School, TPD’s and a resident 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 resident 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 residents whose OOPs have not been approved.
The OOP panel will give priority to residents who have not have OOP previously.
Overall, you cannot have more than a total of 3 years OOP (with the exception of OOPR where you may be granted a 12month extension to complete writing up your thesis towards a higher degree). Additionally, you cannot go from one type of OOP straight to another other than in exceptional circumstances.
Criteria for assessing applications
To ensure consistency and transparency of application reviews, the following criteria is 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 is judged on a case-by-case basis.
Essential:
- Application submitted within deadlines
- Clear objectives and learning goals
- Evidence of commitment to OOP 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
Desirable:
- Contribution to specialty competencies as set out by RCPCH, especially those difficult to achieve in resident’s particular rotation
- Contribution to personal development plan/career goals
- Contribution to society/global public good
- Benefit to paediatrics as a specialty
FAQs
Can I apply for an OOP at any time during my training?
As per the Gold Guide, you cannot apply for an OOP during the first or last year of training.
I received an outcome 2/3 in my last ARCP. Can I still apply for an OOP?
No. You must have received a satisfactory OOP in the ARCP immediately before the OOP application to be eligible to apply for an OOP.
I am a skilled worker/ Tier 2 Visa holder, can I apply for an OOP?
NHSE are your Skilled Worker/ Tier 2 lead sponsor whilst you are in a training programme. Going on OOP may impact this as your lead sponsor may need to change when you step out of programme. Please check your eligibility for OOP and any impact this may have on your Visa status before you apply. More information can be found on: NHSE Out of Programme (OOP) and your sponsorship. You can also contact the Oversees sponsorship team for more guidance (england.sponsorship@nhs.net).
Do I have to complete all my MRCPCH exams before applying for an OOP?
There are no strict rules about exams and OOP applications. That said, in paediatrics, we have learnt that breaks in training before completion of MRCPCH can be detrimental to progression. We would advise any resident considering an OOP to complete their written membership exams prior to applying for an out of programme experience. One exception to this would be an OOPC.
I’m due to start a GRID sub-specialty at the same time I wish to start an 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 long-term sick leave). If you are already a GRID resident, you will need to let the CSAC know about any changes in your training plans, including an OOP.
Can I apply for an OOP outside of the rotation dates?
Some residents 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 resident and whose service provision may be derailed by losing a resident 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.
What is the maximum time I can take out of programme?
A maximum of 3 years out of clinical training will be allowed, however this will only be for OOPRs. A maximum of 1 year is allowed for OOPC, OOPT and OOPE. Extensions to this will only be allowed in exceptional circumstances and will require further written approval rom the Head of Specialty/Postgraduate Dean.
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 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.
You will aliso need to prepare for your ARCP as you would for a clinical post in training, including mandatory WPBAs, ES training report(s) etc.
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 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 ePortfolio. You will also need to update the training posts section of your ePortfolio to reflect that you’ll be on an OOP.
Does OOP affect my rights as an NHS employee?
Time spent in an OOP placement, approved by the Postgraduate Dean, is not considered a break in service, but it also doesn't count towards continuous service (provided that the employer considers there has been no unreasonable delay between training or OOP ending and the commencement of the subsequent NHS post). This means you will be entitled to the sam NHS benefits (e.g. maternity leave and pay, sick leave entitlement) on your return.
When you are on your OOP, you work under the regulations and benefits of your new employing organisation. This may potentially have substantial impact on residents. For instance, a resident who goes on maternity leave when overseas, or on OOPC, will not get maternity benefits as you are not considered to be in NHS service at that time. There may also be an effect on your pension. We would recommend you seek advice on this from your employer or the BMA if you are a member.
While I am on OOP do I still need to undergo the ARCP process?
Yes.
All residents 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 residents. All residents are required to be reviewed annually for revalidation purposes. An Enhanced Form R should be provided by all residents irrespective of the type of OOP you are on. ARCP prep form should be completed for all residents except those on OOPC.
Residents 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. This is also true for the period of OOPR counted towards training.
Residents on OOPE & OOPP 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.
Residents on OOPR (research) should ensure they follow the Academic Residents Checklist for ARCP Academic Residents Checklist for ARCP. This checklist is available on the London School of Paediatrics website. If you are on an OOPR that DOES count towards your training, or on an integrated academic post (ACF/ACL), you will be expected to submit all the above evidence, as well as all the evidence required for a clinical ARCP (Educational supervisor form, MSF, WPBAs, form R etc. WBPAs required pro-rata proportional to clinical time being counted since last ARCP). You should also consider logging any conference presentation, publication, teaching activity on Kaizen as portfolio events.
Residents on OOPC should complete a Form R. No other forms need to be completed.
Do I still need to remain registered with the GMC when I am on an OOP?
Residents must maintain their license to practice while on OOP as well as their connection with NHSE, for the purposes of revalidation and might be at risk of training number/contract withdrawal (see Gold Guide) if they do not.
Can I apply for study leave funding whilst on an OOP?
Currently, the NHSE position remains that individuals on OOP are not eligible for study leave time and funding, except for OOPT (Out of Programme Training) providing there is clear evidence linking the application to specific curricular requirements. If you are undertaking an OOPE or OOPP, your department may have local study leave arrangements for clinical fellows. You should discuss this with your supervisor or the local Postgraduate medical education team.
REFERENCES/FURTHER INFORMATION
Gold Guide 10th Edition August 2024
SUMMARY TABLE
| Documentation required for application | ARCP requiremensts | ||
| OOPT | Time out of programme for approved clinical training in a post which already has prospective approval from the GMC | OOP and Acting Up as a Consultant Application Form and:
|
Enhanced Form R & ARCP prep form
and:
|
| OOPE | Time out of programme for clinical experience in a post which will not count towards the award of a CCT | OOP and Acting Up as a Consultant Application Form and:
|
Enhanced Form R & ARCP prep form
and:
|
| OOPR | Time out of programme for research (up to 12 months may be counted towards CCT with prospective GMC approval) | OOP and Acting Up as a Consultant Application Form and:
If you want to count time during OOPR towards training, Letter of confirmation from Royal College that the post has College approval (Please note that a maximum of 12 months WTE can count) |
Enhanced Form R & ARCP prep form
and:
|
| OOPC | Time out of programme for career breaks | OOP and Acting Up as a Consultant Application Form and:
|
Enhanced Form R only |
| OOPP | Time out of programme pause in a post which will not count towards the award of a CCT | OOP and Acting Up as a Consultant Application Form and;
|
Enhanced Form R & ARCP prep form
and:
|