Out Of Programme – OOP

Out of Programme (OOP) relates to trainees that wish to participate in an experience that is out of their planned programme of training.  There are a number of circumstances that trainees may wish to spend time out of programme; to gain training or clinical experience, to undertake research or to take a career break.

Time out of programme will not normally be agreed until a trainee has been in a training programme for at least a year and only one year in total can be taken during the ST years 5, 6 and 7. The trainee should return to the UK for the last six months of the CCT training programme. An OOP will not normally be allowed in the last 6 months of training other than in exceptional circumstances.

Before applying for OOP, trainees must discuss their plans with their Educational Supervisor and Training Programme Director.  This discussion will determine the suitability of the out of programme experience and ensures the proposed post will meet the educational needs of the trainee.

Health Education West Midlands requires OOP Application Forms and supporting documentation to be submitted at least 6 months in advance of the proposed OOP start date. Please note that applications that do not meet the minimum 6 month timescale will be rejected and Trainees will not be supported to go on an OOP. It is the Trainee’s responsibility to ensure all relevant information as stipulated in the guidance document is submitted on time. The guidance document is available via the HEE(WM) OOP link.

Experience such as Mercy Ships, mountain medicine or work for organisations such as Médecine Sans Frontières can be applied for as a stand alone OOPE.


There are parallel processes at the Royal College and the Deanery that need to be followed in order to have an OOP approved.

OOPC – Career Break

RCOA – Inform the training department. No Application necessary
HEE-WM – Application Required

OOPE – Experience

RCOA – Inform the training department. No Application necessary
HEE-WM – Application Required

OOPR – Reasearch

RCOA – Application Required
HEE-WM – Application Required

OOPT – Training

RCOA – Application Required
HEE-WM – Application Required


HEE(WM) – OOP
RCoA – OOP


Out Of Programme Secondments

OOPT application forms are only required when the post is in a location not listed on the GMC website as Approved for Training.

GMC List of Approved Locations for Training (updated fortnightly.)

If a trainee wishes to go outside of the local training programme to an approved location then this would be considered a secondment rather than an OOPT.

The RCoA requires a Secondment Notification Form to be completed. HEE(WM) still require College approval for this secondment. As a result, approval has been delegated to the local College representative – the Regional Advisor. There is a space on the document for the Regional Advisor to sign to say that the post has been discussed with them and that they agree that the post forms part of a balanced training programme.

For all secondments could you please send Secondment Notification Forms to training@rcoa.ac.uk alongside a copy of a job description so that there is a record of approval, as well as for data collection purposes.

HEE(WM) may still require a deanery OOP form to be completed as they don’t have an equivalent form for secondments.


Notification of Secondment Form


Within HEE(WM) Secondments

If part of your training requires you to spend time in either the Birmingham or Warwickshire Schools of Anaesthesia, then this is considered within the training programme and so there is no requirement for any paperwork.


Anaesthetic Fellowships Worldwide

If you are interested in an Anaesthetic Fellowship either as an OOP or a post CCT fellowship somewhere else in the world then there is a fantastic resource available to you. It is continually evolving and updating so take a look.

Anaesthetic Fellowships