Intended for healthcare professionals


Taking a break: doctors opt out of training after foundation year 2

BMJ 2019; 365 doi: (Published 02 April 2019) Cite this as: BMJ 2019;365:l1509
  1. Jennifer Cleland, John Simpson chair of medical education research, director, director123,
  2. Peter Johnston, consultant histopathologist, codirector, head of research24
  1. 1Institute of Education for Medical and Dental Sciences, Aberdeen, UK
  2. 2Centre for Healthcare Education Research and Innovation
  3. 3Scottish Medical Education Research Consortium
  4. 4NHS Education for Scotland
  1. jen.cleland{at}

The UK’s inflexible training system looks increasingly unsustainable

There has been an explicit assumption in the UK that doctors will seamlessly progress upwards through the postgraduate training pathway. This was perhaps the case in the early years of the UK’s foundation programme (the first two years of generic training following medical school)—in 2010, 83% of foundation year 2 (FY2) doctors progressed directly from foundation to specialty training, including primary care. By 2018, however, that figure had fallen to 38%.1 Nearly two thirds of UK medical graduates now opt out of the training pathway at the first natural opportunity.

Most doctors who opt out return to specialty training within three years.2 This suggests that the break from formal training is the postgraduate equivalent of gap year—a time to recuperate from intense educational experiences, resolve uncertainties about the next steps in life, and make a …

View Full Text

Log in

Log in through your institution


* For online subscription