The Foundation Application...
Well, after very kindly being asked by Tom to start a blog on almostadoctor.com, I was struggling to think what I could write about. After some thought I decided I might as well just write a little bit about something which all final year med students across the country, myself included, are currently dealing with; foundation programme applications. Next Monday (the 11th October) the application form comes online and we are given a little less than 2 weeks to complete the 6 ‘white space’ questions. Whilst there are changes to this process on the horizon, I thought it might be useful for some of the younger students to briefly mention a few of the keys parts of the application and hopefully get other tips from fellow final year students. I know that I personally didn’t really think about the application form itself until towards the end of year 4 and whilst I feel relatively well prepared for it (kind of), I think there are areas of the application which I would have liked to start thinking about a little earlier.
In case you don’t know very much about it the foundation programme application is a national form which must be completed by all students who wish to obtain a place on the UK Foundation Programme. Applicants are allocated to their Foundation School (a UK region e.g. the North West) based on a combination of their preference order and their score from the application. Basically, the higher your score the more likely you are to get your first choice of foundation school, and subsequently your first choice hospital and track.
The form itself is a potential total of 100 points. 40 marks are purely for your academic ranking (40 – top quartile, 38 – second quartile, 36 ….), with the remaining 60 marks depending on your answers to the 6 questions, a maximum of 10 points for each. In fairness only 5 of these are the so called ‘white-space’ questions I mentioned earlier. The first question is 10 marks which can be obtained by listing your own additional qualifications or achievements. In this section it is having an extra degree, any publications to your name and/or national prizes and presentations which combine together to make the 10 points. Actually reaching the full 10 points to me seems a near impossibility as you basically need a prior Phd and an extensive back-catalogue of prizes, presentations and publications. As a result I wouldn’t worry about this area too much, though getting the few bonus points for having one of these achievements could be crucial if it’s a highly competitive school you’re going for. And to be honest if you can get them you might as well.
The core of the application is therefore the 5 genuine ‘white space questions’. Here you are expected to demonstrate your suitability to the role by answering the multipart questions 200 words. Whilst a part of answering these questions is almost certainly exam technique, the areas it is trying to explore are more fundamental than this. The GMC, our regulatory body, has quite clearly published its expectations of us as future clinicians. Whilst it never seemed particularly relevant in the early years of medical school, ‘Good Medical Practice’ is the cornerstone of what is expected of us as doctors. This is in turn reflected in the foundation application’s ‘Person specification’ and hence is again reflected in the way the application questions are marked. I think this is what I would consider to be the most important point of this blog.
To me the main focus of this blog was to try and give some of you 3rd and 4th year students some advice on this application in advance and also on the importance of your portfolios (yes I said it). It took me a while to get to grips with the purpose of portfolio and even when I first did I seemed to use it more as a tool for purely academic development. I think it is with this application process that the importance of the other areas, which initially seemed more peripheral, becomes clear. To highlight this an example of a past white space question was to describe your own personal experience of a disagreement in clinical management. Within this question they want to know about more than the facts of the encounter, they want to know about your understanding of ‘Good medical practice’ in relation a situation such as this. There is a wealth of different areas which could be relevant to this question: working in teams, respect for colleagues, relationship with patients, good communication and more. These are not areas which first come to mind when I do anything portfolio-based and yet it constituted 10 points on a previous application and has been clearly described as an important area for us to be aware of by the GMC. When I first saw this question I was able to think of an example of such an incident which I had witnessed and yet had not written anything about it in my portfolio, with no reflection upon those different areas. If I had I do feel I could have answered the question easier than I did.
Anyway, I have talked quite a lot about this now so should probably wrap it up. I think the summary I want to make is based around using your portfolio well during your clinical years (I know I keep saying it, sorry). I feel that if you do understand the separate areas of medicine, other that the academic component, which are highlighted by ‘Good medical care’ then you can easily reflect on many of the situations that occur in daily clinical practice. Once you have thought about these different components, and reflected on your own experiences of them, the foundation application shouldn’t be quite as bad.
I know that there are already proposed changes to the application process in the future and as a result much of what I have described won’t be accurate before too long, but despite this I think the main points will still be valid for a few more years yet. Employers want to know that there is more to you that the ability to pass examinations and want to know that you are aware of the other aspects of being a competent clinician. It is the GMC’s ‘Good Medical Practice’ which these aspects are based upon.
These are all just my own personal thoughts which I have put together throughout the course of preparing for this application process so I hope that some other final year students might add there own thoughts or tips. There is loads more information on the whole process at the foundation programme website itself (www.foundationprogramme.nhs.uk) and if you haven’t already make sure you do have at least a quick scan of ‘Good medical Practice’. I hope that was at least a tiny bit useful and please feel free to comment about anything.
Thanks for reading