ORT/OOPT

January and July 2010 Update

There has been a sharp rise in the number of trainees applying for time out of programme this year. To ensure that the application system is fair, and to allow the continuing smooth running of the training programme in Wales for the benefit of all trainees, the Welsh School has made some ammendments to it's rules regarding the approval of time out of programme.

Time out of programme should be taken for periods of either 6 or 12 months beginning in August or February
The application process and final approval should be completed 6 months in advance
Numbers will be limited to six trainees per year. If more than six trainees apply, a panel will be convened and approval granted on the merit of each individual proposal

This is in addition to the guidance and rules already in place and set out below. If your proposed time out of programme does not comply with these rules then it is unlikely to be approved.

If an OOPT/E panel is required, trainees will be invited to submit a covering letter indicating their plans and also the educational and training value of the OOPT/E and how this will benefit their career pathway. The following factors will be considered when selecting the 6 best applications.

submission of the appropriate paperwork in a timely manner
does the OOPT/E contibute to a rounded and balanced training programme
if the OOPT/E is focused on a specialist area of anaesthetics, does this fit with applicants chosen career path
does the OOPT/E impact unduly on the training programme and other trainees within the Welsh School of Anaesthesia
does the OOPT/E delay the provisional CCT date
will the trainee's rotation need to be altered in addition to the planned OOPT/E in order to meet the demands of the RCoA curriculum

The panel may need to consider other factors not mentioned but the above list should give an indication of the type of issues which will be examined

Taking time Out Of Programme (OOP)

Out Of Programme Training (OOPT) and Out Of Programme Experience (OOPE) are time spent working in anaesthetics but outside of the Welsh School of Anaesthesia. The commonest reasons for applying for OOPT or OOPE are to either gain more experience in a field of anaesthesia in which you would like to specialise e.g. a placement at Papworth Hospital as a fellow in cardiac anaesthesia, or to gain more general experience in a hospital overseas. The latter may also include some specialist training. Training that counts towards the award of CCT is referred to as OOPT and training thet does not count towards the award of a CCT is known as OOPE. If you wish training to count towards CCT then PMETB approval must be obtained before leaving the programme. The process for obtaining prospective PMETB approval is complicated and will only be granted once approval from The Welsh School of Anaesthesia, The Royal College of Anaesthetists (RCoA) and the School of Postgraduate Medical and Dental Education Wales College of Medicine i.e the Deanery has already been sought and granted. As you can imagine this needs planning in advance. It is generally advised that you start planning at least a year in advance and the process should be completed 6 months before you intend to leave your current training programme.

If the training is not to count towards CCT i.e.OOPE, then PMETB approval is not required. Approval from the Welsh School and the Deanery is still required however and may not be forthcoming. The Deanery will not approve an additional year of training lightly if it means a years delay to CCT date.

A year may also be taken out of programme as a career break - OOPC, and up to three years to undertake a research post - OOPR at the discretion of the Deanery and the Welsh School.

Frequently asked questions

Is it for me?

If you are thinking of OOPT then you should first seek the advice of a consultant trainer. This could be your local educational supervisor or college tutor. If you are planning on gaining experience in a specialist field when away, e.g. paediatric anaesthesia, then it is very important to speak to a consultant within the Welsh School who specialises in that area. They can provide some career counselling, and also may be able to suggest an appropriate overseas or UK placement. In general, the Welsh School of Anaesthesia encourage individuals to take OOPT.

When can I go?

You must have passed the final FRCA and have entered SpR 3 or StR 5 to be eligible for OOPT. For logistical reasons, OOPT taken for a six or twelve month period from the beginning of August or February is much easier to acommodate and more likely to be approved.

Where can I go?

Consultant trainers, trainee colleagues and trainee forums such as the one on Doctors.Net are the most valuable resource trying to find a suitable post. The Welsh School of Anaesthesia has a small database of placements that welsh trainees have undertaken in the recent past. In the database you will find details of each post as well as useful information like contact numbers, help with arranging accommodation and pay, and also an overall assessment of the placement.

What do I need to consider?

The RCoA curriculum is very proscriptive and changes in the structure of training mean that gaining the higher training competences required in a standard training programme within the designated time can be difficult.To do so with a year out of programme is much harder. To train as a "generalist" anaesthetist you will need to complete higher training modules in most of the sub specialties outlined in the RCoA curriculum. You are expected to complete modules in Intensive Care Medicine, Obstetric, Paediatric, Cardiothoracic and Neuro Anaesthesia. Paediatric Anaesthesia and Neuro Anaesthesia higher training modules are only availabe in the University Hospital of Wales, Cardiff. You must also undertake at least 6 months of "General Duties". It is also expected that you are in programme for the last 6 months of your training.

Meticulous planning when organising the sequence of training modules in the hospitals on your rotation is vital if CCT is not to be delayed. Approval for OOPT which co-incides with the time in your rotation when you're due to be placed a "DGH" during your final 3 years will not be approved. These hospitals provide invaluable experience of a more "generalist" nature which can't be gained in Teaching Hospitals.

If you plan to undertake advance training in a sub-specialty it is important to remember that only 1 year in total can count towards the award of CCT. You must also still complete the majority of the higher training modules.

What do I do?

The first thing you should do is contact the programme director by e-mail and state your intentions. He can then guide you through each step of the process. Once you've identified an appropriate post and have obtained a job description, you must fill in a RCoA OOPT form (see below) and submit it to the Programme Director. The guidance on the form is useful and self explanatory. If the Programme Director and Regional Advisor are happy, the form will be sent to the RCoA for consideration. If the information satisfies the RCoA that the post is suitable for training toward CCT, they will issue a letter accordingly. You must then ask the Deanery to request prospective PMETB approval using the Deanery form. The Deanery also have some guidance on applying for OOPT.

All of the above should be completed at least 6 months before you intend to leave your training programme. Hopefully, all will go well with your OOPT and you will have a rewarding and enjoyable experience. When you do come back however, you must submit a summary of your experience to the RCoA so that they can verify any experience that you wish to count towards the CCT.