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Out of Programme

Out of Programme Opportunities

Have you identified a learning or development opportunity outside of your training programme that you would like to take up for six months, a year or longer? Do you need to take a career break to focus on domestic responsibilities or for other personal reasons? If so, the option of taking time 'out of programme' is available to you.


Tell me more about time Out of Programme

There are four types of OOP:

OOPT Out of Programme Experience for Training - has approval from the GMC and will contribute towards obtaining your CCT.
OOPE Out of Programme Experience for Clinical Experience - has not received approval from GMC for contribution towards a trainee's CCT.
OOPR Out of Programme Experience for Research - can be up to three years and can lead to a higher degree. For academic trainees, the time 'out of programme' for research purposes is essentially part of your training programme.
OOPC Out of Programme for a career break - e.g. to work in industry, for domestic responsibilities or for ill health reasons.

Refer to the Gold Guide for full details on the rules and the process that most LETBs/deaneries follow for undertaking time OOP.1

You should also review your LETB/deanery website for guidance specific to your region.


How do I apply?

To apply for OOP, you will need to follow the process described on your LETB/deanery website.

If you are undertaking an OOPT, your LETB/deanery will apply for approval to the GMC. The GMC is the only body which can give, amend or withdraw training approval for any OOP intended to lead to the award of CCT. The GMC will not accept applications for OOP directly from trainees, colleges or faculties.

You do not need to consult with the GMC if your time OOP is not to count towards the award of CCT. Full details of the GMC approval process are available on their website.


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When should I apply?

You are usually expected to have undertaken at least a year of training before applying for OOP. Each individual case will be considered on merit and all plans for taking time out of programme, and their impact on your progression, should be discussed with your educational supervisor. Your time out of programme should normally be completed with at least 12 months whole-time equivalent training remaining.

Exclamation markWe recommend that you seek advice from those familiar with your specialty, such as experienced colleagues or your college/faculty postgraduate clinical tutor, on the best time to take time out during training. 

Exclamation markIf you wish to take time OOP with a humanitarian or charitable organisation, you should note that most agencies require a minimum of two to three years’ postgraduate clinical experience and training.

Stage of training
Some trainees go OOP during core training, however gaining approval may be difficult, as postgraduate deans will often take the view that trainees should complete core training prior to doing so. There may also be local variation on approvals due to capacity and post availability.
The majority of trainees taking time out of programme do so in the period between entering higher specialty training and gaining a CCT. You are usually expected to have undertaken a year of higher specialty training prior to making a request.


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What permissions do I need?

Your application for OOP must be approved by your LETB/deanery, and if your time out-of-programme will include training which will count towards your CCT, it must also be approved by the relevant college or faculty and the GMC. Once the appropriate approval is confirmed, you must write to your current and/or next employer to give them notice of at least three months. This letter should not seek permission, but it should make the following aspects clear:

  • your central reason for taking time out of programme
  • your expected date of return
  • that your time OOP has been approved by your LETB/deanery and the GMC (if applicable)
  • any reference numbers or names attached to your approval if necessary
  • anything else you’ve specifically been required to disclose under the terms of your OOP agreement with your LETB/deanery

If you are undertaking a fixed term specialty training appointment or a LAT, you cannot request time out of your fixed term appointment. Where time needs to be taken away from work, for example following bereavement or for illness, the service gap may be filled but your fixed term appointment contract will not be extended.2

