There are six main types of time taken out of programme:

Out of Programme Training (OOPT): undertaking clinical training which is not a part of the trainee’s current specialty training programme. OOPT will count towards the trainee’s CCT date for up to 12 months of the agreed period.

Out of Programme Research (OOPR): undertaking a period of research, e.g. clinical trials. The trainee cannot take more than 3 years out of programme for research unless in highly exceptional circumstances (subject to approval by the Head of School and HEE). OOPR can` count towards the trainee’s CCT date for up to 12 months of the agreed period.

Out of Programme Experience (OOPE): gaining clinical experience which is not approved by the GMC, but which may benefit the trainee, e.g. volunteering overseas in a medical capacity. This does not count towards the trainee’s CCT date.

Out of Programme Career Break (OOPC): planned career break related to personal circumstances or other requirements. This does not count towards the trainee’s CCT date.

Out of Programme Pause (OOPP): Out of Program Pause is a new opportunity where trainees can step off training to undertake NHS work or similar patient facing work in the UK. They can potentially accrue skills and capabilities which will count towards their training. OOP(P) has been piloted in other regions and, because of the pandemic, is being rolled out nationally.

Acting up as a Consultant (AUC): temporarily taking on consultant duties in the trainee’s current speciality (subject to confirmation that this is permitted within their curriculum). This counts towards the trainee’s CCT date.



If a trainee wishes to take time out of programme, they should first discuss with their Training Programme Director and Educational Supervisor as early as possible. All time out of programme must be approved by Health Education England, and in some cases, the Royal College / JRCPTB / JCST and GMC. Please refer to the guidance on page 1 of the application form, and the FAQ section below.

The assessment of the CiPs and GPCs (high-level outcomes of the curriculum) involves a global professional judgement of a range of different skills and behaviours to make decisions about a learner’s suitability to take on particular responsibilities or tasks that are essential to consultant practice at the standard of certification. The MCR assessment must be carried out by the consultant CSs involved with a trainee, with the AES contributing as necessary to some domains

Referrals to the The Professional Support and Well-being Service (PSW) would normally be made by either the clinical or educational supervisor, Training Programme Director (TPD) or Head of School (HoS).

If your course is listed on this link and you are requesting less than £600 you will need to complete the local study leave form only. (Please ensure this form has been agreed with your rota co-ordinator and is signed by your educational supervisor). These must be submitted a minimum of six weeks in advance of the course being requested.



All courses not listed with in the Curriculum requirements, and all applications in excess of £600.00 are classed as ‘Aspirational Activity’ and require TPD approval for funding. Complete the HEE form (downloadable from the link below) and submit to your TPD for approval.

To ensure all trainees are clinically confident and fully supported when returning to training following a sustained period of absence, HEE EoE is committed to offering a number of mechanisms in order to support the return to clinical practice:

Individualised SuppoRTT plan
Access to ring fenced places on pre-existing specialty specific courses and regional teaching days
Period of enhanced shadowing 2 weeks prior to the trainee’s return date
Return to Clinical Practice Days
Wellbeing courses
Additional funding for bespoke training may be available
A contribution towards childcare costs when attending shared parental leave in touch (SPLIT) days & keeping in touch (KIT) days may be available
PSI Resilience Questionnaire and Feedback

The purpose of the T&O curriculum is to produce, at certification, competent doctors, able to deliver excellent outcomes for patients as consultant surgeons in the UK. The curriculum will provide consultant T&O surgeons able to manage patients presenting with the full range of emergency T&O conditions and elective orthopaedic conditions in the generality of the specialty. Trainees will also be expected to develop a special interest within T&O in keeping with service requirements.

Settle in as you are welcomed to the EoEOrtho family. There's plenty of opportunities in this diverse community. Please refer to https://heeoe.hee.nhs.uk for everything deanery related.

The Annual Review of Competence Progression (ARCP) looks at your progression through your year of training. For October starts, generally your ARCP should be around August time. For ST3s, you will have a mid-point ARCP. For February/April starters, you should have an August mid-point ARCP. Please contact Amy.britain@hee.nhs.uk The Principle purpose of the ARCP is to assess whether you are making satisfactory progress. It is also an opportunity to review previous training, identify and correct any deficiencies, agree a plan for future training and receive feedback from you on the quality of your training posts.


Please see the ARCP guidance in the Gold Guide and COVID outcomes on COPMed website: https://www.copmed.org.uk/gold-guide-8th-edition/

Information for trainees in response to COVID pandemic: https://www.hee.nhs.uk/coronavirus-information-trainees

**This webpage is no longer being updated. Trainees and trainers should refer to the current curriculum for the latest information. From August 2021, there will be new curricula. Further information is available on the ISCP website.**

Each of the SACs has produced a set of certification guidelines to identify what a trainee will normally be expected to have achieved during their training programme. The guidelines cover such aspects of training as: clinical and operative experience; operative competency; research; quality improvement; and management and leadership. The guidelines can be accessed via the links below.

Trainees and trainers should use the guidelines to inform decisions about the experiences trainees need to gain during their training programme. Trainees will be monitored throughout their training to ensure they are receiving appropriate exposure to all aspects of training and some of the SACs have set benchmarking guidelines for use at ST4 and ST6 ARCPs. These will help to ensure that any necessary remedial action can be taken in a timely manner so that trainees can meet the overall guidelines by the time of their certification.

A Reference Guide for Specialty Training in the UK

Health Education England (HEE) is responsible for providing you with assistance for relocation expenses, including removal or excess mileage.