OUT OF PROGRAMME (OOP) Request and Annual Review Document

(incorporating Appendix 3 from the Gold Guide)

For new requests, this form should be sent to the Postgraduate Dean, complete with the trainee’s educational supervisor & TPD/Head of School signature.
For annual review and renewal, the document should be signed by the trainee and Head of School/Training Programme Director.
The Postgraduate Dean will use this form to support any requests for prospective GMC approval.
Trainee Details
First Name / Surname
Address / Postcode
Telephone / Email
NTN/DRN / GMC Number
Current Training Programme Information
Specialty / Head of School
Indicative year of Training Programme / Current expected CCT date
GMC Programme Approval Number / Educational Supervisor
Trust
Site (please give full address)
Site Contact Number
OOP Information
Is this a new request? / Yes No
Have you discussed your plans to take time out of programme/continue your time out with your educational supervisor and/or Head of School/Training Programme Director? / Yes No
Do you intend the OOP to count towards CCT (OOPT/R only)? / Yes No
Has the OOP been prospectively approved by the GMC? / Yes No
Which category of OOP is being applied for:-
Out of Programme for Training (OOPT) / Yes No
Out of Programme for Experience (OOPE) / Yes No
Out of Programme for Research (OOPR) / Yes No
Out of Programme for Career Break (OOPC) / Yes No
Please note that if an OOP is agreed, you will be required to give your Head of School/Training Programme Director and current/next employer a minimum of 3 months’ notice.
Proposed OOP start date (for renewal please state actual start date):
Proposed OOP end date:
Proposed date to return to Training programme:
Proposed provisional date from completing training after OOP:
Location of OOP:
OOP Supervisor:
Give a brief description of what will be done during time out of programme/attach job description (please attach extra sheets if required):
(OOPR outline research proposal)
Additional Documentation required enclosed
Details of proposed training for GMC prospective approval / Yes No N/A
Letter from Royal College/Faculty Training Committee confirming provisional prospective approval of the placement / Yes No N/A
Or letter from host institution/Deanery confirming GMC approval of the placement / Yes No N/A
Statement detailing purpose and structure Of OOPT/OOPR placement, including confirmation placement is subject to quality management in line with GMC requirements from host institution/Deanery / Yes No N/A
OOPE renewal, short report from supervisor confirming still undertaking clinical experience / Yes No N/A
OOPR renewal, report from the research supervisor / Yes No N/A
OOPs that count towards CCT, Assessments in accordance with Specialty Curriculum / Yes No N/A
Job Description / Yes No N/A
Declaration
I am requesting approval from the Postgraduate Dean’s office to undertake the time out of programme described*/continue on my current OOP* whilst retaining my training number. (*delete as appropriate)
I understand the following:
  1. Three years out of my Training Programme will normally be the maximum time allowed. Extensions to this will only be allowed in exceptional circumstances that will need further written approval from the Postgraduate Dean.
  2. I will need to liaise closely with my Head of School/Training Programme Director(s) so that my re-entry into the Training programme can be facilitated. I am aware that at least six months’ notice must be given of the date that I intend on returning to the clinical programme and that the placement will depend on availability at the time. I understand that I may have to wait for a placement.
  3. I will need to return an annual out of programme report for each year that I am out of programme for consideration by the annual review panel. This will need to be accompanied by an assessment report of my progress in my research or clinical placement. Failure to do this could result in the loss of my training number.
  4. I will need to give at least 3 months’ notice to the Postgraduate Dean and to my employer before my time out of programme can commence.

Trainees Signature: / Date:
Educational Supervisor Signature: (new requests only) / Date:
TPD/Head of School Signature: / Date:
Postgraduate Dean (or deputy) Signature: / Date:

NB: The Postgraduate Dean will only sign this form after all the appropriate signatures have been collected.

OFFICE USE ONLY
Date application received:
Confirming all sections complete before processing: / Yes No
Date passed to Head of School/Associate Dean:
Date passed to Approvals Officer:
Date endorsement letter sent to GMC (OOPT/OOPR applications only):
Approved: / Yes No
Date Letter sent to Trainee:
INFORMATION ONLY
Essential
Application submitted within deadlines / Yes No
Clear objectives and learning goals / Yes No
Evidence of commitment to OOP project / Yes No
Evidence of appropriate project planning. For OOPR this will usually be that the project has been peer-reviewed, or that sufficient evidence is provided about funding arrangements, project hypothesis, power calculations, weekly timetable to reassure the panel that registration for and achievement of a higher degree are likely. / Yes No
Appropriate plans for supervision during time out / Yes No
Commitment to return to training number / Yes No
Starting and finishing dates of time out coincide with rotation changeover dates / Yes No
Unless clearly exceptional circumstances:
  • Applicant should have completed ST1 before the start of the proposed OOP
  • Applicant should be not less than 12m from the end of training before the start of the proposed OOP
  • There should be no concerns about the applicants progress through training
/ Yes No
Yes No
Yes No
Desirable
Contribution to personal development plan/career goals / Yes No
Contribution to society/global public good / Yes No
Benefit to specialty / Yes No