Junior doctor Applying for training

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Approved practice settings restrictions

All UK and International Medical Graduate (IMG) doctors who are newly fully registered, or recently restored to the register, are subject to approved practice setting (APS) restrictions, until they are automatically lifted after their first revalidation.

The APS scheme is intended to ensure that new doctors work only in organisations where medical practice is of high quality, safe, well governed and supportive of training and continued professional development.

When it was first introduced, the APS scheme required all new UK and IMG doctors to practice only in an organisation that held an APS designation.

As of 30 April 2014, doctors subject to the APS restriction are allowed to practice using the legal privileges of a doctor in any organisation and at any event in the UK so long as the doctor has “a connection to a designated body.”


Am I APS connected?

As a doctor in training you are APS connected, as your postgraduate dean or educational supervisor will act as the ‘designated body’ to which you are attached.

If you are practising in an approved and/or managed training programme, you are generally considered to be practising in an approved practice setting.

If you were registered as a doctor before 2 June 2014 and do not hold a connection to a designated body, you are allowed to continue to practice in your current APS until you revalidate for the first time.


How do the APS restrictions apply to you?

If you are APS connected, you are able to:

  • Carry out category 2 work whilst employed by a local authority, as a trainee in public health.
  • Carry out assessments under the Mental Health Act, as a trainee in psychiatry
  • Volunteer to provide medical assistance at festivals or charity events, providing your educational supervisor is aware of this arrangement and you comply with the appropriate reporting requirements
  • In accordance with the APS connection, however, all such activities require reporting to the postgraduate dean on the enhanced form R completed for each ARCP.


Locum Work

If you are APS connected, you are able to:

  • Work a locum shift as a GP trainee in a surgery other than your own
  • Fill a locum shift in a hospital in which you do not usually work
  • Fill a locum post with a private healthcare provider

You must ensure your educational supervisor approves of the locum work arrangements, and you must also meticulously record all such activities on your enhanced form R, completed before each ARCP.

If you are an IMG doctor carrying out locum work through an agency, you can only practice in an APS designated workplace. It's important to note that locum agencies and most primary care settings do not hold APS status themselves.


Working abroad

When practising outside of the UK as a doctor in training, you must notify the country’s regulatory body and meet the terms of the country’s licencing and practice requirements.

Additionally you must:

  • Comply with the reporting arrangements set by your Responsible Officer or training body (if applicable).
  • Continue to comply with UK revalidation while abroad, if you continue to hold a licence to practice from the GMC.
  • Comply with Good Medical Practice, as detailed by the GMC.
    Paragraph 11 of the guide states:
    “In an emergency, wherever it arises, you must offer assistance, taking account of your own safety, your competence, and the availability of other options for care”. You should make an assessment and provide medical help and advice within your competency.

You can also check if your circumstances mean you are complying with APS restrictions, check the GMC guidance.

As a BMA member, you can also get personal advice and guidance on this issue - contact us through email or telephone 0300 123 1233.