foundation year 1

The induction
Before you start your first placement, you will undertake an induction course at your
trust. As well as receiving information about the hospital, your timetable and what is
expected of you, you will be advised of the contact details of your educational
supervisor and of the careers advice that is available locally.
The first foundation year will be similar to the old PRHO year. During your first year
you will do a medical attachment and a surgical attachment. Some rotations offer six
months of medicine and six months of surgery but some deaneries have already
moved to offering three, 4-month attachments.
Both surgical and medical attachments are required as GMC registration is
dependent on you completing at least three months in each by the end of your
first year of training.
Your F1 year will:
1. make sure you can put the knowledge, skills and attitudes you learnt as a
student into practice as a doctor (as outlined in The New Doctor)
2. equip you with new knowledge and skills whilst supporting your
professional development.
The placements
Your F1 placements will be determined by the post or programme for which you are
selected. In addition to medicine and surgery, your post may include any of the 65
recognised specialties such as:
• haematology
• infectious diseases
• dermatology
• gynaecology
• acute stroke medicine
• paediatrics
• ENT
• anaesthetics
This list is far from complete but does give you an idea of the possible specialties that
may be available to you. Each deanery will have a different list to choose from but all
jobs will enable you to work towards the Foundation Programme competences.

Your study time
Your foundation training programme director (FTPD) will ensure that you have access
to a formal taught programme of education which addresses the professional
elements of the Curriculum.
You will have up to three hours per week of protected, bleep-free time set aside for a
timetabled learning programme. Alternatively, this time may be aggregated to give
you seven days of whole day release.
Assessment
Assessment and feedback are central to the philosophy of foundation training. They
ensure you are progressing and provide documentary evidence of your achievements.
They also can identify any problems you are having early on.
Why am I being assessed?
1. Public accountability – Patients need to be assured that all doctors have demonstrated
their ability to practise in accordance with standards, as set out in publications such as
the GMC’s Good Medical Practice. Satisfactory overall performance will be required for
you to be recommended to the GMC for full registration.
2. Personal development – Choosing a career in medicine means you’ve chosen a
career where you can look forward to life-long learning. This assessment model will
provide you with constructive feedback that can inform and strengthen your
personal development plans. The goal is to help you provide better care and if
areas of weakness are identified, to help you accordingly.
You will be assessed against the standard of competence that is expected of a PRHO
upon completion of the F1 year. This means that, in your first days as a PRHO, you are
unlikely to reach the standard required. Don’t worry, this is to be expected and is NOT
a failure. The assessments are designed to measure your progress through the year.
At the end of F1, you will be expected to have progressed to a satisfactory level.
How and where will I be assessed?
These assessments are workplace-based – your educational supervisor wants to see
what you actually do on the job and your ability to translate what you’ve learned
into practice. You will do your assessments in the workplace and they will be
incorporated into your everyday practice.
There are four methods, or ‘tools’ for assessment. Each tool is based around an
assessment form. For three of them you are responsible for asking more senior
doctors and other health professionals to assess you. They will discuss your assessment
with you and give you back the completed form. You are then responsible for
submitting it to your administrator.
The fourth form is for peer evaluation. You will be contacted in advance when it is
time to complete the fourth form of assessment (multi-source feedback) and will be
responsible for submitting names of those who you would like to have rate you.
They will then be provided with forms which they are responsible for submitting
after completion.

Assessment tools:
Multi-source feedback (MSF) – 1-2 per year
This assessment uses a questionnaire to collate views on how you are doing from
a range of co-workers, as well as a self-rating form. You will be asked to nominate
8-12 people to rate you. Time required: 3-8 minutes per assessor.
Direct observation of procedural skills (DOPS) – 4-6 per year
This is simply a structured checklist to assess practical skills.
Time required: 15 minutes per assessment.
Mini-CEX – 4-6 per year
Mini-CEX is a snapshot of a doctor/patient interaction. It is designed to assess the
clinical skills, attitudes and behaviours of trainees essential to providing high
quality care. Time required: 20 minutes per assessment.
Case-based discussion (CbD) – 6 per year
This is a structured discussion with your supervisor about a clinical case you have
been involved in. It is designed to assess, in particular, clinical reasoning and
judgement and will focus on the actual written record in a patient’s notes.
Time required: 20 minutes per assessment.
The assessments may sound intimidating, but they all come with instructions and
training material for you and the assessors.
How will it all work?
At induction, you will receive forms for DOPS, mini-CEX and CbD, along with their
guidance notes. You will be expected to complete a bare minimum of four mini-CEX
and DOPS in your F1 year, and a minimum of six CbD assessments. In the second
year, the number of assessments you will be required to complete will increase (see
the section on Foundation Year 2 in this guide for more details).
Your responsibilities
Once you have completed your form with your assessor, it will be your responsibility
to photocopy it and return one copy of the form to your administrator*, and keep
the other copy in your portfolio. All completed assessments should be kept in your
portfolio, whatever the outcome. If you do not do as well as you would have liked
on an assessment, keep it anyway. The idea is that you should improve from
assessment to assessment.
What do I get out of all this?
Put simply, you learn more. The assessments give you an opportunity to regularly
receive direct and instant feedback from experienced members of staff.
The strengths and areas for development that are identified in the assessment will help
you with your personal development planning for the next year.
The assessments will also inform your educational supervisor’s report to the deanery at
the end of the year. This is important to ensure you’re granted a full GMC registration
at the end of the F1.
What do I do if I have a problem or question?
Although you are responsible for your own assessments, there is plenty of help available.
Talk to your educational supervisor first, or go to www.mmc.nhs.uk/assessment. You can
also speak to your local administrator or foundation programme training director (FTPD).