FPAS is the Foundation Program Application System. Roughly similar to the UCAS process you used to get into medical school, FPAS will determine where you end up working as an FY1/2. It's run by the UK Foundation Program Office, or UKFPO. FPAS runs once a year, and it takes nearly ten months from registration to your first day on the job - pretty much your entire final year at medical school!
Your medical school will no doubt give you advice and guidance on how to navigate the system, but knowing how medical school's are fond of playing chinese whispers with career-determining information, this guide is provided for you to refer to along the way. Students prior to final year may also find this helpful as an idea of what is yet to come, though bear in mind that the system may change before you reach this stage.
A brief glossary
FPAS - Foundation Program Application System. The system through which jobs are allocated for first time junior doctors.
UKFPO - The UK Foundation Program Office. They run FPAS.
UoA- Unit of Application This is a small number of foundation schools grouped together for the purpose of allocating jobs. Also known as a deanery.
AUoA - Academic Unit of Application Foundation schools may group themselves differently for allocating academic jobs through the AFP.
AFP - Academic Foundation Program The allocation system for junior roles in academia, which include dedicated time for teaching or research.
SJT - Situational Judgement Test The exam every FPAS candidate must sit, which awards them up to 50 points for their overall score.
EPM - Educational Performance Measure The score, to a maximum of 50 points, collated from your ranking, degrees, and other achievements.
These are the dates for the 2013/14 cycle.
August 14th - Deadline for submitting documentation to the Eligibility Office, if you are graduating from a non-UK medical school or graduated from any medical school prior to August 2012.
September 30th - Registration & enrolment begins.
From this date, all UoA and AUoA programs will be available to view online, so that you can start making a draft list of which AFPs you might apply to, and how you might rank your FP deaneries. Remember that you need to rank all the UoAs for an FP application.
Once you're registered, you'll be able to see your EPM decile score. At this stage, make a note of the PubMed IDs of any publications and details of any prizes you have or presentations you've done. Read over the application questions so that you have all the information ready to input once the application window opens. If you're an academic applicant, prepare your answers for the white space questions.
October 7th - Applications open.
You've not got long to get your application filled out and submitted. If you're going to be away on elective in this period, make sure you'll have internet access or nominate someone you trust to fill out the application for you back home. Do not leave your application until the last minute - the computer system is almost guaranteed to die on the 18th, so don't risk being caught in the last minute rush that overwhelms the servers - get your application submitted early.
October 18th - Applications close at midday.
From this time, the UKFPO can try to clarify whether you truly did that presentation or not, and let you know your overall EPM score (not your overall score - the SJT is still to come). AFPs will start shortlisting applicants and calling people for interview, according to local processes.
December 6th - First SJT sitting.
Your medical school will let you know which sitting of the SJT you'll be in, as this often depends on whether or not you're on elective at this time of year. Take a very good eraser into the exam! Last years papers were screwed up by the computer misreading eraser marks or misplaced answers.
December 13th - Deadline for submitting extenuating circumstances to UKFPO - if you have a legitimate, recognised reason for wanting to be placed in a certain deanery, this is the last day to claim this.
January 6th - Second SJT sitting. Double check the time - whilst the December SJT is an afternoon paper, this one's in the morning.
January 22nd til Febrary 19th - Offers are made for the AFP (Academic Foundation Program).
If you got an AFP job, congrats! You can relax, your FPAS journey is over. If you didn't, it's not the end of the road for you yet - many applicants get offers through reserve lists or second offer rounds, and if this still doesn't get you an AFP post, you're back in the main FPAS pool at no disadvantage to anyone who didn't go through AFP.
March 10th - First round deanery offers are made for the Foundation Program.
This allocates the vast majority of students to deaneries. Approximately 300 applicants will be left without jobs at this stage, but so far the UKFPO has managed to place every single UK graduate in a job before August. You might just have to wait a while, as you're waiting for someone else to give up their place, either by choice or by having failed finals.