To gain the necessary permission for taking time out of the specialty training programme while retaining a NTN, you must do the following:

icon blue infoComplete the OOP request annual review form (Appendix 4 Gold Guide 5th Edition), obtainable from your LETB/deanery or online
This form must be countersigned by your educational supervisor before being submitted to the postgraduate dean and training programme director for approval. Note: Individual LETBs/deaneries may require further documentation and evidence in addition to a completed OOP application form.
You must clarify the OOP policy and procedure of the approving LETB/deanery before submitting an application as practices vary.
Note: In some instances, the educational supervisor may need to provide a supporting statement or record of discussions with you about your application
It is your responsibility to ensure that full supporting documentation is submitted within the required timeframe.
Once all the required information is received, the LETB/deanery will consider your application for approval. Each case will be considered on its individual merits, however you are more likely to have your application accepted if you have received an Outcome 1 at your most recent ARCP. Trainees who have received an Outcome 3 may well be excluded from consideration.
icon blue infoContact the relevant body with responsibility for signing off training, such as the training departments of your respective college or faculty.
 All colleges and faculties have procedures in place for reviewing OOP applications, though terminology may differ between them.
 Full details about the process for taking time out can be obtained from the training and education departments of the relevant college or faculty.
 Your LETB/deanery should be kept informed of all correspondence.

 icon blue infoDecide whether or not you want the time you are spending out of programme to count towards your CCT or CESR CP, and discuss this with your educational supervisor.
If the time OOP is to count towards CCT, your LETB/deanery will submit the application to the GMC on your behalf for approval. If the period of OOP will not count towards CCT requirements, GMC approval is not required – but the relevant college or faculty should also be informed in order to amend the trainee's expected CCT date.
Once the application has been approved, your educational supervisor and employer (current and/or next) must be given notice of the proposed absence in writing as soon as possible.

The process varies slightly between specialties so be sure to check the approvals pathway of the relevant college or faculty. The GMC does not retrospectively approve training for the Certificate of Completion of Training (CCT) or CESR CP.

icon blue infoEnsure that all parties are informed about any changes to the OOP.
You must inform all involved parties if your OOP is not going ahead, or if the start date, duration or location changes.
Failure to provide information to the relevant authorities could result in the loss of your NTN.


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Will my time OOP contribute towards my Certificate of Completion of Training?

The decision about which type of OOP to apply for, and eligibility for accreditation to Certificate of Completion of Training (CCT), must be clarified with your educational supervisor in advance of any application.

If the time OOP is to count towards your CCT, the LETB/deanery will submit the application to the GMC on your behalf for approval.

If the period of OOP does not require approval, then your college or faculty should also be informed in order to amend your expected CCT date.

Once the application has been approved, the educational supervisor and employer (current or next) need to be given notice of the proposed absence in writing as soon as possible.

The process varies slightly between specialties so be sure to check the approvals pathway. The GMC does not retrospectively approve training for the Certificate of Eligibility for Specialty Registration (CESR).

If your time OOP is to count towards your CCT the GMC must approve your application to go out of programme before the post starts. We would recommend that you start this process six months before the post starts, to give you enough time to secure approval and give your employer three months’ notice.

Applications must be sent to the GMC by your LETB/deanery and will only be considered if they contain a completed CN18 form and the endorsement letter from your college or faculty. If an application is received with information missing, the GMC will hold the application and only return to consider it once all the information has been received.

Although trainees on career breaks will be encouraged to keep up to date through attending educational events, there is no entitlement to study leave funding for this. Arrangements will be subject to local agreement. Since this is not prospectively approved training, it cannot be attributed to award of a CCT or CESR.3


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Can I defer the start date of my training?

Sometimes trainees attempt to defer the start of their training in a new post to take time out of programme. LETBs or deaneries will not normally agree to deferment except on statutory grounds (e.g. maternity), or for time to complete a higher degree.

Applicants currently being allocated to higher specialist training (ST3 level or above)
In order to take time out of training, trainees will need to defer their start date.

It is important to give as much notice as possible to your educational supervisor and postgraduate dean prior to ST3 (ST4 in psychiatry and paediatrics) allocation.
Applicants for higher specialist training (ST3 level or above) 
If you do not have a National Training Number (NTN) or academic National Training Number (NTN[A]) and are applying for a new post, you will need to clearly state that you wish to defer your start date when applying.

