Surinder Dosanjh
Foundation Year 2 Doctor, Broomfield Hospital
Foundation Year (FY) placements are there for you to primarily fulfil the competencies of a Foundation Year Doctor (FYD). They are there for you to develop into a well-rounded Doctor.
However, with a competition ratio of almost 10:1 many who plan to apply to Ophthalmology will undoubtedly need to keep an eye on the prize also (1).
Here we will focus on the benefits of certain foundation year rotations and how you can maximise your time in each specialty towards your application.
Academic Foundation Placements (AFP)/ Priority Foundation Placements (PFP):
When it comes to applying to FY programmes keep in mind that you can submit applications to AFP and PFP placements alongside the regular applications. This enables the chance to apply to more niche programmes which may have something useful to offer.
During academic foundation year placements there may be time allotted to research and other activities which can help to score points on your Ophthalmology portfolio. During such time you may be able to work toward publications and presentations for instance. Remember that publications submitted to the publication section do not need to be specialty specific, nor do the presentations. To note the case reports/non-peer reviewed publications submitted to the “commitment to specialty section” should still be specific to Ophthalmology (2).
When applying to foundation year placements keep in mind that there a PFP placements. These are placements offered in areas which are either hard to fill or may have a slight divergence from the regular foundation year programme. There is a good deal of opportunity amongst these placements. Some may give you more opportunity to teach and complete a PgCert in Medical Education. Other programmes may give you time to develop leadership qualities and gain extra qualifications. Importantly, there is a select handful of rotations with Ophthalmology as a rotation.
If you were to gain a rotation in Ophthalmology there would be great deal of opportunity. For instance, you could form links with the department and get involved in projects which could score points. You could develop understanding and knowledge that could carry you on through the application to your chosen career. For instance, developing an good understanding of Ophthalmology could be very useful if you are planning to sit the Part 1 examination prior to application. You could also develop basic skills in the use of a slit lamp and other basic procedures. Once you are amongst the Ophthalmologists it may be easier to get advice regarding interviews and application. The same applies for going down to your local department/taster weeks and getting involved with the specialty.
Regarding AFP and PFP placements it is important to review Oriel and other resources available through specific deanery websites as what is on offer changes and differs greatly from one to another.
What if I ended up on the regular Foundation Year Programme without an Ophthalmology rotation?
All is not lost by any means. This will be most of those planning to apply to Ophthalmology. There is ample opportunity to get involved in Ophthalmology specifically by taking a taster week or emailing/visiting the local department.
It is important to note that there are very few points that are Ophthalmology specific. This means it is still worth getting involved in audit/quality improvement projects (QIP)/publications if the opportunity arises. It is particularly worthwhile teaming up competencies of the FY programme and your Ophthalmology portfolio. This could mean completing a QIP/audit which could be used for your FY portfolio and worthy of inclusion in your Ophthalmology portfolio also. Do keep in mind that if you wait for the opportunity to arise it may never to come. It is best to be proactive and ask around.
Preparing for MSRA:
Remember that this exam is still based on general medicine with small portion of it being related to Ophthalmology. It is important that you engage in each rotation to develop as a well-rounded Doctor. In addition, if you were to do some light revision of general medicine as you go it could pay dividends when you come to sit the MSRA examination. Unfortunately, it does appear that this exam is due to stay for now. All the more reason to keep up your general medicine knowledge and not to throw away those finals notes just yet. It could be worthwhile picking a General Practice rotation to help when it comes to SJT section and maintaining a good base in general medicine for the examination. The examination has its origins in the GP selection process so many of the questions may still be orientated towards making decisions as a GPST1.
Opting for more supernumerary positions
Being supernumerary essentially means you are excess to the staffing required. This may happen in the instance of a very well-staffed unit. It may also happen in more specialised specialties. For instance, many of my colleagues who underwent a FY1 placement in Paediatrics felt they were more supernumerary compared to being the on-call FY1 on General Surgery for instance. This could provide opportunity, namely in freeing up time and energy to be spent on portfolio and extra-curricular activities towards your future Ophthalmology application. It could be useful to team up a lighter rotation with the time of applications or examinations so that you are less drained and more motivated to spend time on your application/exam revision after work.
Do keep in mind that the staffing levels and workload in a department may fluctuate wildly from one year to the next, it will also differ greatly from one department to another and one region to another. If you are able to get in touch with people you may know or friends of friends to get and idea of the workload it may help.
What about swap shop and changing foundation year placements?
It was not too long ago that foundation year doctors were able to swap specific rotations for one which they would prefer, provided they could find someone to swap with.
This is most definitely not the case anymore and the process was stopped few years ago.
The only instance of being able to swap once you have already started seems to be extenuating circumstances, such as a new caring role, etc.
To summarise:
AFP/PFP:
- Provides extra opportunities to gain points towards portfolio as you go along.
- Placement in Ophthalmology may be ideal.
Rotations without Ophthalmology:
- The vast majority of applicants
- Links can be made within the speciality by visiting your local department/taster weeks.
- Very few points for the portfolio are Ophthalmology specific.
MSRA:
- Has become a cornerstone of the application process and looks to be here to stay.
- Keep this in mind whilst rotating. May be worthwhile revising topics whilst on rotation to further solidify knowledge.
Opting for more supernumerary positions:
- May provide extra time/energy that can be put towards application.
- Try to contact those who have gone through the cycle, if possible, to get a better understanding of workload
Swap shop
- No longer exists!
Taking an FY3
- For many it may be a good idea to spread things out to avoid burnout. You could try to take up a clinical teaching fellow role which may itself provide great opportunities to gain extra points on the portfolio.
References
- National Health Service England. Workforce, training, and education: Medical Hub Competition Ratios for 2023. [online]. 2023 [Accessed 24 January 2024] Available from: https://medical.hee.nhs.uk/medical-training-recruitment/medical-specialty-training/competition-ratios/2023-competition-ratios
- Health Education England. Severn Postgraduate Medical Education Ophthalmology: Evidence Folder [online]. 2024 [Accessed 24 January 2024] Available from: https://www.severndeanery.nhs.uk/recruitment/vacancies/show/oph-st1-24/evidence-folder-lib