Many trainees choose to spend some time out of programme (OOP) during their training. Undertaking time Out of Programme (OOP) is a privilege and attitudes towards trainees taking OOP varies between specialities and between Deaneries. 

The Severn Deanery School of Obstetrics and Gynaecology is very supportive of trainees undertaking time OOP and has always had a very encouraging and flexible approach to allow O & G trainees to benefit from this opportunity. There are other specialities in the Severn Deanery where trainees are not permitted to take time OOP unless it counts towards CCT. 

In order to allow this flexibility to continue it is essential that plans are made well in advance. Trainees are expected to discuss their plans with their Educational Supervisor to ensure an OOP is appropriate at the current time of training and then to discuss their plans at their ARCP/RITA and with the Training Programme Director. 

When a trainee takes time OOP, the training slot must be backfilled. In the current climate in the UK this is not always easy. If plenty of notice is given then sometimes it is possible for an overseas doctors to be allocated to the training slot through the RCOG International doctors training scheme (IDTP) and this is encouraged.

The start of the OOP should co-incide with the rotation dates and then only three months notice is required once approval has been granted. To start at a time outside the rotation dates requires a minimum of six months notice after approval and preferably more notice to allow time to find a replacement doctor in the rotation.

All time out of programme requires prospective approval from the Head of School, the Training Programme Director and the Postgraduate Dean. The period of notice does not commence until the OOP has been approved by all of the above.

If the OOP does not co-incide with the rotation date, once approval has been given by the PG Dean, the trainee should then give their notice to the current employing Trust of their intention to leave before the end of their contract which should normally be a minimum of three months.

A summary of the different types of Out of Programme are explained below:

OOPT – this category involves undertaking clinical training outside the Deanery training programme, where time will count towards award of the CCT. It requires prospective approval from PMETB, with confirmed support from the RCOG (via the Chairman of the Specialty Education Advisory Committee [SEAC]). The training must be undertaken within a programme that has a quality management system that satisfies PMETB requirements. From 2008 Subspecialty Training is undertaken as an OOPT and therefore approval must be sought from the PG Dean but the programme will already have PMETB approval. OOPT may involve only some of the time counting towards CCT; for example undertaking a clinical fellow post in undergraduate teaching which involves some clinical sessions and O & G on call should be approved as partial OOPT.

OOPR – Research is not a formal, optional element within the approved curriculum for obstetrics and gynaecology. If the research post does not include any significant time in general obstetrics and gynaecology, the time will not count towards CCT and PMETB approval is not required. However, if there is a clinical component that the trainee wishes to consider as counting towards CCT, then prospective approval from PMETB must be sought. OOPR would normally only be approved for a trainee expecting to submit for an appropriate higher qualification such as an MD, PhD or MSc. Trainees would not normally be approved to undertake an OOPR to start in their final year of training.  

OOPE – Out of Programme Clinical Experience This category involves no formal training supervision, or training is within a programme that does not meet PMETB quality management requirements. This experience does not count towards CCT and therefore does not require PMETB approval. However the other Deanery procedures must be followed including appropriate prior approval. This would normally involve working in a developing country and trainees are encouraged to apply for RCOG/VSO Fellowships for this type of experience.  

OOPC – taking a ‘career break’ means stepping out of a training programme for a designated and agreed period of time to pursue other interests. The trainee can be secure in the knowledge that they can re-join the training scheme but there may be a delay until a placement is available.  

Other regulations for OOP  

A number of senior trainees in the Severn Deanery O & G Training Programme have experience of OOP and some of their accounts can be read in the secure area of the website.