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 that time.

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

But firstly, there are some important questions to ask yourself before you can decide how you want to spend your F3 year. 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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You may also have certain goals you want to achieve, such as:

    🩺  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 both in the short-term and long-term. Here’s a list of the most common options (which, of course, won’t cover absolutely 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

    Option 6: Non-conventional roles

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To help ease the burden of assessing all these options, we'll now look into each of these in more detail, including what you might expect, their pros and cons, and how you can learn more.

And if you’re still at the earlier stage of deciding whether or not to do an F3 year altogether, you should 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 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.

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✅   Pros

This will minimise your time out of training, whilst still giving you plenty of free time and the opportunity to travel. It would also allow you 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 in your F2 year, giving you time to complete the rest of your rotations and 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'd 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 right for you if six months off isn't going to be long enough to achieve any other goals you have.

👉   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.

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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.

These are usually contracted for at least six months, but can vary depending on the post advertised.

🤷   What to expect

Clinical fellowships are a similar job plan to the SHOs in training on the rota. They're usually organised 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 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 chances to progress educationally compared to locuming, with more access to structured teaching and learning opportunities, as well as being supplied a clinical and educational supervisor.

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

Gaining experience in a specialty

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

Financial certainty and lifestyle

Because these are contracts of at least six months, you'll have stable income for this duration.

Sometimes the roles are Monday to Friday, nine-to-five, so you won't be on the on-call rota. This offers a better lifestyle (although this will affect your pay).

⛔️   Cons

Pay

Pay varies depending on the role, but you'll likely only be paid slightly higher than an NHS SHO trainee post 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 SHOs in training. This means you’ll have the same annual leave allowance and request process as a trainee.

You should also check your contract before signing to see exactly what you'll be expected to do, as these roles will usually include some degree of on-call work.

👉   What to do next

Most fellowship roles are advertised on NHS Jobs, and some can also be found on LinkedIn. These typically come out in June for August starts, but will occasionally be released earlier. Keep an eye on the NHS Jobs website.

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 for you.

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

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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, often for a year-long post but sometimes shorter. You'll typically be in a service provision-type appointment, where you’ll cover similar things to the SHOs in training.

This is essentially doing F2 (or what your grade is) again. You may get slightly better pay, but expect 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 you want to 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 nine-to-five arrangements. Make sure you read the contract before signing anything, and remember if you ask for any changes to check they've been added.

✅   Pros

‍Educational and portfolio opportunities

Similarly to clinical fellowships, you'll have more opportunities to develop educationally and professionally. You may also have regular teaching opportunities and a study budget, but the amount of opportunities are considerably less than a fellowship role (although there is room to negotiate).

Financial certainty and lifestyle

This will give you guaranteed work and stable income for a fixed period of time, with a notice period needed from both the employer and yourself, unlike locuming.

You can also gain certain work benefits such as annual leave and sick pay, both of which are unavailable to locums.

Gain experience in a new specialty

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

⛔️   Cons

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.

Variable training opportunities

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.

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

Pay

As above, your pay will be much lower than locuming, and remember to check your contract situation carefully

👉   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 them much less to employ 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 are doctors who temporarily work shifts that are unfilled on the hospital or clinic rota.

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.

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

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

✅   Pros

‍Pay

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

A new locum SHO doctor will earn between £35 and £45 per hour, depending on their location and specialty. To put that into perspective, in your F3 year you can earn £35,000 (which is roughly the same as your F2 annual salary) by working less than two days per week at £40 per hour for a year.

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 sizable holiday or a trip travelling the world (Covid-permitting).

Clinical experience

You can also use locuming to try out lots of different specialties and work in different Trusts. This will be a 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. So 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 scheduled to attend clinics or teaching as a locum. This means you must actively search for learning opportunities if you want to build your portfolio for appraisals or specialty applications.

Tip: If you frequently locum at the same hospital, build strong relationships with your seniors to increase your opportunities for occasionally receiving impromptu teaching sessions.

👉   What to do next

See our F3 Resource Hub for an extensive list of articles providing guidance on this topic.

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Option 5: Work Overseas

🤷   What to expect

If you’re thinking of working overseas, you'll need to organise this well in advance, because you'll usually need a job waiting for you on the other side before you can secure a work visa.

Many people choose to work in English-speaking countries, particularly in Australia and New Zealand, where you won't have to do any additional exams to start working as a doctor, unlike the US (USMLE). 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 work abroad and 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 in the workplace.

This gives you 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 training posts in the UK.

Pay

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

⛔️   Cons

A big change

This is a big decision, so think carefully about it. Personally, this will 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 put any plans in motion!

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

Costs

It's not just moving fees you have to worry about, either. You'll also 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.

👉   What to do next

Give yourself plenty of time to think about this. Ideally, begin planning as early as the start of F2 as you'll need to secure a job before you can even apply for a visa in most cases.

Once you've made your decision, research and choose where you want to go first, and then research how to find and source jobs there!

For plenty more information and help with this, including some fascinating 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!

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Option 6: Non-Conventional Roles

This is an extremely broad topic, and could eventually be the focus of a dedicated article all by itself.

For now, instead of listing the pros and cons, let's look at some of the most exciting options and some useful tips to help get you started.

Non-conventional F3 options

Here are some ideas for jobs that require your medical knowledge, but are outside of conventional clinical routes:

    👉  Adventure or expedition medicine

    👉  Medical journalism or writing

    👉  Medical education

    👉  HealthTech and start-up roles

If you have a good appetite for adventure, you might want to try looking into expedition medicine. The Adventure Medic is a great resource for this.

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

And there are plenty of interesting roles emerging in the tech sector these days too. You can find more advice on this here.

💡  Tips

The grass isn't always greener

Less conventional careers may look enticing, but you really need to make sure that it's not simply a case of looking for something different for the sake of it. If you're going to go a totally different route, make sure you're really committed to that career path before pursuing it.

Do your research

Research what the job roles will actually entail, rather than just thinking about the payslip or the shorter hours.

Use LinkedIn, or similar career resources, to look at job descriptions, and think about whether you could see yourself doing those things every day.

Reach out and network

Whether researching what jobs will involve, or looking for opportunities, don't be afraid to reach out to your wider network. Ask others who have made similar decisions to the one you're considering about their experience. Starting with friends, but also reach out wider using LinkedIn to find relevant contacts.

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

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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 experienced different F3 years if you can.

In order to make the most of your time, 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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