Your LETB/deanery may not accept applications a year in advance, but we recommend you consult with the LETB/deanery before applying, as successful candidates may be allocated with an NTN with a delayed start date.
Deferral with regard to research
We recommend that you seek guidance from your LETB/deanery about deferrals for research purposes. Where training programmes are of short duration, such as in general practice, deferrals for OOP may be less likely to be agreed, and a discussion with educational supervisors before applying is recommended.


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How much notice must I give?

National minimums for notice periods are stated below but we advise that you give as much notice as possible for approval of application, as this may increase the likelihood of OOP being approved.

You must give your postgraduate dean and employer (current and/or next) a minimum of three months’ notice. If you are seeking GMC approval for your time out of programme to count towards your CCT, we advise you not to give notice until you have received this.

If you are applying for an OOPT post, you must have:

  1. Support from your LETB/deanery
  2. Endorsement from the relevant college or faculty
  3. Approval from the GMC

You must therefore prepare well in advance of leaving the training programme.4

Before you go Must do
Ideally 12 months or more before you go Inform your educational supervisor or training programme director.

Inform the final approving authority (i.e. postgraduate dean) of your intention to take time out
during following year of training. 
Ideally at least 6 months*
before you go
Submit application form
3 months
before you go

Give notice to your employer

Finalise dates and process for return

*As soon as possible or minimum 6 months before you intend to go


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How long can I be Out of Programme?

This will depend on the nature of the project or task you are undertaking. You will be asked to declare your return date in your application to your LETB/deanery. OOPT is normally for a maximum of one year. In exceptional circumstances it can be up to two years. Time out of programme for a period of research (OOPR) does not normally exceed three years, which may affect any plans for PhD studies.5 The length of other types of OOP, for example for a career break, may vary - you should discuss this with your LETB/deanery at the time of making an application.

If the nature of your OOP changes you must notify your LETB/deanery as soon as possible. They may be obliged to seek further approval from the GMC regarding contribution towards your CCT.


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Will I retain my NTN while Out of Programme?

You will retain your NTN (national training number) during your OOP, as long as you follow the agreement reached with your LETB/deanery prior to leaving your training programme.

For example, you should be weary of pursuing a course of research other than that which has been agreed, or failing to maintain frequent contact with your LETB/deanery, to ensure you retain you NTN or NTN(A). You may also be asked to provide progress updates, and evidence of ongoing achievement, particularly if a scheduled ARCP falls during a period of OOP and you should ensure you comply with these requests.

If you receive notification that your NTN has been removed, contact the BMA on 0300 123 1233 or use the enquiry form urgently to discuss your situation. In some circumstances, you may be able to appeal this with the postgraduate dean. This is a very rare situation and each case will be determined on its individual merits.

The duration of OOPC is normally limited to two years, but may be longer in exceptional circumstances which must be agreed with the postgraduate dean. If you want to take longer OOPC, you will normally need to relinquish your NTN and re-apply in open competition for re-entry to the same specialty or to a new specialty.6

You may also need to consider the effect of a career break on your ability to revalidate and maintain your licence to practise with the GMC, and should note that remaining fully registered with the GMC during your time out of programme is a condition of retaining the NTN.7


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What should I consider when returning to training?

You must ensure that your educational supervisor is aware of the anticipated date of return, in order to secure your re-entry to the training programme.

Where the duration of the OOP is longer than a year, the OOP request and annual review document should be returned on an annual basis to the LETB/deanery while you are out of programme, and at least six months’ notice must be given of the intended return date. Please note that there are some additional requirements for extending each type of OOP which are detailed on the document.

The OOP Request and Annual Review document is located in the latest version of the Gold Guide as Appendix 3.

Note that training placements depend on availability and you may have to wait for a placement upon your return. The smoothness this transition will depend largely on you maintaining good communication with your LETB/deanery throughout your time OOP, however you must be prepared to work in a location that you may not prefer upon your return. If you want to extend your OOP period you will need permission from the LETB/deanery as if it were a new period of time out, including requesting further approval from the GMC where applicable.

