Foundation Programme Application Guide

Final year is notoriously busy and can be immensely stressful. There are a lot of impressions about what the process involves, but I hope this article will help you have a clearer idea of the process and put you at ease. The whole process is not too complicated, but it can seem daunting for someone unfamiliar with the system. The UK Foundation Programme Office (UKFPO) has kindly made resources available on their website to help with the process, and I will be regularly referring to it.

What will we cover?


Depending on your medical school, you will spend between 4 to 6 years studying to be a doctor. In your final year, you need to apply for your foundation job. Your foundation years are the first two years you spend after completing medical school, and the successful completion of foundation year 1 (FY1) enables you to hold a full license to practise medicine in the UK.

I will be writing from my own experiences as a final year medical student at Bart’s. There is a difference in the application process if you graduated from an overseas medical school and potentially a difference in the process from other UK medical schools. Also, if you happen to read this in future years (i.e. not for 2022 entry), then the deadlines will be different!

Step 0 – make sure you’re eligible!

Certain medical students need to take note of some earlier deadlines. If any of the following apply to you, you must submit an eligibility application before the main foundation programme window.

  1. You are studying at or have graduated from a non-UK medical school
  2. Have graduated from a UK medical school on or prior to 3rd August 2020
  3. Are a non-UK/settled worker studying for a UK medical degree at a campus outside of the UK

An Eligibility Applicant Guidance document is available on the UKFPO website, which should take you through the process and answer the most common questions people have. This year, the window to send off your eligibility application was between 14th July and 4th August, so you need to prepare weeks before this window!

Step 1 – prep work

It might also be helpful to streamline the process if you gather together all the information you need. Here are some helpful things you might want to do in advance of the window opening:

  • Registering for an Oriel account and navigating the platform (see step 2)
  • Download and read the UKFPO applicants handbook
  • Collect all your evidence for publications and additional degrees
  • Ask your academic referee for permission before nominating them on your application

Step 2 – registering for an Oriel account

For those of us studying medicine in the UK, the first step is relatively passive, but it’s important to clear any confusion. To apply for foundation jobs and subsequent speciality posts, you need an Oriel account; the system used to apply for postgraduate jobs. You need to register an account with your university email address; however, first, the university nominates you. For Bart’s students, this happened in mid-August and we received an email from Oriel stating that our medical school nominated us. There is a link on the email which takes us to the Oriel website and the rest is self-explanatory, filling out your account details. You want to do this as soon as you can before the main application window opens.

Step 3 – submit your foundation year application.

There is a two-week window by which you need to submit your foundation year applications on Oriel. This year, it was between the 8th – 22nd September. 

Thankfully, there is only one application system, so it doesn’t get more complicated if you apply for multiple programmes. You need to fill in some important details such as your name and address. Then you need to say which programme(s) you are applying for. Here, you will have the option of applying for other programmes such as specialised foundation programme (SFP, used to be called AFP), foundation priority programme (FPP), psychiatry foundation fellowship (PFF), etc.

In the initial 2-week window, you only need to submit your preferences to foundation schools (the geographical region where you will spend your foundation years) and enter your educational achievements such as publications and additional degrees, amongst other minor things. You can also request special arrangements for the Situational Judgement Test (SJT) if you require it. Then submit your application! You can change your preferences until later on in the academic year if you have a change of heart but don’t be caught out by the deadline!

During this 2-week window, if you need to be in a specific location for your foundation year jobs, you can apply for pre-allocation (previously called “special circumstances”). If this is you, then it’s important to have sufficient and robust evidence to back up your claim that you need to be in a certain location. Here are the different criteria that the UKFPO will accept.

  • Parental/guardian responsibilities
  • Primary and significant caring responsibilities
  • Medical condition
  • Unique circumstances
  • Educational circumstances
  • Widening participation

Step 4 – wait to be allocated your foundation school and rank jobs

Some time around March, you will be informed which foundation school you are allocated to. When this happens, it’s time to rank your jobs. Each foundation school has an assortment of hospitals and rotations, and this can be a very time-consuming job as there can be hundreds of jobs to rank. This is where you’ll be able to rank the jobs in order of preference but it is far from a guarantee of getting the job.

The way the UKFPO allocates jobs is using FPAS. This is a scoring system where individual candidates get up to 100 points depending on their performance in medical school (Educational Performance Measure, EPM) and the Situation Judgement Test (although this is prone to change). Up to 50 points can be achieved according to EPM and 50 points for the Situational Judgement Test. Those who score higher in FPAS will have their top preferences given, and then the jobs work down according to merit.

Final Words

After you accept the job, you wait until the start of your foundation job, which is classically on the first week of August. This is what you have been working towards during your time at medical school. Congratulations on becoming a doctor!

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