Out of Programme (OOP)

Out of Programme

Taking time Out Of Programme (OOP)

Out Of Programme Training (OOPT) and Out Of Programme Experience (OOPE) are opportunities spent working in anaesthesia but outside of the Welsh School and HEIW. The commonest reason for applying for OOPT or OOPE is to gain either more experience in a field of anaesthesia in which you would like to specialise e.g. a placement at Papworth Hospital as a cardiac fellow, or 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, the GMC, RCoA & HEIW must give approval 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 HEIW have done so. This needs planning well in advance. It is generally advised that you start planning at least one year in advance. In August 2015, the GMC no longer approved 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 HEIW is required.

A year can 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 HEIW and the Welsh School.

Any out of programme application must be discussed with the Training Programme Director before it is submitted. Trainees are asked to submit their OOP requests to the TPD/HoSS in the September or March application windows prior to the intended year out. There must be clear educational reasons and details provided at the initial point of discussion.

Further information on the HEIW process and application for OOP time can be accessed here

Please see below some useful video presentations about out of programme training:

Going Out of Programme (OOP)

A video by Dr Caroline Evans

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 plan 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 may be able to suggest an appropriate overseas or UK placement. In general, the Welsh School of Anaesthesia are supportive of trainees planning OOP.

When can I go?

You must have passed the final FRCA to be eligible for OOP. Ideally we expect trainees to have completed Stage 2 training and plan for OOP during Stage 3. 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, the RCoA and AAGBI are valuable resources when seeking a suitable post. The Welsh School of Anaesthesia has contact with a variety of trainees who have undertaken OOP placements which may be a useful starting point. Please contact the HoSS or TPD if you wish to explore other potential links and experience.

What do I need to consider?

The RCoA 2021 curriculum is very prescriptive, changes in the structure of training mean the time spent in Stage 2 is very busy and there is a lot to achieve including the exam and all the sub-specialty blocks. Many trainees find achieving all the Stage 2 key capabilities demanding which is why going OOP is much more suited to latter years (ST6-7) of training. During Stage 3, one year will be spent gaining all the general competencies of the curriculum and up to one year can be spent undertaking the Special Interest Areas (SIAs). It is perhaps the SIAs that lend themselves best to taking OOP time coupled with some general work. It will be important to consider what your interests are and how it would work when mapping the Stage 3 time if you are interested in applying for an OOP.

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 on this RCoA OOP link 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 HEIW to request prospective GMC approval using the HEIW form using this HEIW Link. HEIW also have some guidance on applying for OOP. All requests are presented at the Specialty Training Committee (STC) by the TPD and approval obtained (or not).

Out of Programme

The steps above should be completed at a minimum of 6 months before you intend to leave your training programme but 12 months is more sensible to allow for the School programme planning. On return, you are required to submit a summary report of your experience to the RCoA for them to 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 and an ARCP outcome will be awarded. The timing of this ARCP can be discussed with your TPD. We encourage any trainee who has completed an OOP to consider submitting a report for the School of Anaesthesia Geoff Clark Annual Award.

The Geoff Clark Award

This prestigious award was initiated by the Welsh School of Anaesthesia to acknowledge the enormous contribution to anaesthetic 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 the first Training 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 as the very first recipient.

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 anonymously and ranked by the STC membership, including all trainee representatives. The winner of the award will be invited to a presentation 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

  • 2024 - Dr Kat Shelley ST5, for inspiring many trainees and trainers with work achieved whilst out of programme
  • 2023 - Dr Jaiker Vora, ST6, Welsh Clinical Leadership Fellow
  • 2022 - Dr Ellie Powell, ST5, Perioperative Medicine Fellowship, UCLH London
  • 2021 - Dr Crawford Deane, ST6, Sydney HEMS, Australia
  • 2020 - Dr Matt Creed, ST6, South West PHEM fellow, Bristol
  • 2019 - Dr Will Packer, ST7, following developing world anaesthesia training module in Zambia
  • 2018 - Dr Thomas Kitchen, ST5, Welsh Clinical Leadership Fellow
  • 2017- Dr Agnieska Ganska, ST6, 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, Afghanistan
  • 2011 - Dr Owen McIntyre, ST6, following his training in simulation medicine in Perth

Returning to training after a period of OOP may require consideration of 'Return To Training' procedures and support, particularly if the OOP has been in a non-clinical setting.

Further advice and guidance can be found on the Return To Training page. Return To Training