The relevant college or faculty must be informed of any extension to the OOP period agreed by your LETB/deanery. Be sure to communicate any differences in your placement from those outlined in your original application.

During OOPC there is no guarantee that the return date will be within six months of you indicating your wish to return to training. If there are likely to be problems accommodating your return to the programme, you should be advised about this at the outset of the OOPC.8


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What happens when I return to training?

Each trainee will have different needs when returning to work after time OOP, reflecting their experiences and circumstances. Your employer should put in place an appropriate process for your return to practice that ensures patient safety and the effective resumption of your training programme. Refer to the Academy of Medical Royal College’s ‘Return to practice guidance’ for more information.

You will be required to participate in a Return to Work package at the end of any time you spend OOPC, or if you have been OOPR with no clinical care component for longer than three months. This should include consideration of returning to clinical learning as well as to clinical practice, and may include ‘Keep in Touch’ arrangements. Regardless of the type of OOP you are undertaking, make sure you discuss returning-to-work issues with your training programme director or educational supervisor when planning your time out of programme, and also shortly before you return.


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How will taking time OOP affect my contractual benefits?*

* The BMA is currently in negotiations with NHS Employers regarding changes to continuity of service for those who take time Out of Programme. The information in this section is accurate at the time of publication, however any changes affecting contractual benefits will be reflected in this guidance before they come into effect.

If you undertake time Out of Programme for Research (OOPR) while not in possession of a national training number (NTN), you typically transfer from NHS to University employment for the duration of the research, which may be done on an honorary contract. This involves potential changes in pay, pension, maternity leave and other terms and conditions of service and it is important to be aware of these.

See our guidance on Transferring between NHS and university employment during training for more detailed information.

In order to qualify for certain contractual entitlements such as occupational maternity leave, trainees need to have both:

  • a certain length of time served
  • for that time to be unbroken

Breaks in service due to time OOP should be disregarded in respect of:

  • pay progression
  • occupational maternity/parental leave

However, these breaks will not add to your duration of service.

In other words, because your continuity of service will not be broken, the above entitlements will be protected. However the time you spend out of programme won’t be added on to your length of service (which affects the qualifying period for such entitlements), rather it will essentially pause the stopwatch to be resumed once you return.

Periods of OOP will break continuity in terms of statutory maternity pay entitlement, unless the OOP is taken with the same NHS employer. If you are going OOPR we would encourage you to seek an honorary contract with your employer, where applicable, in order to protect certain benefits relating to continuity of service, including statutory maternity pay entitlement.

It is important to note that trainees must relinquish their NTN if they take more than a two year break from training on either an OOPE or OOPC.9

You can continue contributing to your NHS pension during time OOP – see BMA guidance on your pension during an authorised absence or career break.

**Foundation doctors do not have National Training Numbers, and unfortunately will not have breaks in service disregarded as outlined above for specialty trainees.


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What if my application for time Out of Programme is refused?

If your application for time OOP is refused you should:

  1. Write to your Deanery to request written confirmation of the reasons your application for OOP was refused and written confirmation of the amendments to your application that would satisfy their criteria for an OOP request.
  2. Upon receipt of the letter from your LETB/deanery, see if you are able to amend your application to fulfil the criteria they set. If you are able to make suitable amendments, write to your LETB/deanery to explain the amendments and request approval
  3. If you have any problems, contact BMA on 0300 123 1233 or use the enquiry form

An appeal against a decision can only be made on procedural grounds. In other words, you are able to appeal an OOP decision if you believe the published procedures have not been correctly followed to reach a decision. You are not able to simply appeal the outcome itself.

Before beginning the full appeals process, trainees and deans must first jointly attempt to resolve the issues of concern through informal discussion. We would encourage you to bring a BMA representative or colleague to support you in these discussions.

If, after due consideration, the matter can be resolved without recourse to the appeals procedure, then this agreement should be confirmed in writing by all parties.

