Overseas or Out of Programme Training

This page contains information and guidance for UK trainees wishing to have Overseas or UK OOPT/OOPR counted towards their ICM programme. In addition, information is also provided for overseas doctors wishing to work or train in ICM in the UK, or obtain Fellowship of the Faculty.

Out of Programme (OOP)

When a doctor in training takes time out of their approved programme, this is called out of programme (OOP). There are currently 5 OOPs:

1. OOPE – Out of Programme Experience. This time does not count towards the CCT. Normally for one year maximum. Does not require GMC approval.
2. OOPC – Out of Programme Career break. This time is to allow ICM doctors in training to pursue alternative interests such as other responsibilities, work in industry, or developing skills in other areas. Applications are considered on individual merits and are normally limited to one year. It should not be used for sickness.
3. OOPP - Out of Programme Pause –permits doctors in training to step out of their programme for up to one year. They may have any capabilities and learning outcomes achieved during this period assessed on return and have considered when assessing their CCT date through the ARCP process.
4. OOPT – Out of Programme Training. This counts towards your CCT and is for clinical training which isn’t part of your training programme. It is normally a maximum of one year (six months may be OOPT and six months OOPE depending on your plans and agreement with your TPD). You can apply to have 3 months, 6 months, 9 months or the full 12 months counted towards your CCT. 
5. OOPR – Out of Programme Research. This is for research purposes and up to one year can normally be counted towards your CCT. OOPRs do not usually go beyond three years.

For OOPT & OOPR: If the training location already has GMC approval then you do not need to apply to the Faculty as long as you have local approval. You can find out if the location already has approval by contacting the GMC at quality@gmc-uk.org or by viewing their updated list.

If the training or research location (overseas or in the UK) does not have GMC approval and you wish for the OOP time to count towards your CCT, this is assessed and approved on a case by case basis and you will need to apply to the FICM for prospective approval using the OOPT/R Application Form

In considering an OOP of any kind, you should first discuss your OOP request with your local trainers i.e. ICM Training Programme Director (TPD) & ICM Regional Advisor (RA) to ensure that they approve the time off-rotation.

All OOPs must also have the Postgraduate Dean’s PROSPECTIVE approval.

If the Faculty's Training, Assessment and Quality Committee approve the OOPT or OOPR as a suitable placement/experience to count towards your CCT, you will be issued with a letter of support. You will then need to submit this to the GMC for official approval, along with other documents. This submission is co-ordinated by your TPD/local deanery admin team, you should contact your Deanery to confirm their local process. The whole process may take up to 6 months.

Further guidance can be found via:

• COPMeD: Gold-Guide-9th-Edition - August-2022 
• HEE-NHS: What is time Out of Programme (OOP)?

The Medical Training Initiative: Information for overseas doctors and UK hospitals

The Medical Training Initiative (MTI) is a national scheme designed to allow a limited number of doctors to enter the UK from overseas to benefit from opportunities to work within the NHS, before returning to their home countries.  It applies only to doctors who have qualified outside the UK or European Union, who want to come to the UK for a limited period of specialised training in Intensive Care Medicine.

The Royal College of Anaesthetists manages the MTI scheme for Anaesthetics, Intensive Care Medicine and Pain Medicine through their Global Partnerships Office.