Out of Programme Experience (OOPE) - Information for Trainees
Introduction
Travelling abroad on an OOPE is exciting and yet very challenging. The question you ask yourself is why you wish to work overseas, for how long, in what capacity and how will it benefit your training. The IAC (international affairs committee) have set out some guidelines to assist you, however you need to tailor your plans to suit your requirements. Whatever kind of post you do overseas, you should try to keep in touch with your Programme Director regularly since there may be changes happening in the UK which you need to know about. This is especially important if you are considering going away before you have a run through NTN eg after “Core training” before specialisation. Considering the timing and preparation for exit examinations and any subspecialty interviews is also important. Careful discussion with your Programme Director at an early stage of planning is the wisest course of action. Mentioning your plans in passing to your local consultant is not enough!
How to arrange an overseas experience
You need to be clear about what you want to do and why. There is a big difference between the kind of overseas experience which MAY be approved towards your CCT and that which will not. Both may be worthwhile , but each one requires a different approach and different approvals.
1: An overseas post which you hope will be approved for training
These are quite limited as the current PMETB regulations require PROSPECTIVE approval before departure. This requires that the post will fulfil the curricular requirements of your specialty, uses the same assessment tools, and has a named Educational Supervisor who will return the appropriate reports to your programme Director (this requires that they have reliable internet access and time to do this). The vast majority if 3rd world locations cannot achieve this, so third world surgery is not likely to be approved prospectively at the present time. In order to get approval you need Deanery approval, SAC approval and a submission to PMETB. All the necessary paperwork and information from abroad needs to be completed no less than 3 months ahead if you are to have any hope of getting approval and giving notice of departure to your Programme Director. For this reason, it is likely in the foreseeable future that the only PMETB approved overseas posts will be those familiar to the SAC already, for which detailed information already exists and agreement by the overseas trainers is forthcoming.
If you are in a paid post overseas you will not get any pension contributions in the UK unless you make special arrangements – this is important to consider. You also need to consider how you will fulfil your financial obligations (eg mortgage) at home.
2. An overseas posting not for CCT approval
You may want to spend up to a year or less working overseas just for experience, or in a humanitarian/voluntary capacity. While neither of these are likely to get PMETB approval for the reasons listed above, you can still ask your Deanery for a leave of absence OOPE and a delay in your CCT date (depending on how long you are going for). There is an allowance of 3 months out of programme which does not require a delay in CCT (special leave) but this can obviously only be used once in the whole programme.
Advance planning is essential since you Deanery will have to fill your space with a locum – you are usually required to give a minimum of 3 months notice. Early discussion with your programme director and Deanery is essential.
Preparations for this experience must include safety and health isssues as described below, as well as a realistic financial appraisal. If you are working overseas you will NOT get your UK salary and unless you make special arrangements, your pension contributions will stop.
What to expect:
- Have no expectations. Go with an open mind.
- Living and working within the local community, you’ll need to be prepared to work creatively, often with few resources.
- Be flexible and adaptable so that you may maximise your training needs without compromising your peers.
- Have a flair for solving problems as unexpected challenges are common in low resourced environments.
- Work within the framework of the institution and with your peers. Seek advice from your trainer as and when needed.
- Team working is vital for your development.
- Be positive and have realistic goals.
- Know when to terminate the OOPE with discussion from both linked trainers.
- Remember you may not have a post to come back to unless the date of your return has been agreed with your Programme Director well in advance.
Once OOPE arranged:
· Start organising your paper work with your host trainer and UK
trainer 2 years in advance. Requirements vary by country.
· Flight bookings through your known travel agent or online.
· Arrange appropriate travel insurance especially regarding medical cover
· Discuss your travels with GMC regarding registration and work abroad
· Check if you need medical registration for the country you are going to
· Discuss your OOPE with MDU or equivalent
· Arrange health requirements for your travel through your GP i.e vaccinations, CXR, immunisation status.
· Contact the foreign office for advice
· Be familiar with money transfer before departing.
Before Departure:
· Prepare a check list (see below for a guide)
· have useful numbers at hand i.e foreign office, insurance, banks, host trainer etc.
Useful Links:
Information on hospitals:
Check on line
MDU has a good database on hospitals world wide Website www.the-mdu.com
Passport Offices, Embassies & Travel Advice
The Foreign Office is dedicated to providing British nationals with the best possible assistance while overseas. Includes detailed information on safety and entry requirements to individual countries.
Tagish is a searchable directory of embassies worldwide
UK Passport Agency assists new applicants and existing passport holders by providing information and on-line facilities for all aspects of application, renewal and amendment of passports for British nationals resident in the UK.
Health
Overseas travel can expose you to plenty of health hazards, particularly in tropical or developing countries, but as long as you have all the recommended immunisations, are informed of the risks, and take sensible precautions, you are unlikely to suffer from serious ill health while overseas.
For general travel health information visit the Department of Health's booklet online EHIC and health advice for travellers.
Working in healthcare in a foreign country has its own set of risks that are very important be aware of and prepare for. Specific health advice for medical volunteers is provided by International Medical Volunteers Association - IMVA.
Vaccines – check with GP
MASTA (Medical Advisory Service for Travellers Abroad) Associated Travel Clinics offer professional advice from fully trained staff about immunisation requirements, anti-malaria prophylaxis and travel health recommendations.
Checklist:
BASIC ITEMS |
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HEALTH / FIRST AID |
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Mobile phone |
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Prophylaxis:e.g. anti- malarials |
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Airline tickets |
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Immunisation records |
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Alarm clock |
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Medical kit (plus anti-AIDS kit) |
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All contact information * |
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Personal medication |
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Batteries for equipment |
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Sunscreen (& after sun) |
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Book(s) |
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Alcohol gel |
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Camera + computer |
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Mosquito repellant gel |
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Insurance paperwork |
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Light torch |
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IN HOSPITAL |
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Map |
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BNF |
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Money belt & wallet |
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ID badge |
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Padlocks (& chain) |
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Handbooks |
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Passport (& visa if applicable) |
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Pocket torch & pen(s) |
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Penknife |
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Disposable gloves where appropriate |
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Suitable clothing and footwear |
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Stethoscope |
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Sunglasses |
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Diagnostic set (optional) |
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Telecom card |
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Theatre clothes |
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Address book |
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Travel guide(s) |
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Travel money |
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Traveller’s cheques |
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Visa card |
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Waterproof |
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*Remember to take contact information for: your host hospital, your embassy abroad, your travel insurance company, your lost traveller's cheque help-line, and your friends back home.
Miss Kokila Lakhoo, IAC member
& Miss Evelyn Dykes