Your F3 Options Explained

So you’re reaching the end of your Foundation Training and you’ve decided you want to take an F3 year rather than applying for specialty training. Now you need to decide exactly what you want to do with your F3 year.

This article will outline all your options to consider so you can start planning your dream F3 year. If you’re considering whether or not to do an F3 year altogether, you should read our article, To F3 or Not to F3?

The main decision points you have are:

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    "Do I want to work full time as a clinician, or part-time alongside other things?"

    "Do I want to stay in the UK or go overseas?"

    "Do I want to try something outside of clinical medicine?"

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Here’s a list of the most common clinical options (which of course won’t cover everything you could do!)

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    Option 1: Jump back into training after a short break

    Option 2: Find a fellowship post

    Option 3: Take a Trust-grade post

    Option 4: Locum and/or bank work

    Option 5: Work overseas

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Now we’ll look into each of these options in more detail below, including what you might expect, their pros and cons, and how you can learn more.

Option 1: Jump Back into Training in February 2023

🤷   What to expect

Some specialty training runs recruitment for a February start each year, as well as the August intake. This is usually for ST3 posts but is sometimes also for ST1 entry.

In the past, specialties offering February ST1 entry have generally been ACCS/Anaesthetics, GP, and Psychiatry, but this can change.

To give you a rough idea of the timeline, specialty applications opened in July 2021 for training starting in February 2022.

✅   Pros

This will minimise your time out of training, whilst still giving you plenty of free time and the opportunity to travel, or to do some ad hoc work through locum or bank shifts to save some money before entering your next training programme.

You wouldn’t have to apply until later on in your F2 year, giving you time to complete the rest of your rotations to firm up your decision on training specialty before you apply. It’s also helpful to have extra time to decide if you have a changing situation in your personal life.

⛔️   Cons

If you won’t have decided on your specialty by the end of your F2 year then this option isn’t for you, as you would likely need to apply around July 2022. This won’t work for you if you don’t have a rotation in your preferred specialty, or if you feel like you need more time to decide.

This option also won’t be for you if six months off is not going to be long enough for you to achieve your other goals.

👉   What to do next

We’re not sure how recruitment will happen this year because of how the application processes are changing, so we’d recommend you keep up-to-date on the Specialty Training HEE Recruitment page here.

Option 2: Find a Fellowship

There are multiple options for fellowship posts in the NHS. This may include clinical fellowships, research fellowships, and teaching fellowships.

Generally these are contracts of at least six months, but that can vary depending on the post advertised.

🤷   What to expect

Clinical fellowships are usually a similar job plan to the SHOs in training on the rota. Usually rota’d for a mixture of clinics, ward work, on call shifts, and other work, depending on the specialty.

Research fellowships tend to be more heavily involved in research than clinical work. These can sometimes contribute towards a qualification in research, like a Masters or PhD, depending on the role advertised.

Teaching fellowships may be teaching only, or mixed with a clinical role as well. You’ll normally be expected to provide teaching to medical students in the form of small group teaching or seminars, clinical skills teaching, and OSCE examining. You are usually funded for a PGCert in Medical Education, or can sometimes get funding contributions towards a Masters in Medical Education.

✅   Pros

You’ll usually gain more opportunities to progress educationally here, with more access to teaching and learning opportunities as well as a clinical and educational supervisor.

You’ll have the ability to try out a new specialty or role with a similar amount of support as a trainee.

Sometimes the roles are Monday to Friday, 9 to 5, rather than being on an on-call rota, which is great for lifestyle (although obviously this will affect your pay).

You’ll also be given a study budget in most cases, and study leave for any educational activities you think are relevant to your job, like conferences or extra courses.

⛔️   Cons

If you’re on an on-call rota, you’ll usually be treated the same as the SHOs in training on the rota, which means you’ll have the same annual leave allowance and request process as a trainee.

You’ll need to check the contract carefully, as sometimes you can be put on the old contract which may come with less pay and different rules on things like rest periods compared to the trainees on the new contract.

👉   What to do next

Most fellowship roles are advertised on NHS Jobs and some can also be found on LinkedIn. If you know where you want to work and have a role in mind, it’s worth contacting the relevant department. You might be able to find out in advance if they’ll be advertising a suitable role in advance.

If there’s anything you want for your role that isn’t included in the contract, try to negotiate for it and make sure it then appears in your contract before signing.

Option 3: Take a Trust Grade Post

🤷   What to expect

Previously, these positions have sometimes been called Locum Appointment for Service/Training (LAS/LAT) but the entitlements for each post can vary in different Trusts.

These are usually filling a rota gap, and are often for a year-long post but can sometimes be shorter.

This will typically be a service provision-type post where you’ll cover similar things to the SHOs in training, although some are more progressive.

