Your F3 Options Explained

So you’re reaching the end of Foundation Training and have 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 that time.

Taking an F3 year has become increasingly popular over the past decade. In 2019, 65% of all F2 Doctors in the UK decided against going straight into training, compared to just 17% in 2011.

Finding the best F3 opportunities depends on whether you have first identified what you want to gain from your F3 Year. Hopefully by now, you have worked through our F3 Workbook and have clear answers to some of the following questions.

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    "Do I want to work full time as a clinician, or split my time doing multiple different 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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You hopefully have also defined your goals and priorities, such as whether you want to:

    🩺  Try something new to expand your clinical expertise

    📄  Gain more experience on your CV before committing to specialty training

    💼  Sampling work outside of medicine or outside the NHS

    💰  Earn and/or save more money

    🔋  Re-charge your batteries

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Taking the time to think this through (and possibly talk it over with family or friends) is really important, as you need to make the choice that's best for you in both the short-term and long-term. Here’s a list of the most common options for F3 doctors but, of course, it doesn'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 work

    Option 5: Work overseas

    Option 6: Non-conventional roles

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Let's explore each of these options in more detail, including their pros and cons, and where to learn more about each.

If you’re still deciding whether or not to do an F3 year altogether, read our article To F3 or Not to F3?

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Option 1: Jump Back into Training in February 2023

🤷   What to expect

Some specialties recruit 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.

You still need to apply for these posts in your F2 Year, but generally applications for these positions will open in the summer for a start the following February. That means you have 6 months of F3 to enjoy before resuming training.

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

✅   Pros

This minimizes your time out of training, whilst still giving you plenty of time off and the opportunity to travel. It would also allow you to do some ad hoc locum work to save some money before entering your next training programme.

Applying for these posts towards the end of your F2 Year gives you time to firm up your decision on training specialty before you apply.

⛔️   Cons

If you won’t have decided on your specialty by the end of your F2 Year then this option isn’t for you. If you don’t have a rotation in your preferred specialty, or if you feel like you need more time to decide, then give this option a miss.

This option also won’t be right for you if six months out of training isn't long enough to achieve any other goals you have.

👉   Next steps

Keep up-to-date on the Specialty Training HEE Recruitment page here.

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Option 2: Find a Fellowship

🤷   What to expect

There are multiple options for fellowship posts in the NHS. This may include clinical fellowships, research fellowships, and teaching fellowships. They are generally 12 months long but can be shorter or longer depending on the agreed contract.

Clinical fellowships are similar roles to SHO training on the rota but can offer a more robust experience of a specialty with more time in clinic, theatre, ward, research, teaching, and other specialty-specific opportunities.

Research fellowships tend to be more heavily involved in research than clinical work. These can sometimes contribute towards a qualification, 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 teach medical students in the form of small group teaching or seminars, clinical skills teaching, and OSCE examining. You're usually funded for a PGCert in Medical Education, or can sometimes get funding contributions towards a Masters in Medical Education.

✅   Pros

‍Educational and portfolio opportunities

Fellowships offer more development opportunities than locuming, as they have more access to structured teaching and learning opportunities, and contact with clinical and educational supervisors.

In most cases, you’ll be given a study budget and study leave for any educational activities relevant to your job like conferences or courses. Documenting these opportunities into your portfolio will increase your chances of getting into your chosen specialty training.

Gaining experience in a specialty

Unlike from a training post, you’ll have the ability to spend a long period of time experiencing a particular specialty which can be great if you are trying to decide whether to commit to a career in that area.

Financial certainty and lifestyle

Being on a contract means you have a stable income for the duration of the contract, which is generally 12 months long.

Often the roles are Monday to Friday, 9-to-5, and may not be part of the on-call rota (or you may be able to opt-out of on-calls when negotiating your contract) which means a better quality of life for you.

⛔️   Cons

Pay

Pay varies depending on the role, but you'll likely only be paid slightly higher than a trainee SHO and a lot less than locuming.

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

On-calls

If you’re on an on-call rota, you’ll usually be treated the same as the trainee SHOs in terms of annual leave allowance and leave requesting process.

Check your contract before signing to see exactly what shift pattern you'll be expected to do, as these roles often include some degree of on-call work (but there may be scope to negotiate this).

👉   Next steps

Check NHS Jobs and LinkedIn for fellowship posts, and also speak to your Medical HR to enquire about jobs that may not yet be advertised. Job advertisements typically come out in June for an August start, but will occasionally be released earlier.  

If there is a specific job you want to do, but you cannot find a fellowship that matches your wants, then try speaking directly to the head of that department as hospitals are often open to creating or adapting a fellowship if a doctor is keen to work. If there is something you want in a role that isn’t included in the contract, negotiate for it and ensure it's added to your contract before signing.

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Option 3: Take a Trust Grade Post

🤷   What to expect

Previously called Locum Appointment for Service/Training (LAS/LAT) posts, trust grade roles are usually filling a rota gap. Often lasting a year (but sometimes shorter) you'll typically be in a service provision-type appointment, where you’ll cover the same or similar things to the SHOs in training.

You may get slightly better pay, but you are essentially doing an SHO post again but usually with fewer learning opportunities than a trainee.

The scope of Trust Grade jobs is somewhat negotiable. When you’re offered the job, you can request things be included in your contract like a supervisor, or time in clinics or theatres, or study leave or a study budget. Whether you get these will depend on how competitive the jobs are, as well as your negotiating skills.

There are many different contracts for these roles. Some will include on-calls, nights, and weekends, while others will be 9-to-5 arrangements. Make sure you read the contract before signing anything, and remember - if you've agreed any changes to the contract then check they've been added before signing.

