South Thames Foundation School

South Thames Foundation School

F1–F2 TRANSFER OF INFORMATION (ToI) FORM

The ToI form is designed to facilitate the supportive process of the transfer of information from the Foundation Doctor (FD) to their foundation school and F2 local education provider (LEP).

Full guidance on completion is available on the STFS website.

Please complete every section of the form.

GENERAL INFORMATION

Name:
GMC number:
F1 trust:
F1 start date:
F2 trust
F2 start date:

SECTION 1: HEALTH AND WELFARE

Q1. During medical school/F1 training, have you had a history of any of the following?

Physical health condition (including blood-borne viruses: hepatitis B, hepatitis C & HIV) / YES / NO
Mental health condition / YES / NO
Specific learning difficulties (such as dyslexia) / YES / NO
Any other personal circumstance that has affected your training / YES / NO

If you have selected ‘yes’ to any of the above please provide details:

YES / NO

Q2. Have you had any reasonable adjustments made or received any support at medical school/F1 due to your health or welfare that may need to be continued?

If you have selected ‘yes’ please provide details:

SECTION 2: EDUCATIONAL PROGRESS

Q1. Have you had any reasonable adjustments made or received any additional educational support at medical school/F1 that may need to be continued?

YES / NO

If you have selected ‘yes’ please provide details:

SECTION 3: PROFESSIONAL PERFORMANCE

Q1. Whilst at medical school/during F1, have you received a written warning or other sanction following an investigation into your professional behaviour or fitness to practice?

YES / NO

If you have selected ‘yes’ to either of the above please provide details:

Foundation Doctor Declaration:

I confirm that all information provided is accurate.
Signed: / Date:
I agree that information in this form may be used for anonymised statistical purposes / YES / NO
I agree that information in Section 1 can be shared with Occupational Health without further discussion with me / YES / NO
REMEMBER: Completion of the ToI form does not replace the need to specifically report fitness
to practise issues to the GMC or health issues to your employing, local education provider’s (LEP’s)
HR/Occupational Health departments. These must be made via separate declarations.

Foundation Training Programme Director Declaration

Name of foundation doctor:
Please provide any additional information that may be useful to the Foundation School or F2 FTPD in supporting this doctor in their F2 year:
I endorse the accuracy of the information provided in this form:
Name: / Signed:
Job title: / Date:

STFS is a collaboration between HE Kent, Surrey & Sussex, HE South London, Brighton & Sussex Medical School, King’s College London School of Medicine & St George’s University of London

Page 1 of 2

www.stfs.org.uk

Updated: 12 May 2015