✅   Pros

This will give you stable work for a fixed period of time, with a notice period needed from both the employer and yourself, unlike locuming. As a result, this will probably provide more financial stability.

It’s also an opportunity to try out a new specialty, or a new Trust that you may not have worked in before.

⛔️   Cons

Your entitlement to training opportunities may vary here. Some posts will treat you like a trainee with a clinical or educational supervisor, and others won’t.

Usually you won’t be entitled to any study leave or study budget, which many will see as a big negative.

If you’re part of an on-call rota, you’re usually treated the same as the SHOs in training on the rota, which means you have the same annual leave allowance and request process as them, so less flexibility for your free time.

You’ll also need to check the contract carefully before signing. Sometimes you can be put on the old contract, which may come with less pay and different rules on things like rest periods compared to the trainees on the new contract.

👉   What to do next

These jobs are normally advertised on the NHS Jobs site, but you can sometimes negotiate one directly with a Trust if you know of a rota gap coming up. They’ll tend to be more flexible as it costs much less to employ a Trust grade than a locum.

Negotiate when you’re offered the job if there’s something you want to be included in your job plan, like a supervisor, or time in clinics or theatres, or study leave or a study budget, and make sure it then appears in your contract.

Option 4: Locum and/or Bank Work

🤷   What to expect

Locum work is usually organised through an agency, and bank work is organised between you and a Trust, usually through rota coordinators for different departments.

Here you’ll be working in ad hoc service provision for rota gaps or sickness, sometimes one-off shifts, and sometimes a full-time rota gap.

This will require you to be flexible because you may be asked to move around or do different shift patterns at late notice.

✅   Pros

This kind of work will give you the flexibility to book your own shifts, and to decide when you work and when you don’t!

You’ll get the opportunity to try out lots of different specialties and Trusts.

These roles are also usually associated with better pay compared to Trust grade and training roles.

⛔️   Cons

You will have no notice required on either end to cancel shifts, so there’s more risk and less stability involved for you. For this reason, you sometimes need to work hard to chase up booking shifts and to plan your finances which can be very time-consuming.

You will need to be proactive if you want to get training or further experience from this situation, as you won’t normally be rota’d for clinics or teaching.

👉   What to do next

See our F3 Resource Hub for an extensive list of articles providing guidance on this topic, especially the article Finding Work as an F3 Locum: Bank and Agency, for more information.

Option 5: Work Overseas

🤷   What to expect

If you’re thinking of working overseas, you will likely need to organise this well in advance depending on the type of role you’re looking for.

Many people choose to work in English-speaking countries like Australia, New Zealand, Canada, or the US. Usually these are fixed-term non-training contracts with one specific hospital or centre in the community, but sometimes locum work is available too. If you decide you like it and want to stay, there are lots of opportunities for UK doctors to work towards residency and do their training out there.

If you are interested in volunteering or working with NGOs, there are plenty of opportunities out there as well, such as the MSF, Africa Health Placements, Raleigh, and Blue Ventures.

If you have a good appetite for adventure, you might want to try Expedition Medicine. The Adventure Medic is a great resource for this.

✅   Pros

You’ll be able to try out living in a new country, go on plenty of new adventures, and gain an entirely different experience!

This gives you the option to travel on your days off and during annual leave, which it’s worth noting is often more generous than training posts in the UK.

These roles can often be associated with higher rates of pay compared to the UK as well, which is another great bonus.

⛔️   Cons

Your organisation is key here. There are lots of things to think about, including medical registration, visas, and much more, and plenty of cost associated with this, so think carefully about it.

In some locations you might be expected to speak the local language depending on where you’re going, which could add another layer of complexity.

Personally this will also be a big adjustment, especially if you don’t know anyone in the place you’re going to be working, so you need to be sure you’re up for the challenge before you go!

👉   What to do next

Decide where you want to go first, and then research how to organise jobs there!

For plenty more information and help with this decision, including some interviews with doctors who have moved to work in Australia and New Zealand, see the dedicated section on our F3 Resource Hub.

We’re working on a comprehensive set of guides to living and working as a doctor in Australia, which will be uploaded to the blog in due course!

Final Thoughts

Whatever you end up doing, it’s important not to take this decision lightly. Think very carefully about all the different factors, do your research, and speak to people who have already done different F3 years if you can.

In order to make the most of your time and get the best possible experience, make sure you’ve considered all your options and follow what feels best for you personally. For example, if you’re thinking of working outside of clinical roles, this deep dive article from our friends at Medics Footprints has a breakdown of the different options.  

And, of course, if you need any more guidance on anything specific, please don’t hesitate to reach out to us directly as we’re always happy to help.

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