Please be aware that in this fast-moving situation, this content will be under constant review and added to as the situation evolves.
As part of action responding to the outbreak of Coronavirus, some medical schools and trusts/boards have offered medical students the opportunity to take on contracts of employment in the NHS.
We understand that, given the challenges the NHS is facing, many students will wish to support their medical colleagues.
Please also see our guidance on early registration for final year medical students.
If you have read the below and still require support, please email us at [email protected].
Final year students
Final year medical students who have been approved by their medical schools for early graduation will be allowed to apply for early provisional registration and become junior doctors.
It is likely that you will be offered a FY1 locum appointments for training (LAT) post at either a trust/board near your medical school or near where you are due to start your foundation programme. These roles will be referred to as FiY1 (foundation interim year 1) roles.
Please send your FiY1 contract through to the contract checking service.
For those taking up FiY1 positions in Northern Ireland health and social care trusts, we’ve recorded an updated audio version of our 'Preparation for Practice' presentation that was delivered to final year students from Queen’s University Belfast recently.
Final year medical students in Wales who do not agree to early provisional registration will be offered a ‘medical student assistant’ role. This role is on agenda for change terms as roles available to students from other years; however, it is paid at a higher rate.
We have secured a commitment that final year medical students who agree to early GMC provisional registration will be automatically moved on to the model junior doctor contract.
A guide to your contract
To support you in your new role, we’ve recorded a webinar to help guide you through everything you need to know about your contract, and how we can support you throughout the transition.
Watch the video, and if you do have an questions email our team of advisers on [email protected] who will be happy to help you.
For existing members and new joiners, we are waiving the remainder of membership subscriptions for 2019-20. Pay nothing until 1 October 2020 and access all the benefits of FY1 membership.
Students from other years
The below guidance concerns students who are taking up roles within the NHS which do not require provisional registration, and are employed under agenda for change T&Cs. These roles are likely to be:
- healthcare assistants
It is essential that you have the following:
- an offer letter from your employer
- a contract of employment
- a role profile for the job you will be undertaking - due to being without provisional registration, it is crucial that you do not act outside of the specified duties of your role
- the level of pay for the role and the relevant band within AfC (agenda for change)
- your hours of work
- certain contractual benefits (see below)
- in Scotland, you will also need a letter of assurance from your university stating that this role will not adversely affect your medical education
- in Wales, you will also need an appointment letter (see below), as well as the job description and contract of employment.
Before signing your employment contract, you should contact our contract checking service. This service will review your contract and point out any areas of concern/variation. If the contract checking service do identify areas of concern, then your case will be referred to a local employment advisor.
Unlike the national junior doctor contract, AfC contracts may be subject to local variation across employers.
In Scotland, if you wish to express an interest in such a role you can do so via NES’s COVID-19 accelerated recruitment portal.
In Wales, we have secured agreement with the Welsh Government that all medical students undertaking these roles should be offered the same model contract across the country on AfC terms with extra protections.
These will be detailed in the appointment letter that you should be provided alongside your contract of employment. The appointment letter should set out that:
- your notice period is 2 days
- your hours of work will be in line with the job description and can only be varied by mutual agreement with your employer and so long as there is sufficient supervision in place
- you will receive 30 minutes uninterrupted break every 6 hours plus natural breaks
- you will be automatically enrolled into the NHS pension scheme and receive corresponding benefits such as death in service
- you will be indemnified via the Welsh Risk Pool (although you should still take out necessary insurance)
- work undertaken under the contract will count towards continuous statutory and NHS service.
Things to look out for when initially reviewing your position
A contract can be made up of more than one document but must include at least:
- the trust’s or board's name
- your name, job title or a description of work
- your start date
- if a previous job counts towards a period of continuous employment, the date the period started – it is unlikely that this would be applicable unless you have worked in the NHS previously
- how much and how often you will get paid
- whether you will be enrolled in the NHS pension scheme, and consequently have access to death in service benefits
- your hours of work (and if you will have to work Sundays, nights or overtime)
- holiday entitlement (and if that includes public holidays) - this must be the statutory minimum of 28 days (including public holidays)
- where you will be working and if you are required to work at a different site
- how long a temporary job is expected to last (although that might be extended given the current situation)
- the end date of a fixed-term contract
- what notice is required
- details of any collective agreements
- pension position
- who to go to with a grievance
- how to complain about how a grievance is handled
- how to complain about a disciplinary or dismissal decision.
What a written statement does not need to include
The written statement doesn’t need to cover the following (but these will be available on your employer’s intranet):
- sick pay and procedures
- disciplinary and dismissal procedures
- grievance procedures
- maternity and paternity leave.
It is important to establish from the beginning the scope of your employment, the duties you will be required to undertake and having certainty about who is responsible for your supervision.
Consider what training is to be provided and whether you feel competent to perform the duties. You should ensure that none of your duties require you to act outside of your current level of competency.
As students do not hold any form of registration with the GMC, you should never be asked to perform a duty which should be the responsibility of a doctor.
The student and employer must comply with the regulatory limits set out in the working time regulations.
You will not be required to arrange or fund your own clinical negligence indemnity cover.
Any clinical negligence claims will automatically be covered by the NHS via national schemes.
Medical graduates with provisional GMC registration are strongly advised to arrange their own professional indemnity cover with a medical defence organisation.
Medical students supporting the NHS in non-doctor roles are advised to hold medical student membership of a medical defence organisation, and to discuss with them what, if any, additional professional cover is necessary.
Concerns regarding the FY0/pre-FY1 roles
Some medical schools and trusts/boards have asked their final year students to ‘step up’ and work in the local hospitals in a ‘FY0’ or ‘pre-FY1’-like role.
This is not an existing role and the BMA does not support this being locally negotiated. We have significant concerns that these contracts are inappropriate and offer little clarity on the competency expected of medical students and the remuneration offered. This may have the inadvertent consequence of students working unsafely or not taking on these roles with adequate information being provided. If you do encounter issues, the BMA is still here to offer advice and support where possible.
To be clear, we are not against students undertaking work or assisting in this climate. However, it is our responsibility to ensure students are protected when taking on these duties.
While some students will be offered formal contracts of employment, others will be offered the opportunity to volunteer to support their colleagues in non-paid roles.
We believe that any students asked to undertake a role in the NHS should make the decision to undertake this work voluntarily. Under no circumstances should this be imposed, nor should you feel obligated or pressured to serve in order to meet medical school curricula.
- not be asked to work beyond your competencies
- be adequately supervised where necessary
- be provided with adequate personal protective equipment and full instruction in its use.
We would recommend that students are informed that they can withdraw from these roles at any point to take up paid employment.
If you are already working
Students may have agreed to volunteer already, or have agreed to work under a specific set of terms and conditions.
Where this has been agreed, the BMA will continue to provide support and advice, and give you support to withdraw from that agreement if you wish.
If you are concerned about your contract offered, please do send it through to us and we may be able to offer advice.
Any role offered to students during the COVID-19 response effort, whether voluntary or remunerated, must be clear that it is term-limited and offered only for the duration of supporting responses to the crisis.
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