General guidance


The Foundation Doctor e-Handbook  has been produced by the Foundation Doctors Feedback Group along with the LETBs.  It is a valuable quick guide for Foundation trainees, with links to documents and websites covering all aspects of Foundation training.

Employment conditions

The Postgraduate Centre or HR department at each Trust will deal with matters relating to doctors training including: details of posts, contracts, salaries, banding, accommodation, hours of work, study leave and the date of the induction course.  All the above vary between the Trusts and all queries should be directed to them.  The Foundation School does not have information on those matters and will always refer enquiries back to the Trusts.

Please avoid contacting the Trusts before April as they may not have all necessary information yet, and may not be able to deal with queries.

European Working Time Directive (EWTD)

The European Working Time Directive (EWTD), Directive 2003/88/EC, is a directive of the European Union  to protect the health and safety of workers in the European Union. It lays down minimum requirements in relation to working hours, rest periods, annual leave for all workers and working arrangements for night workers. The original Directive, Directive 93/104/EC was enacted in UK law as the Working Time Regulations, which took effect from 1 October 1998.

The main features of the EWTD are :

  • a limit of an average of 48 hours work per week (workers can choose to work more if they want to)
  • a limit of an average of 8 hours work in 24 for nightworkers
  • a right for night workers to receive free health assessments
  • a right to 11 hours rest a day
  • a right to an in-work rest break if the working day is longer than six hours
  • a right to four weeks paid leave per year

Note: If you feel you are being asked to contravene the EWTD please notify your FTPD who will take appropriate action.

The EWTD originally did not apply to doctors in training (junior doctors) but the Amending Directive, Directive 2000/34/EC removed this exclusion so that:

  • by August 2004 average working time did not exceed 58 hours per week
  • by August 2007 there will be a 56 hour week
  • by August 2009 there will be a 48 hour week although this could be extended to 2012 with a maximum of 52 hours

 Quoted from the website:  NHS Health Management

Flexible/Less Than Full Time Training (LTFT)

The less than full times training (LTFT) scheme is aimed at meeting the needs of those trainees who are unable to work full-time for well-founded reasons i.e. caring for dependant children or adults in need of care, disability, or ill health.  Applications require LETB approval to work part time and the preferred way is as a slot-share with another flexi trainee.  This provides you with a better quality of training and the LETBs is more equipped to cater for the demand for LTFT training in this way.  More information is available on the Less Than Full Time Training webpage.

To apply:

1. Discuss the matter with the Foundation Programme Training Director (FTPD) at the hospital and the Foundation School Manager (FSM) before beginning your application.  They will be able to advise you of the likelihood that you application will be successful and also provide you with information on how your flexible training might be managed if approved.  They will discuss your training needs and identify a suitable available post which you can be placed in.  They will take into account where you like and childcare requirements (if applicable) wherever possible.  However, trainees should be aware that there is no guarantee that the content of the less than full-time training programme or employing hospital will be the same as their full-time placement, although preferences will be considered.

2. To begin the application process please contact the Foundation School Manager via email at:

Inter-Foundation School transfer

If you already have a place within a Foundation School you are not permitted to move to another Foundation School unless you qualify for an Inter-Foundation School Transfer (IFST). Guidance and application documentation for Inter-Foundation School Transfer can be found on the UKFPO website. 

If you wish to move and think you might be eligible you must discuss this in the first instance with your allocated Foundation School Manager (if you are an incoming F1 trainee / final year medical student) or with your Foundation Training Programme Director and your Foundation School Manager (if you are an existing F1 or F2 trainee).

You must submit the application form to your Foundation School Manager and, if the application is approved, he or she will contact your chosen Foundation School and forward the documents for approval.

The criteria are the same for those for special circumstances (see tab below) and the potential transfer depends on available vacancies in the receiving school.

Internal application for vacant F2 posts

Each year NWTFS may have a number of vacant F2 jobs.  NWTFS F1 trainees are given the chance to move to one of these jobs before the vacancies are recruited to externally.  The process is normally in spring and run along with the F2 swap shop.

The list of vacant F2 posts will be advertised to all eligible (full-time, non-academic and non-LAT) NWTFS F1 trainees.  Those who are interested will email the jobs ranked in their order of preference, to the School if they wish to apply for one of the jobs. Jobs will be allocated according to PAS scores (please see Synapse for more information). The Foundation School will notify approval or non-approval via email.

Information about the internal application for vacant F2 posts along with the F2 swap shop will be posted to synapse only.

Once the swap shop and application for vacant F2 process is finished there will be no more swapping or moving allowed. 


NW Thames trainees are encouraged to get involved in a number of Leadership and trainee Management initiatives offered by our Trusts.