✅   Pros

‍Educational and portfolio opportunities

Like fellowship posts, you'll have more opportunities to develop educationally and professionally compared to locum work. You may have regular teaching opportunities and a study budget, but the amount of opportunities are generally less than a fellowship role (although there is room to negotiate).

Financial certainty and lifestyle

A contract means guaranteed work and stable income for a fixed period of time, with paid annual leave, sick pay, pension, and maternity benefits (unless your contract stipulates otherwise).

Gain experience in a new specialty

You'll have the ability to spend a long period of time experiencing a particular specialty which can be great if you are trying to decide whether to commit to a career in that area.

⛔️   Cons

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

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.

Variable training opportunities

Some posts will treat you like a trainee with a clinical or educational supervisor, and others won’t. Some positions come with study leave and study budgets, but others wont.

Pay

Your pay will be much lower than locuming.

👉   Next steps

Check NHS Jobs and Linkedin for job advertisements, but you can sometimes agree a post directly with a Trust if you know of an upcoming rota gap. Trusts will tend to be flexible with your requests as it costs them much less to employ a trust grade doctor than a locum.

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Option 4: Locum and/or Bank Work

🤷   What to expect

Locuming is the most popular option for doctors taking time out of training.

Locums provide ad hoc service provision where there are rota gaps that are permanently unfilled due to under-recruitment, or temporarily unfilled due to sickness emergency.

Locum work is organised through an agency, or a hospital staff bank.

Rota coordinators may ask you to move departments or change shift patterns at late notice, and depend on your flexibility. However you are always entitled to cancel if you don't want the changed shift.

✅   Pros

‍Pay

These roles are associated with significantly better pay compared to the other options. 

A locum SHO doctor will earn between £35 and £45 per hour depending on their location and specialty. To put that into perspective, a locum F3 can earn their entire F2 annual salary (roughly £35,000) by working less than 2 days per week for a year at £40/hour.

See the calculations in our article "How many days per week do I need to work as an F3 to earn my F2 salary?".

Flexibility

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

You can choose to work either full-time or part-time. Some doctors choose to do locum work intensively for a few months, followed by a long holiday or a trip around the World.

Clinical experience

You can use locuming to try out lots of different specialties and work in different Trusts. This is useful experience before deciding what specialty to go into and where you’d like to apply for a training post

⛔️   Cons

‍Risk

Depending on your grade, and the region you’re looking for work, shifts can be hard to come by due to a more competitive job market.

These shifts can also be cancelled or changed at a moment's notice, so there’s more risk and less stability involved for you. You must be proactive and take accountability to finding work, booking shifts, and managing your finances, which can be very time-consuming.

Fewer training opportunities

You won’t normally be released to attend clinics or formal teaching sessions as a locum. This means you must actively search for learning opportunities if you want to build your portfolio for appraisals or specialty applications.

However, if you frequently locum at the same hospital, and can build strong relationships with your seniors, then they may offer impromptu teaching sessions.

👉   Next steps

See our F3 Resource Hub for an extensive list of articles providing guidance on locuming. You can also check out our free Locum Finding Service, where we use tech to find you the best agencies and shifts based on your own personal circumstances. Find our more about how this works here, and why we're better than joining an agency directly here.

Option 5: Work Overseas

🤷   What to expect

English-speaking countries, particularly Australia and New Zealand, are very popular destinations for F3 doctors. You don't need any additional exams to work there, unlike the USA (USMLE). The quality of life for doctors overseas is generally much better than it is in the UK.

You will need to apply for roles in advance and secure a position in order to get a work visa. Usually the roles are fixed-term, non-training contracts with one specific hospital or centre in the community.

If you decide you want to stay long-term, there are lots of opportunities for UK doctors to work towards residency and do their training out there.

✅   Pros

Experience a new country and culture

You’ll be able to spend time living in a new country, in a different culture, and gain an entirely different experience of healthcare.

You have the option to travel on your days off and during annual leave, and it's worth noting that annual leave allowance is often more generous than in UK training posts.

Pay

Often these roles come with higher rates of pay compared to the UK.

⛔️   Cons

A big change

Moving so far away will mean a big adjustment, especially if you don’t know anyone in the place you’re going to be working. Be sure you’re up for the challenge before you put any plans in motion!

Some locations ay require or expect you to speak the local language which could add another layer of complexity.

Costs

Beyond moving fees, you'll have to pay for your visa, medical registration, professional exams, and your own medicals. For Australia, even though you won't be required to take additional exams, this will cost upwards of £2000.

👉   Next steps

Begin planning as early as the start of F2 by researching where you want to go and who to contact for jobs out there. You'll need to secure a job before you can apply for a visa, and this will all take some time.

For lots more information and some fascinating interviews with doctors who have moved to 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!

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Option 6: Non-Conventional Roles

This is an extremely broad topic which we have covered in more detail here, but to give you a taste of what is possible, here are some things that you could do.

Non-conventional F3 options

If you want a job that uses your medical knowledge, but is outside of conventional clinical medicine:

    👉  Adventure or Expedition Medicine

    👉  Medical Journalism or Medical Writing

    👉  Medical Education

    👉  HealthTech and Start-Ups

    👉  Pharmaceutical Industry

    👉  Medicolegal Industry

    👉  Medical Sales

    👉  Working with an NGO

If you are thinking of working outside of clinical medicine, this deep dive article from our friends at Medics Footprints has a breakdown of the different options.

💡  Next steps

‍Reach out and network

Whether looking for ideas, jobs, or new opportunities, don't be afraid to reach out to your wider network. Ask others about their experiences to build a richer picture of what kinds of incredible things you can achieve during your F3 Year.

You can use the Alternative Careers for Doctors page on Facebook as a great resource for this.

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Final Thoughts

In order to make the most of your F3 Year, make sure you’ve considered all your options and follow what feels best for you personally.

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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