Out of Programme

For a variety of reasons trainees may wish to spend some time outside of their training programme. Such requests are considered by the deanery whose agreement is required. Trainees undertaking OOPs retain their NTNs.

Out of Programme falls into four categories:

  • Out Of Programme for Training (OOPT)
  • Out Of Programme for Experience (OOPE)
  • Out of Programme for Research (OOPR)
  • Out of Programme for Career break (OOPC)

NB: Sub-specialty training in Paediatric or Pre-Hospital Emergency Medicine does not need an OOPT. Trainees who have been selected to a sub-specialty post will, however, need to inform the College's training department in order to have their completion of training date amended.

The College has produced guidance for trainees who want to go Out Of Programme and a flowchart explaining the process.

Trainees who undertake OOPTs and OOPEs should provide the College with a brief report to this template: OOP Report template.

A statement from the Training Standards Committee on Chief Registrar posts is now available to read.

Opportunities for going Out of Programme

Ask your Head of School for Emergency Medicine for local information. Opportunities might include medical education, geriatrics, sports medicine, leadership training and informal research opportunities.


Trainees may undergo clinical training, whether in the UK or overseas, out of programme which can count towards training in their EM programme. All OOPTs need to be prospectively approved by the College (please use this form for College approval) and then by the GMC.

NB: The GMC have stated that they do not need to give prior approval to Acting Consultant posts provided the management part of the curriculum will be covered during the post.


Trainees may wish to undertake time out of programme to enhance their clinical experience but which will not contribute towards their CCT. Reasons for requesting an OOPE include:

  • To experience different working practices or another area of practise
  • To experience and support overseas work and training, particularly in developing countries
  • To gain experience as a locum consultant which will not contribute to CCT

A deanery form containing start/finish dates will need to be completed which must be signed by the Postgraduate Dean. NB: It is important that the College is sent a copy of this form as the trainee’s expected completion of training date will need to be extended.


Trainees may wish to undertake a period of research. An OOPR will not normally exceed three years. The clinical element of an OOPR may be recognised towards training; TSC recommendations for counting clinical time for EM trainees on OOPR (including higher degree/research fellows) can be found here. The expected completion of training date will be amended by the College as appropriate.


OOPCs allow a trainee to step out of a training programme for a designated and agreed period of time:

  • For domestic responsibilities
  • To work in industry
  • To pursue other interests such as law or sport
  • Ill health

The agreement of the Postgraduate Dean is required who will give priority to requests involving:

  • Ill health
  • Caring responsibilities for family members which cannot be accommodated through flexible training options
  • Childcare responsibilities which cannot be accommodated through flexible training options
  • Those with a clearly defined life goal which cannot be deferred

Trainees need to consider how a career break might affect their licence to practise with the GMC.

Trainees who take a career break of more than two years will normally need to relinquish their NTN and re-apply in open competition.

For all OOPs

In normal circumstances OOPs will not be approved in CT1 and CT2, and not until after a year of starting training. OOPTs will normally be supported only if the trainee has an NTN.

Important factors that deaneries consider when deciding whether to grant requests are:

  • Ability to fill resulting gaps in interest of patient care
  • Capacity to accommodate return

Further Information about OOPs can be found in the Gold Guide.