One such initiative is ‘Today’s Doctors, Tomorrow’s Leaders’, which is a leadership programme run by Imperial College Healthcare NHS Trust to enable Foundation Doctors in North West Thames to develop their clinical leadership skills. This programme offers a series of modules consisting of a core lecture programme, teamwork and self-awareness exercises, small group workshops and the opportunity to participate in small change management projects in base hospitals.


  • to develop skills that can be used to appropriately challenge and improve patient care
  • to understand the soft and hard aspects of delivering change
  • to gain skills in negotiating, influencing and team building
  • to develop self awareness of one’s personal qualities

'Leading Together, Learning Together' is an initiative to pair FY2 trainees with NHS Graduate Management Training Scheme trainees in the same Trust, to build on the success of these experiences and to try and extend the experiences and learning to a wider group. This is led by the NHS Institute for Innovation and Improvement in partnership with medical education leads across London.


  • encourage collaborative working between doctors and managers at an early stage in their training.
  • allow junior doctors and management trainees to learn from each other and achieve specific educational objectives around leadership and management.
  • support junior-doctor/management trainee pairs to realise the benefits of collaboration and to role model this within their organisations and professional groups.
  • drive quality improvement outputs by encouraging buddy pairs to work on projects together.
  • help enable graduate management trainees to recognise the return they are providing on the investment in them, and the implications on the “front line”.

There is more information on the Excellence in Leadership webpage. 

Swap Shop

NWTFS runs an F2 Swap shop for F1s who wish to arrange a swap of their allocated F2 post commencing the following August.  The process is open to all eligible F1 trainees in NWTFS (those who are full-time, non-Academic and non-LAT). The swap shop is run alongside the Internal application for vacant F2 posts in early spring.  Only whole F2 posts of 12 months duration can be swapped, not individual placements or specialties. These will only be available via Synapse and will not be emailed direct to F1 doctors.  If you have forgotten your Synapse password, use the link on the login page to obtain a reset. Please read the Swap shop (Word) guidance document.

Once the swap shop and application for vacant F2 process is finished there will be no more swapping or moving allowed.  F2 posts that become vacant as a result of this process or subsequently will be returned to the Trust and will be recruited to as an F2 Locum Appointment for Training (LAT). If trainees wish to apply for these jobs they would need to resign from the Foundation School (with appropriate notice) and apply for the LAT in open competition.


During the F2 year, foundation doctors may undertake 'tasters' to widen their experience of different specialties.  F2 doctors should discuss opportunities with their Training Programme Director. 

Further information on Tasters can be found in the document "Specialty Tasters in the Foundation Programme: Guidance for foundation schools" in the Careers Advice section on The Foundation Programme website.

Teaching as a Foundation Doctor

The GMC documents : - Tomorrow's Doctors, The New Doctor, Good Medical Practice and the Foundation Programme Curriculum all outline the need for junior doctors to develop their teaching skills. Foundation year doctors are extremely well placed to take on the role of clinical teachers. They are able to identify important teaching areas because they remember skills and competencies which may have caused them anxiety during their own revision and can provide relevance to learning by drawing on their own experiences.

For these reasons Imperial College London Medical School recognises and welcomes the role of junior doctors in undergraduate education, and encourages them to be involved in planning and running patient based informal bedside teaching.

If you would like to get involved in teaching you can contact the ICSM Medical Education Society:


If you had concerns about the professional performance of one of your colleagues would you know what to do?  Are you aware of your Trust's policy on whistleblowing? Each Trust has it's own policy and your Medical Education Manager or Foundation Administrator will be able to advise you about this very important issue.

The following Whistleblowing Guidance (PDF) has been prepared by the North Thames Foundation Schools to offer further advice. 



Banding is a Trust issue and the Foundation School does not have information on it. Where reference is made to banding in any Trust documentation, this refers to the current situation, and applicants should not assume that the banding will remain the same for when they commence working as a Foundation Doctor. Your banding will be the applicable banding at the time the post is offered and accepted (both in writing) by you.

Foundation Dr withdrawal

Applicants who feel they have valid reasons for withdrawing from the School must contact the Foundation School Manager at the earliest opportunity. The School recognises that trainees’ circumstances do change, and endeavours to offer assistance and support in such cases.

Maternity leave

NWTFS is very supportive of trainees who wish to take maternity leave during their Foundation Programme.  As your training may be affected by family commitments it is important that you consider how you can balance your training and personal circumstances. This may involve some important decisions such as delaying completion of Foundation training if this is appropriate for you. The Foundation School wishes to support your decision and discuss your needs with you on an individual basis within the range of options available. In the first instance, you should contact the Foundation School (

This guidance does not cover employment aspects as this is the responsibility of the employing NHS Trust.  Information about your employment entitlement can be obtained from the Human Resources/Medical Staffing department at your hospital and from the British Medical Association (BMA).

Trainees can take anywhere between two weeks and 12 months off for maternity leave. A place will be held for you in the Foundation School but we cannot guarantee the same job or Trust as when you left. Many doctors who return from maternity leave prefer to return on a part-time basis. This can be arranged if we have a suitable placement, and should be discussed with the Foundation School Manager at least three months prior to returning to work.

