Time Out of Programme


Please read the following carefully before downloading the application form and guidance notes available at the bottom of this page.


Absences from the training programme to undertake time out of programme for clinical training (OOPT), research (OOPR), clinical experience (OOPE) or career breaks (OOPC) must be approved by the Postgraduate Dean or her deputy on the advice of the relevant Specialty School. Applicants are therefore advised to discuss their proposals as early as possible with their Training Programme Director.


All postgraduate doctors in training must give at least six months’ notice of intention to take time out of programme and all trainees are therefore advised to think about taking time out of programme well in advance of the intended date and seek the advice of their Educational Supervisor and Training Programme Director so that it can be considered at Annual Review as part of learning objectives for the forthcoming year. This is particularly important if the time out of programme will count towards training and GMC approval is required.


Categories of OOP


OOP for Clinical Training (OOPT) - allows the trainee to spend time in clinical training that has been prospectively approved by the GMC, and which is not part of the trainee's specialty training programme. This includes time 'acting-up' as a consultant. The duration of OOPT will normally be for a period of up to 12 months (‘acting up’ is limited to 3 months and can only take place in the final year of the programme).


OOP for Clinical Research (OOPR) - allows the trainee to undertake research, normally for a higher registerable degree, e.g. PhD. Time spent out of programme for research purposes can be recognised towards the award of CCT when the relevant curriculum includes such research as an optional element. The duration of OOPR is normally up to a maximum of 3 years, with a 4 year maximum in exceptional circumstances which requires the prospective approval of the Postgraduate Dean.


OOP for Clinical Experience (OOPE) - allows the trainee to gain clinical experience, which is not a requirement of the specialty training programme curriculum. This does not require prospective GMC approval and does not count towards CCT. This includes working overseas in developing countries. The duration of OOPE will normally be for a period of up to 12 months.


OOP for Career Break (OOPC) - allows the trainee to take a planned career break to pursue other interests (e.g. domestic responsibilities, work in industry, developing talents in other areas and entrepreneurship). The duration of OOPC is normally for a period of up to 12 months, with a second year at the discretion of the Postgraduate Dean.


Out of Programme Pause (OOPP) - allows trainees in specialty training to step off the training ladder and undertake work in the NHS or a similar patient-facing role in the UK. Experience and competences gained outside of training may be then considered on the trainee's return to their training programme.


There is also a separate application process for Acting Up as a Consultant - please refer to the Acting Up as a Consultant (AUC Form) and  AUC Guidance notes


Royal Colleges/Faculties/GMC


If your time out of programme is to count towards your CCT you will need to liaise with your relevant Royal College/Faculty to obtain a letter of support and recommendation.


For medical specialties, if you want to apply for OOP time to count towards training, the Royal College of Physicians (JRCPTB) requires you to complete and submit a form that you can download from the below link:

Link icon https://www.jrcptb.org.uk/training-certification/out-programme


If the site of the OOP is on the list of GMC approved sites, you should also send the JRCPTB a screen shot of the location from the GMC list of approved sites which can be downloaded from the below link:

Link icon https://www.gmc-uk.org/education/28373.asp


Please also inform the JRCPTB if the site is not on the GMC list of approved sites.


All periods of unpaid leave/time out of programme that are intended to count towards CCT must also have the prospective approval of the GMC. Health Education England - North West Office will facilitate this, where relevant, once approval for the time out of programme has been granted.


If the time spent out of programme for research or training is not required to count towards the award of a CCT, then GMC approval or involvement is not necessary, but it should be noted that the GMC will NOT consider time out of programme towards a CCT if prior approval has not been given.


PLEASE NOTE: Failure to comply with the 6 month notice rule may result in GMC approval being delayed and your time out of programme not being eligible to count towards the award of CCT.



Approval of Applications


If your request to take time out of programme is refused, you can submit an appeal in writing to the Postgraduate Dean within 10 working days of confirmation of refusal, stating the reasons for your appeal. The Postgraduate Dean will respond within 10 working days.


Time out of programme will not normally be agreed until a postgraduate doctor has been in a training programme for at least one year, unless at the time of appointment deferral of the start of the programme has been agreed for statutory reasons.


OOPs may be considered in the final year of training if the postgraduate doctor is on track for an ARCP outcome 6.  


