Out of Programme (OOP)

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 that does not count towards the award of a CCT is known as OOPE. If you wish training to count towards CCT, then GMC, RCoA & Deanery approval must be obtained before leaving the programme. The process for obtaining prospective GMC approval is complicated and will only be granted once approval from The Welsh School of Anaesthesia, The Royal College of Anaesthetists (RCoA) and Wales 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. From August 2015, the GMC will no longer approve OOPT without a minimum of 6 months' notice.

If the training is not to count towards CCT i.e.OOPE, then GMC 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 OOP 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 OOP.

When can I go?
You must have passed the final FRCA and have entered StR 5 to be eligible for OOP. For logistical reasons, OOP taken for a six or twelve month period from the beginning of August or February is much easier to accommodate 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 2010 curriculum is very prescriptive and changes in the structure of training mean that gaining the higher and advanced training competences required within the designated time can be difficult.To do so with a year out of programme is much harder. You are expected to complete higher training in the following specialist modules; Intensive Care Medicine, Paediatric, Cardiothoracic and Neuro Anaesthesia, and complete a minimum of 8 out of 13 of the 'general duties' training modules in no less than 12 months. Paediatric Anaesthesia and Neuro Anaesthesia higher training modules are only availabe in the University Hospital of Wales, Cardiff. In exceptional circumstances, a 3 month placement at The Walton Hospital, Liverpool can be arranged during a placement in North Wales. Cardiac Anaesthesia can only be completed in Cardiff and Swansea. Ideally any out-of-programme training time should be mapped to the RCoA 2010 advanced training curriculum, as this element of the curriculum is the most difficult time with your in-programme placements. It is also expected that you are in programme for the last 6 months of your training prior to CCT.

Meticulous planning when organising the sequence of training modules in the hospitals on your rotation is vital if CCT is not to be delayed.

What do I do?
The first thing you should do is contact the programme director by e-mail and state your intentions. They 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 OOP form www.rcoa.ac.uk 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 GMC approval using the Deanery form www.walesdeanery.org. The Deanery also have some guidance on applying for OOP.

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 OOP 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. An ARCP will be scheduled after your return date to ensure that any OOP time has been appropriately assessed. I would encourage you all to consider submitting a report for the Dr Geoff Clark Annual Award after your return.

The Geoff Clark Award

This prestigious award has been initiated by the Welsh School of Anaesthesa to acknowlegde the enormous contribution to anaesthesia training by the late Dr Geoff Clark. Geoff played a central role in the setting up of the Welsh School of Anaesthesia in 1996. As founding Programme Director, his meticulous planning and commitment to the highest standards over many years set strong foundations for today's training scheme. Many past and present trainees have paid tribute to Geoff's many qualities and have highlighted the efforts he took to accommodate individual needs. In particular, we all remember Geoff's sparkling sense of humour. The inaugural award was presented by Geoff's sister, Lizzie Cambray, to Dr Owen McIntyre on 13th January 2011.

The award will be presented annually to the anaesthetic trainee who has achieved the most value from a period of out of programme training or experience (OOPT/E). Reports on OOPT/E should be submitted to the Programme Director by the end of September each year (maximum one side of A4, minimum font size of 12). The reports will be considered and ranked by the STC (including trainee reps). The winner of the award will be invited to a presentaton on the day of the January Specialty Training Committee when they will be expected to give a short presentation on their OOPT/E.

Dr Geoff Clark Award Winners

  • 2017- Dr Agnieska Ganska, ST 6, Burns and Plastics Fellowship, Brisbane
  • 2016 - Dr Laura Jackson, ST7 Sydney HEMs, Australia
  • 2015 - Dr Lowri Bowen, ST7, following her experiences working in Zambia.
  • 2014 - Dr Cat Cromey, ST6, following her teaching fellowship in Perth, WA
  • 2013 - Dr Louise Webster, ST6, following her training in retrieval medicine in Sydney
  • 2012 - Dr Ami Jones, ST6, detailing her experiences of military anaesthesia in Camp Bastion, Arghanistan
  • 2011 - Dr Owen McIntyre, ST6, following his training in simulation medicine in Perth