If you've been allocated a deanery, they'll send you details of how to rank the jobs available to you. Often they'll tell you where you rank within the deanery cohort - technically, if you're number one then you are guaranteed your first choice job, but if you're number 347, you'll probably need to rank at least 347 jobs to be sure of getting something you picked. Some deaneries ask you to select groups of programs (usually grouped by location) before running a second round of ranking for programs within your allocated group.
April 4th - Deadline for entering program preferences on FPAS.
This is where you select the rotations (usually specified as a certain department in a certain hospital) you want to do during FY1. Some deaneries attach a certain FY2 placement onto each group of FY1 groups, others have a separate job allocation process for FY2 once you've started working. Jobs are grouped together so that you can't do an entire year of surgery or avoid it altogether.
April 8th - Job allocations are announced.
This is the stage where you can finally tell your mum that you're going to be an FY1 in Such-and-such Hospital, starting in the Thingy department! Celebrate, then check over the details of when you need to sort GMC registration, shadowing placements, and contract signing.
April 9th - Deadline for references to be submitted to FPAS
May onwards - Reserve list allocations are made.
If you're on this list, you'll have received an email letting you know which dates further jobs are being released on, as well as being told the range of scores on the reserve list as the highest scoring applicants will be placed first.
May to July - Pre-employment checks are undertaken. This may involve an interview with your deanery.
If you're at a UK medical school, regardless of whether you're a Home, EU, or International student, then you're automatically eligible to apply for FPAS and your medical school will put forward your name to the UKFPO.
If you're outside the UK for any reason, or you graduated from a UK school prior to 5th August 2012, you need to submit documentation to the Eligibility Office between 15th July and 14th August 2013 to prove that you're eligible to apply. The Eligibility Office will then nominate you to carry on with the FPAS process if it deems you eligible.
Extenuating Circumstances and Linked Applications
There are a small but precise list of circumstances under which you can be pre-allocated to an agreed deanery. These usually require that you are the primary carer for a close relative, are a parent/legal guardian with significant caring responsibility for a child, or have a medical condition which requires follow-up care at a specific place.
If you meet these requirements, you need to let UKFPO know by mid-December. You need to make it onto the primary list (i.e. not be on the reserve list when the first set of allocations are made) in order for your pre-allocation agreement to count.
You can choose to link your application to a partner or friend if you wish to be placed in the same deanery. You both need to be applying for an FP post, not the Academic program, and rank the deaneries in the exact same order. The link only ensures that you get the same deanery - bear in mind that some deaneries are entire countries and not all deaneries will agree to place you within commutable distance of each other. You will both be allocated on the basis of the lower of your two scores.
Improving your chances
The score that determines where you rank within all the FPAS applicants for this year is made up from your EPM and SJT scores. The EPM (Educational Performance Measure) is made up of points from your ranking at medical school, as well as points from any additional qualifications you have, and any prizes, publications or presentations you have done or achieved, to a maximum of 50 points.
This is determined by your medical school. As a general rule, they look at your results over the first four years of medical school (not including an intercalated year) and rank you against your peers. The class is then split into ten deciles, with points allocated as follows:
Top decile: 43 points
2nd decile: 42 points
3rd decile: 41 points
4th decile: 40 points
5th decile: 39 points
6th decile: 38 points
7th decile: 37 points
8th decile: 36 points
9th decile: 35 points
10th decile: 34 points
As you can see, there's only 9 points between the top and bottom of the entire cohort, so don't stress too much if exams haven't been your strong point so far.
This gives you points for having an extra degree. It doesn't matter if it was an intercalated degree or one you did prior to medical school, and science & arts degrees are counted equally.
The points allocations are as follows:
5 points - PhD
4 points - 1st class Honours degree, or Masters, or BDS, or B Vet Med
3 points - 2.1 Honours degree, or 1st BMedSci (Notts)
2 points - 2.2 Honours degree, or 2.1 BMedSci (Notts)
1 point - 3rd or non-Honours degree, or 2.2 BMedSci (Notts)
0 points - MBChB/MBBS/BM/BMBS only, or 3rd BMedSci (Notts)
- Intercalated degrees from Nottingham are worth less here, because they don't add any time to the overall length of your course.
