Out of Programme (OOP) Guidance

The below guidance outlines the process for trainees who wish to take time out of training, and for some of that time to count towards their CCT.

Introduction to taking time out of programme 

The Gold Guide sets out the circumstances, purpose, eligibility, and procedures that need to be followed if a trainee is to spend time out of the specialty training programme to which they have been appointed. The main points are summarised below. Trainees should read this in conjunction with the Gold Guide and local Deanery/LETB procedures.

General points for consideration

  • Retrospective approval will not be given.
  • All OOP requests need to be agreed by the Postgraduate Dean and trainees must follow the local procedures. Trainees are advised to discuss their proposals as early as possible with their Training Programme Director. At least three months’ notice is usually expected so that employers can ensure that the needs of patients are appropriately addressed. Trainees must not assume that approval will be given. Any commitments made before approval is received in writing are made at the trainee’s own risk. Trainees who depart from their programme without approval may be putting their employment at risk.
  • OOP will not usually be agreed until a trainee has been in a programme for at least one year, unless at the time of appointment deferral of the start of the programme has been agreed, e.g., for statutory reasons. Trainees need to complete the first year of training (CT1 or ST4) before undertaking OOP.
  • The trainee will need to submit annual Out of Programme paperwork and keep the relevant Training Programme Director (TPD) informed.
  • For trainees undertaking approved training or research, their paperwork will form part of the ARCP process.
  • Trainees on fixed term or locum appointments for training will not usually be eligible for OOP, except following bereavement or illness, but the period of their appointment will not be extended.
  • Trainees should note that each Deanery/LETB will have its own process; some deaneries require College support before they will send the application to the GMC, others do so pending College support. The College's QA Committee (QAC) will review applications after the TPD, and Head of School have given their approval. The success of any application is dependent upon Deanery/LETB approval and College support.

Out of Programme (OOP) routes

Out of Programme for Approved Clinical Training (OOPT)

If this training, in terms of achieving the required competencies, otherwise compliments the rest of their individual programme, it may be approved and count towards their CCT.

Examples of such training might include:

  • A period of time abroad in a different but relevant clinical environment where there is equivalent clinical and educational supervision.
  • An attachment with a non-psychiatric sub-specialist such as a neurologist where the competencies gained will contribute to the management of psychiatric cases.
  • An opportunity to gain management or teaching skills.

There are three stages to approval: Postgraduate Deanery/LETB, College Support and GMC approval.

Postgraduate Deanery/LETB

Trainees may retain their national training number (NTN) whilst undertaking a clinical approved training opportunity, as long as the OOPT has been agreed in advance by the Postgraduate Dean, and trainees continue to satisfy the requirements for annual review.

Trainees who undertake OOPT must submit the appropriate evidence of acquisition of competencies required by the relevant curriculum to the home Deanery/LETB’s annual review panel, along with annual OOPT documents.

College Support

The College recommends that when devising an out of programme training experience, the postgraduate deanery/LETB and TPD should consider the GMC’s Promoting Excellence: standards for medical education and training.

All applications for OOP counting towards award of a CCT will be reviewed by the Quality Assurance Committee (QAC) of the Royal College of Psychiatrists. The committee will consider the application and give its view on the proposed OOPT in terms of its suitability to gain the relevant competencies. The committee will consider the trainee's training as a whole and may support the OOPT for only part of the time out of programme. The committee places particular value upon the acquisition of skills such as leadership, that can only be gained through sustained membership of a multidisciplinary team; an application that includes a programme of fragmented posts may not be approved.

Please note that the QAC’s assessment process takes between two and four weeks. Please ensure you consider these timings when applying to take time out of training.

If the applicant is a higher trainee, they must state whether the OOPT or OOPR is part of their main CCT (e.g., General Adult CCT) or their endorsement where applicable (e.g., Liaison Psychiatry). In general, it is usual to request the OOP to count towards the main CCT and not the endorsement (sub-specialty). This is often due to the need for the endorsement year to be one full year totally immersed in the sub-specialty with not just clinical or research experience but the opportunity to take a leadership role within the team. This may be difficult in split academic roles where the trainee may have 1 or 2 sessions of clinical work in the sub-specialty but is not available to take a leadership role over the whole working week to be fully immersed in the teams’ wider remit.

