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Doctor’s Diaries – Part 2, Applying to be a doctor

I think everyone’s experiences of medical school will be different, according to where you go and who you meet along the way. To try and keep this helpful for as many as possible I thought I’d focus today’s blogs on the process of applying for your first jobs, in the UK called Foundation Years.  It will realistically be most helpful for medical students in their final years, but could be interesting to anyone with an interest in medical education.

As yet, there is no uniform medical finals in the UK, every medical school sets there own and holds them at different times.

I had mine in the last January of medical school, leaving the final few months free for elective, student selected modules and apprenticeships.

There are a few exams that are now uniform, and everyone must do:


This is the ‘prescribing safety assessment’ and is now compulsory to enter into Foundation training. It tests candidates ability to safely and effectively prescribe medication.

This test was introduced in 2015 in response to research by the GMC which showed 9% of prescriptions had errors 1, and that new doctors find prescribing one of the most challenging aspects of their job 2.

It assesses competencies from the GMC Tomorrow’s Doctors guide:

  • Writing new prescriptions
  • Reviewing existing prescriptions
  • Calculating drug doses
  • Identifying and avoiding both adverse drug reactions and medication errors
  • Amending prescribing to suit individual patient circumstances

I was the first year who did it and in that stage it was more of a pilot and non-compulsory for medical schools to put on. It’s an online, 2-hour test. There are a couple of online practice questions you can access once your medical school has registered you to take the test, I’d recommend familiarising yourself with this new exam style.


This test presents questions relating to possible work-based scenarios a junior doctor can find themselves in. You will be asked to rank the 5 options from the most to least appropriate or to select the 3 most appropriate answers.

The test assesses attributes drawn from the job specification of a F1 doctor.

There are 70 questions in 2 hours and 20 minutes. I strongly recommend you get practice at this type of exam as again, is often different to something you’ve come across before. There are practice papers online, for example on the Foundation Programme’s website, and with practice books, many readily available on amazon.

One thing to note – I’ll be talking about your score out of 100 below. This accounts for 50 points, which when you think of it is more than your ranking throughout the entirety of medical school is worth – so do practice!


The Foundation Programme takes into account several things when you apply. They use this to generate a score of 100. This score is ranked against your peers and determines how likely you are to get the jobs you want.

The score is made up of two parts:

The Educational Performance Measure:

The maximum points available for this is 50. It comprises in itself several different factors:

  • Your medical school performance – each medical school uses different exams/factors to generate this number. The output is the same however, which decile of your cohort do you fall in. If you are in the 1st decile (top 10% of your year), you will get 43 points, the 10th decile gets you 34 points.
  • You can get up to 7 additional points for either:
    • Additional degrees (max 5 points) – the level of degree (BSc, BDS, PhD) and grade awarded (1st, 2.1 etc) will determine how many points you get.
    • Publications (max 2 points) – note you don’t have to be the first author of a paper, but you do need to be a named author and not a collaborator.

The Situational Judgement Test:

This test alone has a maximum of 50 points available.

  • Once all SJTs have been marked they undergo an algorithm to ensure there is equal weighting between the SJT and educational performance measure.

How you state your job preferences is:


The foundation Programme splits the country up into areas, called deaneries. You rank in order of preference every deanery of the country – you could be sent anywhere. If, unfortunately, your overall score isn’t great you could end up with a deanery at the bottom of your list. On the other hand, if you did well you could get your first choice.

foundation programme deanery map.png


Foundation programmes are split up into either 6 x 4-month rotations or 4 x 3-month rotations. Once you’ve been allocated to a deanery you will then have to rank each set of rotations in order of your preference. For example, you might prefer to do cardiology, general surgery, elderly medicine, obs and gynae, A&E and oncology OR psychiatry, respiratory, orthopaedics, elderly medicine, GP and ENT. By this I mean you don’t get to choose exactly what jobs you want, more a selection of 6 (or 4) jobs combined that you prefer. The same score used to allocate you to a deanery is used to determine which jobs you get!

This was a very basic overview of several key components of the application. A useful resource to look at when applying to foundation training and covers the process in much more detail can be found here.

Good luck to anyone applying to jobs this year or in the future, I hope this helps demystify the country-wide application to foundation training.

Next time on the Doctor’s diaries I’ll start talking about what it’s actually like when you start working on the wards and can call yourself a doctor!

Emma xx


  1. Causes of prescribing errors by foundation trainees in relation to their medical education – GMC. Available at: (Accessed: 21st December 2018)
  2. The state of medical education and practice in the UK – GMC. Available at: (Accessed: 21st December 2018)



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