Application process:

  1. Submission of the OOP application form
  2. Written support from: your educational supervisor, your programme director (GPE) and your patch Associate Dean.
  3. Current CV.
  4. A clear statement as to how this proposed OOP will:
  • benefit the candidate’s career progression in General Practice
  • benefit General Practice in the NHS
  • benefit the health of the country of the placement
  • need to be taken at this particular time – a window of opportunity

Please send your completed application by email to your local Programme Manager. 


  • OOP applications will be considered competitively by a school panel, through a standard application managed by the GP Recruitment and Selection Manager. There will be selection criteria against which each application can be considered including: 1.) benefit to the candidate’s career progression in General Practice 2.) benefit to General Practice in the NHS 3.) benefit to the health of the country of the placement 4.) the capacity of the PCS to accommodate the OOP will necessarily restrict the number of available places in each programme. The panel will include senior educationalists from the Primary Care School and the Deanery with trainee & lay representation. (This could be the same panel as considers intra deanery transfers).
  • The decision of this panel will be final.
  • For OOPE, priority will always be given to: 
    • Trainees seeking a placement with AHP in South Africa.  Then
    • Trainees who have arranged their own placement in a developing country. Then
    • Those who wish to spend time working in the UK or another developed country.
  • For OOPC, priority will be given those with a significant caring responsibility that cannot be addressed through less than full time training.
  • No salary from the School of Primary care will be available and the trainee will no longer be an NHS employee during the period out of training.  It is important to recognise that this will affect both maternity, pension and sickness benefits during OOP as detailed below.  Placements with AHP will normally attract a salary and other benefits from the South African Government.
  • Trainees must remain GMC registered with a current licence to practise while on OOP. This is a School policy, and a requirement in the Gold Guide (section 6.25). Voluntary erasure from the register would compromise a trainee’s right to a CCT.
  • That the school allows a maximum of five additional trainees per year (i.e. as well as those already appointed to 4 year OOPE rotations) to take time OOP. They will be spread across the five programmes as equitably as possible.
  • The placement will normally be for one calendar year between ST2 and ST3, with applications being considered during ST1, or exceptionally in ST2.


Time taken OOP is defined in the Gold Guide sections 6. It is important to recognise that it is not a “right”, and that agreement depends on the practicalities of releasing a trainee from their rotation.

Time OOP can in theory address trainees’ needs in 4 ways:

  • OOP training (OOPT) in which non-programme experience counts towards the award of a CCT – Not generally applicable to general practice
  • OOP experience (OOPE) in which a trainee gains valuable experience, but still needs in addition to complete a full 3 years of GPST
  • OOP research (OOPR) for research – usually towards a higher degree.
  • OOP career break (OOPC) to spend time pursuing other interests or to meet (for example) a health or caring need.


Severn primary care school supports time taken OOP – particularly those consistent with the recommendations of the Crisp report: Global health partnerships: the UK contribution to health in developing countries (2007) that recommends that:

"An NHS framework for international development should explicitly recognise the value of overseas experience and training for UK health workers and encourage educators, employers and regulators to make it easier to gain this experience and training.   PMETB should work with the Department of Health, Royal Colleges, medical schools and others to facilitate overseas training and work experience”

The policy of the school is that OOPE taken overseas should be focused mainly on the developing world. If the OOPE time is to be split between the developing and the developed world then at least half of that time should be spent in a low resource country.

The school offers support for attendance on a 3 day overseas medicine course in Cheltenham.

The School runs a facilitated OOPE half day with an experienced GPE who has extensive experience of working overseas in August each year. This allows an opportunity for the recently returned OOPEs to give a presentation of what they have done. It is an opportunity also for those who are about to go or are in the early days of planning to ask questions and gather useful information. It is also a time when some debriefing of the newly returned OOPEs can take place.

Possible objectives for OOPEs in developing countries

It is strongly recommended that trainees identify the professional or personal goals of the proposed OOPE and ensure these are clearly expressed in the OOP application form or covering letter. For OOPE in developing countries, specific objectives may include:

  • enhancing the trainee’s clinical experience outside that provided by the training programme, such as higher patient loads, perform more procedures, or work more independently than usual
  • experience of practising cost-effective medicine in resource-poor settings
  • experience of working in a small medical centre
  • experience of setting up/developing a particular service
  • experience of leading or being part of leading a service
  • working in a mobile unit (e.g. cataract operations or flying doctors)
  • promotion of health and disease prevention (e.g. family planning, vaccinations, malaria prevention)
  • experience of working with medicines/procedures not used in NHS
  • experience of patient care for illnesses uncommon in the UK (e.g. malaria, HIV/AIDS TB)
  • experience of working with medicines/procedures not used in NHS
  • treating patients from different socio-economic or cultural backgrounds
  • experience that contributes to wider career goals, such as global health or development

Out of Programme Pause (OOPP)

Updated information on Out of Programme Pause (OOPP).

There is also a YouTube video to describe OOPP.