Workforce, training and education
East Midlands

Taking Time Out of Programme


We understand there are a number of reasons why a doctor in specialty training may want or need to take time out of their approved programme. All time out of programme has to be approved by NHS England, and in some cases, the Royal College/JRCPTB/JCST and GMC. We recommend you start discussing any time you wish to take out of programme with your Training Programme Director and Educational Supervisor as early as possible.

It is important to remember that time out of programme is a privilege and is granted on an individual basis at the discretion of the Training Programme Director/Head of School and NHS England. Time out of programme is not normally agreed until a trainee has been on a training programme for at least one year. A Trainee whose Annual Review of Competency Progress (ARCP) is deemed unsatisfactory or with unmet objectives in their PYA (Penultimate year assessment) will not normally be granted OOP.

Important note: Any OOPT or OOPR applications requesting time to count towards training must be made in good time (six months' notice prior to the OOP start date where possible), and must be submitted with a supporting letter from the Royal College or Faculty/JRCPTB/JCST. Once in receipt of the relevant documentation we are required to make an application to the GMC for prospective approval. Applications made in retrospect will not be accepted by the GMC.

*If you are on a Tier 2 Visa please make sure you read the guidance carefully before applying: 

All OOP Applications and Correspondence to:

Secondary Care:

General Practice:


To apply for time out of the programme, a Trainee must apply to the Associate Postgraduate Dean by filling out and returning the form that accompanies this guidance normally at least 6 months in advance of starting their OOP. To assist completing the OOP application form, please see the below flowcharts for each OOP type.

An incorrectly completed or incomplete application will NOT be processed and will be returned to the Trainee. If you are applying for OOPR please use the OOPR Application Form. All other OOPs can be applied for using the standard OOP Application Form. Both of the forms are found below

Please discuss your proposed OOP with your Educational supervisor and your Programme Director prior to submitting your application. This is because their approval is essential and they are obliged to consider the programme’s whole training environment as part of the approval process. They will be able to tell you how your proposed OOP fits in with the curriculum for your specialty.

If supported, you should also inform your Clinical Department (Rota Organiser/Clinical Director/Leave Supervisor) of your intended OOP start and finish date.

Please ensure OOP applications are sent as a single file and word/pdf file.

Educator roles in the process

Educational supervisor

Your ES is responsible for supporting a DiT to make career planning decisions at the right time and think about what is needed for their planned consultant/next training level practice.

Training Programme Director

Your TPD is responsible for considering whether the programme can accommodate the request. They may also support the DiT and ES with guidance about potential opportunities. They may also consult the Associate Postgraduate Dean for Trainee Experience for advice.



The Annual ARCP process applies to trainees on OOP. If in any doubt of what this requires, it is the trainee’s responsibility to contact their Programme for further information, at least 4 months before the ARCP. The following includes:

  • Completion by the trainee of the Form R, Parts A and B to support Revalidation
  • Information from the trainee appropriate to the type of OOP. For example a Supervisor’s Report (OOPT/OOPE/OOPR). Another example might be a progress report from a trainee that includes on OH report (OOPC). The ARCP panel will require this to complete the OOP Outcome 8.
  • Confirmation of the return date agreed at the start of OOP.

The Gold Guide requires that all trainees retain their licence to practice with the GMC during any OOP period. This includes those on OOPC and/or outside of the UK.



HEE-EM does not provide targeted funding for periods out of programme and therefore Trainees must seek external funding e.g. Clinical Research Fellowship. The employment contract between the Trainee and the NHS Trust will be suspended during the period of absence but a training number (NTN) will be retained by the trainee.



If you are applying for an OOPT to act up as a consultant please see below section 3.166 from the Gold Guide (8th Edition):

"Trainees may be able to take OOP to act up as a consultant and may be able to credit this time towards a CCT or CESR(CP) if there is specific provision for this in their specialty curriculum. This would normally be undertaken in the final year of training. Trainees acting up as consultants will need to have appropriate supervision in place. If the experience afforded by this post is in a location already approved for training in the relevant specialty by the GMC, additional prospective approval for OOPT is not required from the GMC. If acting up as a consultant is undertaken in another location, prospective approval will only be necessary if the acting up placement is relevant and contributes to gaining the competences/capabilities, knowledge, skills and behaviours required by the curriculum. In these circumstances, OOPT will normally be for a period of three months or pro rata for LTFT trainees. However, length of periods approved for acting up as a consultant may be specified in the relevant curricula and where referenced in a curriculum, specific provisions around acting up roles need to be adhered to."



Please follow the link below for guidance on NHS Pensions.  You may wish to provide a copy to your employer regarding this:

Whilst the guidance linked above advises that contributions cannot be paid retrospectively we have had confirmation from the NHS Pensions Division that where contributions are paid late, due to the employer not facilitating current collections, then the period can be pensioned in arrears.   

Information provided by the Senior Pensions Officer, British Medical Association.



Please follow the link below for guidance:

*Update from the Study Leave Team regarding OOPT

"As you know, the national study leave guidance has been updated to support OOPT trainees with study leave entitlements, bringing national policy in line with HEE East Midlands’ policy and ensuring an equitable experience for trainees across the country. These applications will only be approved and funded where there is clear evidence linking the application to the specific curriculum requirement for the trainee’s individual specialty. For these trainees, the host HEE local team is responsible for the management of both study leave and expenses, as that is where your employer for that time is based; i.e. if your OOPT placement is in the East Midlands, you’ll follow the East Midlands study leave process and HEE East Midlands will support your study leave through Leave Manager, but if you’re in London, HEE London will support your study leave and you’ll need to follow the London study leave process, so please ensure that you’re following the correct local process.

Unfortunately, for trainees taking OOPT outside of England (i.e. HEE’s remit), your employer will not be based within a HEE local team, and we will not have a payment agreement with them. We have raised this nationally as an issue, but as you are no doubt aware, HEE is only able to pay study leave expenses through a trainees’ employer in line with IR35 guidance; this means that we are currently unable to support study leave/expenses for trainees OOPT outside of England. We will keep you updated with any information and changes that may come into place following national discussions, but wanted to ensure that you were aware where things currently stand."



If you are OOP for more than 6 months, please read the information about Supported Return To Training. This will assist you in integrating back into clinical practice safely.



For trainees on the Paediatrics programme - Please be aware that the school holds an internal OOP panel to assess and approve these applications before they come to the HEE Programmes team. Please ask your Training Programme Director for timelines and process details.