What to consider if you're thinking about a year out

You may be considering a year outside of training after your F2 year and you are not alone. Nearly two-thirds of your peers who finished FY2 in 2018 decided not to go directly into specialty or core training. The number of people taking a so-called ‘F3 year’ has been steadily increasing since 2011 with many making the decision to take a year out before starting foundation training.

What is an F3 year?

An F3 year is an informal label used to describe a junior doctor who has chosen not to transition into a further formal training programme immediately after the successful completion of the UK foundation programme. 

F3 doctors are not part of a formal training programme delivered by their local deanery. Their policies such as study leave, study budget and relocation expenses will not apply if you are on an F3 year. You may have heard of the term ‘out of programme experience’ (OOPE). An F3 year is not an OOPE as you need to be registered as being on a training programme to take an OOPE. As an F3 you will therefore be responsible for directing your training and employment, although currently the experiences you gain during an F3 year cannot shorten the time of any core or run-through training programme you apply to.

You will not be recognised as a ‘doctor in training’ with the General Medical Council (GMC) during an F3 year, but will remain on the register of practitioners licensed to practise unless you choose to withdraw yourself from the register (and then cannot practise). Importantly, you will be responsible for organising your appraisal and finding a way of evidencing your professional development at appraisal. GMC guidance and requirements, such as in Good medical practice, will still apply to you and you may need to consider requirements for practising overseas. 

There are many reasons for taking a year out. For some, it offers the chance to focus on important personal or professional aspects of their life they’d like to develop in depth. For others, it gives them the chance to explore new areas and establish interests before the thought of post-foundation specialist training, as well as a chance to take a break before taking on a further training programme. A year out is also not just beneficial to oneself. As physicians, we have a responsibility to ensure that our skills and practice are maintained, and to develop them in order to benefit our patients. When applying for higher training, you will be asked to demonstrate this. By creating and sculpting your own opportunities and development, you can both explore interests in a time and manner to suit you and demonstrate responsibility for your own practice.

Taking time out after foundation training isn’t for everyone however. Adding another year to an already extensive training programme will make certificate of completion of training (CCT) even further away. Furthermore, some may find taking time out of training later to be more beneficial, for example to complete a PhD or specialty overseas fellowship. The added flexibility of an F3 year can also be associated with increased uncertainty, and those with fixed financial commitments or plans can find this difficult. Many also find themselves feeling ready to take on the challenge of higher training after finding their specialty during their foundation years.

Points to remember

• use it as an opportunity to find a balance you’re happy with in your life
• plan a year to advance your professional development and personal experiences
• be aware of the need to organise and complete an appraisal 
• bear in mind that you need to demonstrate you have benefited either personally or professionally (ideally both) by taking a year out of training.

Questions to ask yourself

• What do you want to achieve?
• Can you achieve this within a training programme? Would being in a training programme enhance the experience or provide you with less time to spend on it?
• Why do you want to have these experiences now?
• Would you derive more from the experience once you are more senior/progressed in your training programme?
• Will you be able to structure your time during a year out?
• Can you guarantee having the capacity to have reliable access to the internet for specialty applications, and be able to attend interviews in person?
• Do you have a specialty in mind? Do you want to do something which will make you more competitive in applications?
• What workplace benefits does your chosen F3 path include and are these important for you? Consider maternity leave, sick pay, pension contributions etc, and also alternative ways you could match these.

Balancing commitments

• How will I balance personal and professional development? Is one more important to me?
• Is having more flexibility for extracurricular activities and courses more important than a regular, clinical job?
• Can I afford experiences now or shall I save money for the future?
• Do I want to travel to areas of the world I haven’t been to or do I want to gain experience in the UK?
• Are there any key issues or needs my family have or will have of me this year? Does taking a year out make this easier or harder?
• Do I want to prioritise strengthening my CV and portfolio? Is there anything I can do to make myself more competitive in the future?

Once you’ve considered these questions, it can be helpful to draw out an overview of your aims, objectives, needs and desires for the year. Then try to weigh the importance of each to help you prioritise certain areas. This can help you weigh up decisions about taking a year out or not, and also what is most important for you to get out of that year.

The decision is yours

Ultimately, the decision as to whether to take a year out is a personal choice. The choice is best made by carefully considering your personal and professional aims and short-term and long-term priorities which should lead you to overall positive and negative reasons for taking a year out of training or not. There is no ‘right’ answer. If you do, after careful consideration, choose to take a year out of training, having an awareness of the variety of opportunities and experiences available to you is also very important to maximise the benefits of this year.

Subsequent articles will provide you with an overview of the multitude of different opportunities available to you and how you can build in as much or as little structure to these as you wish. These articles will be coupled with examples from junior doctors who have undertaken F3 years to exemplify the diverse experiences you can have, and how these opportunities have shaped their careers since then.

To acknowledge the importance of ensuring you undertake an annual appraisal during your year out, and how doing this outside of a training programme can be unfamiliar and present challenges, a guide to appraisals for junior doctors outside of training will follow. Using a lived experience of successfully organising and achieving an appraisal as an ‘F3’ doctor, this should help guide you to an easily attained appraisal. It should also allow you to evidence your personal and professional progression during your year out of training not just for your appraisal, but also for the benefit of your future career.

Dr Josie Cheetham, ACCS (anaesthetics) CT2