GMC Approval

Once the QAC has reviewed the application, the trainee and Postgraduate Deanery/LETB will be notified and a letter of support from the College will be sent.

The Postgraduate Deanery/LETB must then send the application to the GMC’s Quality Assurance section for approval.

GMC approval is sought where posts have not been previously approved by the GMC. Please contact Psychiatrytraining@rcpsych.ac.uk if further advice is required.

Out of Programme for Research (OOPR)

This section should be read alongside the relevant sections of the Gold Guide.

Time spent out of a specialty training programme for research purposes will be recognised towards the award of a CCT when the relevant curriculum includes such research as an optional element. Under such circumstances the GMC is not approving research, but is approving any training, including research, that is deemed to be appropriate and relevant to the CCT curriculum in question. The College must support the application for prospective approval. 

Please note that trainees are able to take time out of training to undertake an OOPR without requesting for this to count towards their training. 

Once prospective approval of the posts and programmes has been obtained it is still for the ARCP panel to confirm that the training (including relevant research) has been completed satisfactorily and satisfies the requirements of the curriculum. This will inform the College’s recommendation to the GMC for the award of a CCT.

When OOPR does not count towards CCT requirements, GMC approval is not required.

Time taken out for research purposes is normally for a registerable higher degree, e.g., a PhD, MD or master’s degree and will not normally exceed three years. Trainees in their final year of training will not normally be granted OOPR.

Obtaining Approval for an OOPR Towards a CCT

There are three stages to approval: Postgraduate Deanery/LETB, College Support and GMC approval.

Postgraduate Deanery/LETB

A trainee wishing to count time spent in an OOPR must apply in the first instance to the Postgraduate Dean by completing an out of programme form which can be obtained from the Postgraduate Deanery/LETB. Trainees must give their Deanery/LETB as much notice as possible (minimum three months’ notice).

Trainees may retain their NTN whilst undertaking an OOPR, as long as the OOPR has been agreed in advance by the Postgraduate Dean and trainees continue to satisfy the requirements for annual review.

Trainees who undertake an OOPR must submit the relevant section of the OOPR document to the annual review panel. This will ensure that the trainee keeps in touch with the Deanery/LETB and registers each year to renew their commitment to the training programme. It requests permission to retain their NTN and provides information about the trainee’s likely date of return to the programme, as well as the estimated date for completion of training. It is the responsibility of the trainee to make this return annually.

College Support

All applications for OOPR counting towards award of a CCT will be reviewed by the College’s QAC. The Committee will consider the application and give its view of the proposed OOPR in terms of its suitability to gain the relevant competencies. The committee will consider the trainee's training as a whole and may approve the OOPR for only part of the time out of programme.

An application for OOPR at core training will count for no more than 6 months towards completion of this stage of training. A research project that continues beyond the end of core training cannot count towards research at advanced training without a further OOPR application.

An application for OOPR at advanced training may count for up to 6 months of advanced training, and additional approved time may be credited depending upon the clinical content of the training. The committee will make note of clinical sessions that run alongside the research project as well as the clinical skills gained during the research. A project that includes regular clinical assessments will be credited more. The committee expects that an advanced trainee will have two sustained periods (e.g., 12 months) of involvement as a senior member of a multidisciplinary team and may make recommendations for the training that needs to follow a period in research.

The College’s QAC will decide, based on the above information, on whether to support the entire duration requested, or a part of the duration and will inform the postgraduate dean accordingly.

Please note that the QAC’s assessment process takes between two and four weeks. Please ensure you consider these timings when applying to take time out of training.

GMC Approval

Once the College’s QAC has reviewed the application, the trainee and Postgraduate Deanery/LETB will be notified.

The Postgraduate Deanery/LETB must then send the application to the GMC Quality Assurance section for approval.

The GMC will not give approval to OOP applications, which require time to be counted towards training, without College support.

Once the application has been reviewed the GMC Quality Assurance Team will inform the Postgraduate Dean and the College of the outcome. The GMC gives the final approval in all out of programme applications.

If you require any further information, or would like to speak to someone about your application, please contact Psychiatrytraining@rcpsych.ac.uk, or call 0208 618 4170.