Incomplete applications missing documentation or signatures will be returned to applicants for completion. Therefore, please ensure that you have completed all sections of the form and included all requested paperwork to avoid delays to your application being processed.



NHS Pensions Scheme


Trainees who wish to undertake a period of unpaid leave/time out of programme and wish to remain in the NHS Pension Scheme are now required to maintain their pension contributions currently.


Months 1-6: For the first six months out of programme the trainee will be required to pay via standing order/ direct debit the amount that would have been deducted in respect of employees' pension had they remained on the payroll.


Months 7-24: From months 7-24, if the trainee wishes to remain in the NHS Pension Scheme, they become liable for both the employees and employers pension contributions and will be required to pay these as detailed above.


It should be noted that trainees taking time out of programme for a period longer than 24 months will be required to take a break in service after the 24 months period is concluded.


Trainees employed by another NHS organisation whilst taking time out of programme can continue payments with the receiving organisation. Trainees who become employed by a University may also be able to maintain NHS pension scheme membership under a Direction arrangement. The University can pay pension contributions under the direction arrangements to the NHS pension scheme

Link icon www.bma.org.uk/advice/career/applying-for-training/out-of-programme


Further detail on these changes to the NHS Pension Scheme can be found here:

PDF Link Icon NHS Pensions Employer Newsletter July 2010



Contacts and Further Information


If you have any specific queries relating to time out of programme, please contact your Programme Support Manager whose details can be found here or for GP queries, please refer to the the GP OOP guidelines 


For further detailed information on time out of programme, please consult Section 3 (3.149-3.182) of the Gold Guide 9th edition, which can be found online at www.copmed.org.uk.


For all queries relating to the NHS Pension Scheme, please contact your relevant payroll department.


Please return all OOP application forms to the relevant school inbox (see below) or for GP, return to GP Rotations.


Specialty School Email inbox
ACCS england.accsem.nw@nhs.net
Anaesthesia england.anaesthesia.nw@nhs.net
Emergency Medicine england.accsem.nw@nhs.net
Intensive Care Medicine england.icm.nw@nhs.net
General Practice england.gprotations@nhs.net
Medicine england.medicine.nw@nhs.net
Obstetrics and Gynaecology england.obsgyn.nw@nhs.net
Ophthalmology england.ophthalmology.nw@nhs.net
Paediatrics england.paediatrics.nw@nhs.net
Pathology england.pathology.nw@nhs.net
Public Health england.PublicHealthNW@nhs.net
Psychiatry england.psychiatry.nw@nhs.net
Radiology engalnd.radiology.nw@nhs.net
Surgery england.surgery.nw@nhs.net


Application form and policies


PDF Link Icon Hospital Specialty Trainees - Policy and Process for Out of Programme Applications

Word Document icon GP Trainees - Guidelines for Trainees Taking Time Out of Programme from GP Specialty Training

Word Document icon OOP Application Form

Word Document icon OOP Cancellation & Curtailment form

Word Document icon Acting Up as a Consultant (AUC Form)

PDF Link Icon AUC Guidance notes


If you wish to extend your current period of OOP please complete the relevant sections of the OOP Application form above.

Please ensure that you download and familiarise yourself with the guidelines prior to making your application.

Please ensure ALL sections are completed.


Additional Out of Programme Pause (OOPP) Guidance 

PDF Link Icon OOPP - How-to Guide for Doctors in Training

PDF Link Icon OOPP - Phase 3 FAQs

Word Document icon Out of Programme Pause Initiation and scope of practice monitoring form

Link icon GP TRAINEES ONLY - Out of Programme Pause – Initiation and Scope of Practice Monitoring Form



Tier 2 Visa sponsorship


If you are on a Tier 2 visa please read the guidance document in the  following link:

PDF Link Icon OOP Guidance for Tier 2


For the majority of trainees on a tier 2 visa going OOP, sponsorship will be withdrawn for the duration of the OOP. This will affect your employment status 

Link icon https://specialtytraining.hee.nhs.uk/Recruitment/Overseas-Sponsorship/Frequently-Asked-Questions-FAQs


You must inform the National HEE Overseas Sponsorship Team of any change in circumstances by completing a Reporting form or emailing england.sponsorship@nhs.net