Your current employer or any future employer is not able to prohibit you from taking time OOP, as long as it has been approved by the LETB/deanery (and the relevant college or faculty, and the GMC if it is to count towards your CCT). You must notify your employer only to give notice so that they can ensure that the needs of patients are appropriately addressed, not to seek permission.


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I am on a visa - does this affect whether or not I can participate in OOP?

If you are subject to the immigration rules you will need to consider your visa status when planning any time out of programme. For example if you are on a Tier 2 visa, which is your permission to stay in the UK, the visa is attached to your job.

Please contact the BMA Immigration Advice Service for detailed information on how your visa status might impact on time out of programme. The service is available to all members.

Check the Immigration section FAQ's


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OOP Top Tips

Trainees who have taken time out of programme have offered the following top tips:

  • Plan ahead! Start thinking about what you want to do at least 9-12 months in advance and ask for your LETB/deanery rules./li>
  • Let your LETB/deanery know plans promptly. Be aware of early cut-off dates for obtaining approval and the more notice you can give your training college and LETB, the better.
  • Do as much preparation work as possible before starting your time OOP (e.g. start organising ethical approvals if you are going to do research).
  • If you are travelling abroad, sort out your visa early on, as there is a lot of paperwork to get through and it can take a good deal of time to organise.
  • Think carefully about what you personally want to achieve during your time OOP and set realistic, clear goals which you should review carefully. Also consider how what you learn can benefit your department when you return. These are important parts of justifying your application.
  • If taking time OOP in a non-clinical post, do some locum work and try to choose something you are passionate about, not necessarily within your specialty. Also, be diverse in taking up opportunities while doing OOPE - try everything once to expand your horizons.
  • Be as discerning as possible about research supervisors and projects.
  • Try to look for a banded OOPE (most of them are not) to increase your pay. Banded posts are usually related to your speciality.
  • Keep your e-portfolio subscription to maintain access to it while not in training.
  • Look for personal contacts: speak to your consultants and colleagues, and see if any of their experiences OOP could lead to an introduction.
  • Make contact with the consultants in the department you're going to be working in - ideally face-to-face.
  • Think hard about the training you've had so far in the NHS and what skills and knowledge you're able to bring to your time OOP.
  • If going abroad, get a PAYG SIM card with plenty of data when you first arrive in the country as many administrative forms will require a phone number.
  • Organising accommodation abroad can be a challenge. Enquire about temporary accommodation until you’re able to secure a more permanent arrangement.
  • Make sure you remain fully registered and retain a licence to practice with the GMC, as it can be time-consuming to regain your licence.


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1. Refer to the Orange Guide if you began your training prior to August 2007. Please note that the Orange Book will no longer be valid for all trainees from 2016.

2. http://specialtytraining.hee.nhs.uk/files/2013/10/A-Reference-Guide-for-Postgraduate-Specialty-Training-in-the-UK.pdf p.43

3. http://specialtytraining.hee.nhs.uk/files/2013/10/A-Reference-Guide-for-Postgraduate-Specialty-Training-in-the-UK.pdf p.47

4. http://www.gmc-uk.org/doctors/seeking_approval.asp

5. http://www.gmc-uk.org/doctors/approval_out_of_programme_post.asp

6. http://specialtytraining.hee.nhs.uk/files/2013/10/A-Reference-Guide-for-Postgraduate-Specialty-Training-in-the-UK.pdf p.47

7. http://specialtytraining.hee.nhs.uk/files/2013/10/A-Reference-Guide-for-Postgraduate-Specialty-Training-in-the-UK.pdf p.48

8. http://specialtytraining.hee.nhs.uk/files/2013/10/A-Reference-Guide-for-Postgraduate-Specialty-Training-in-the-UK.pdf p.47

9. http://www.rcpch.ac.uk/training-examinations-professional-development/general-trainee-support-centre/out-programme-oop/out


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