Requesting documents

If you completed foundation training from 2013 onwards your 5.1 Attainment of Competency and 5.2 FACD can be obtained through your e-portfolio.

If you have completed foundation training prior to the year 2013/14 then in order to request documents you can email with the following details:

  • GMC number
  • F1 & F2 trusts
  • Specialties undertaken and the dates of these
  • Your supervisors' names
  • Current home address
  • Address at the time of foundation training

We will then get your files from archives and send you a pdf version of them.


The GMC has determined that 20 days (when the doctor would normally be at work) is the maximum permitted absence within each 12 month period of the Foundation Programme (F1 and F2). Where a doctor’s absence goes above 20 days (when a doctor would normally be at work), this will trigger a review of whether they need to have an extra period of training.

Any trainee who discovers that they are likely to miss more training time than the total allowable should consult their Foundation Training Programme Director (FTPD) and Foundation School Manager immediately for advice.

More information is available in the GMC document Absences from training in the Foundation Programme (PDF).

Special circumstances

The Foundation School recognises that certain applicants have personal circumstances that require them to work within a particular geographic area. The national criteria for special circumstances together with the application form can be found on the UKFPO website. 

Special circumstances for F1

While you remain a student your Medical School is responsible for deciding your eligibility for special circumstances. Applicants should initially discuss their situation with their Medical School. If their application is approved for special circumstances, the applicant's Medical School will then submit their special circumstances form to the pre-allocated Foundation School.

Students from a non-UK Medical School who are eligible for special circumstances should apply directly through the UKFPO

Special circumstances in NWTFS

Pre-allocation to NW Thames Foundation School due to special circumstances gives a trainee entry to the School but they must be prepared to work at any of our 10 hospitals as this School covers a relatively small geographical area. In order to be as fair as possible to those individuals who have taken part in open competition to get into the Foundation School, we do not take special circumstances into consideration when allocating trainees to jobs.

If a special circumstances trainee is allocated to a Trust that they will find impossible to commute to, they will be put on a waiting list and if a more suitable job comes up before August they can be moved. (Please note that a reasonable commute in London is considered to be up to 90 minutes.)

Special circumstances arising during F1 or F2

While there is no deadline for new special circumstances requests the more notice that is given to the Foundation school the easier it is to rearrange your programme. You should contact the Foundation School Manager as soon as possible if you have a situation of impending pregnancy or suddenly have to assume the role of primary carer. The criteria for special circumstances during F1 and F2 are the same as those for entering F1.

Support and counselling

If you feel in need of guidance or advice, or if you are experiencing problems of any kind during your foundation programme it is important that you seek help without delay. There are a number of people who are available to support and help you:

  • Each Trust has a Clinical Tutor, whose role is to support trainees, and you can speak to them in complete confidence.
  • Your Foundation Training Programme Director or Educational Supervisor, or the Medical Education Manager within your Trust.
  • Counselling services and the Occupational Health Services of the Trust in which you are employed.
  • PHP HEE (London)  The London Deanery counselling service for doctors, to which you can self-refer via the PSU (Professional Support Unit)
  • Your Foundation School Director/Manager:
  • LPMDE Professional Development resources

Tier 4 Visas

The UK Foundation Programme Office provides Tier 4 visa sponsorship for all non-EEA citizens graduating from UK medical schools who have secured a place on a Foundation Programme. Doctors requiring a Tier 4 visa for August 2015 must read the information on the UKFPO website on Tier 4 Visas in order that they are aware of the process and requirements.

The following information is provided for guidance:

The UKFPO will NOT sponsor:

  • Non-EEA citizens who graduated outside the UK.
  • Non-EEA citizens who have not been granted a previous student visa in the UK covering his/her final academic year and at least one other academic year of his/her studies leading to the above degree.
  • Foundation doctors who are not part of a recognised two-year Foundation Programme.
  • Any doctors employed in a locum capacity (LATs or LASs). 

Please read the following information relating to the Monitoring of Tier 4 Visas (Word). Also, issues relating to Maternity leave and Tier 4 (Word).

Time out

Occasionally it is necessary for Foundation Doctors to take time out from their Foundation training for an extended period for reasons other than sickness or maternity leave.  The duration of a time out will usually be 12 months to avoid being out of synch with the Foundation Programme. Time out is typically only granted between F1 and F2. Time out during F1 or F2 will only be considered in exceptional circumstances.

Trainees may take time out for a number of reasons including:

  • Gaining clinical experience outside of the Foundation Programme
  • Undertaking a period of research
  • Taking a planned career break

Anyone wishing to take time out should discuss this first with their FTPD then fill out a request form and submit it to the Foundation School.

Further information can be found in the UKFPO Reference Guide