- Postgraduate qualifications (such as a degree or Masters completed in a post-graduation gap year) do not count.
- MPharm/MEng etc are considered undergraduate honours degrees, not Masters programs.
Additional Educational Achievements:
This gives you points for publications and presentations, but there are very specific conditions to determine what does and doesn't count for these points. They must have been achieved whilst at medical school.
- Publications need to have a PubMed ID and your name must be listed as an author.
- Presentations can be poster or oral, but need to be from national conferences (not undergraduate or trainee conferences) and your name must be listed on the presentation. You don't actually need to have been at the conference.
So, we've covered your entire performance at medical school so far, any degrees you did there or beforehand, and any extra awards you've got. Unfortunately this only makes up half of your score...
The SJT, or Situational Judgement Test, determines the other half of your score, being worth up to 50 points. It's a multiple choice exam taken in either December or January within your application cycle and was first introduced in the 2012/13 cycle. This means that any textbooks claiming to have past papers questions are probably stretching the truth, as only two past papers exist, and the students who sat them are forbidden from discussing the questions afterwards.
The SJT is designed to assess how you, a good FY1 doctor, would respond in different fictional scenarios. It's based on the GMC's Good Medical Practice guidelines, and a quick read-up on what the GMC expects of its doctors therefore wouldn't go amiss before your exam. The organisers claim that the SJT cannot be revised for. It may be worth bearing in mind that this was also said about the UKCAT when it was first implemented...
Questions are either asking you to rank five choices in order, or to pick three choices from eight. Trying to finish the test in the required time limit is reportedly quite challenging - there are 70 questions in 2hrs 20 mins. There is no negative marking.
You'll find out your SJT score when you get your deanery allocation. This means you're applying to deaneries at least partially sighted, if not quite blinded, of your final score.
In previous years, if you missed your first choice deanery you typically ended up with your fifth, sixth, or twentieth choice as deaneries looked primarily at those students who had ranked them first. This led to a lot of tactical applications from students trying to beat the system.
FPAS has now redesigned the matching algorithm to make tactical applications unnecessary. The highest scoring applicant is matched to their first choice deanery. The computer then moves down the list of applicants in score order, matching you to your highest ranked deanery that still has vacancies. So, if you aren't selected for your first choice deanery, you have an equal chance at your second deanery compared to someone else with the same score as you who ranked it first. Deaneries get the highest scoring students possible, students don't have to play a guessing game - a sort of win-win situation.
The increasing numbers of applications to FPAS means that the days of undersubscribed deaneries are also somewhat disappearing. Below are the subscription ratios for each UoA in the 2012/13 cycle. A figure of more than 100% means there were more people placing that deanery as their first choice than there were vacancies available. Bear in mind that this isn't entirely representative of the situation, as overall there are more applicants than places, and getting a job in each deanery requires a different score. It's fair to assume that NW Thames will be massively oversubscribed anyway though, it's the only London deanery to guarantee you two years inside the M25 and the Imperial lot just don't want to move.
East Anglia 57%
Yorks & Humber 80%
North Western 86%
Coventry & Warwick 87%
West Midlands Central 88%
NE Thames 89%
Northern Ireland 98%
South Thames 117%
NC Thames 156%
NW Thames 424%
The minimum FPAS score to be placed on the primary allocation list in the 2012/13 cycle was reported to be 70.2. Nationally scores ranged from 59-97.3.
Much of this information is presented in a lengthier, more detailed format in the UKFPO Applicants Handbook, available on their website.
Hopefully this has served as useful overview of the process, highlighting the important dates for applying and showing what factors will be taken into account in allocating medical students to their first jobs.
If you have any queries, you can ask them in the FPAS 2013/14 thread within the Current Medics subforum.