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Advice for ranking foundation programme jobs

All things UKFPO

Before we tackle the focus of this blog with some tips and tools for ranking foundation programme jobs, it is apt to address the key changes to the UK Foundation Programme this year, including the allocation process move to Preference Informed Allocation (PIA), where applicants are assigned a random computer based generated ranking. This compares to previous years whereby ranking scores were comprised from academic performance (EPM) and the situational judgement test (SJT).  

A key aim of PIA should theoretically result in more applicants being allocated in their top 5 choices. However, despite UKFPO involving stakeholder engagement before implementation, this new system has come under criticism with removal of security for applicants and reports of deanery allocations in unwanted bottom choices. Furthermore, from 2025, it should be noted that the PIA system will also apply to the Specialised Foundation Programme and may have considerable impact on the future of clinical academia. 

We will be writing an up-to-date application guide for 2025 entry as further information is released so do look out for this! 


So how does preferencing work after deanery allocations?

The preferencing process either occurs as a one-stage or two-stage process:

  • One-stage process = rank all of the foundation jobs in that deanery 

  • Two-stage process = firstly rank groups within the deanery (usually divided by trusts or further breakdown of regions); secondly after being assigned a group (with the same computer generated ranking) then rank all of the foundation jobs within that group 

Many of the larger deaneries have moved to the two-stage process which significantly cuts down the workload for applicants and technically should allow for more specific location preferencing. Then by mid-April, all applicants will find out the exact job they have been matched to; and the registration and employment checking process begins!

So where to start with ranking your jobs?

Firstly, it is well worth downloading the list of jobs in a spreadsheet so you can scroll through them easily rather than navigating individual details for each job manually on Oriel. You can do this by selecting “Click here to download preferences in an Excel compatible file (.csv)” under the programmes preferencing area on Oriel. Alternatively, lists of jobs can usually be found on the individual deanery websites but Oriel will have the most up to date job information. 

Note that most jobs will be listed 3 times due to different rotation orders (e.g. 1a- Cardiology, General Surgery, Paediatrics; 1b -  General Surgery, Paediatrics, Cardiology; 1c - Paediatrics, Cardiology, General Surgery) so make sure you start by organising in terms of the overall rotations in each job, THEN look more closely at your preferred order in what rotation you would like to start on - we will tackle a bit more on rotation order later on!

Next, you need to think about your priorities! Everyone has different priorities and there are multiple factors you may want to consider when ranking jobs. Click each dropdown to read more:


  • If planning on living at home, you may want to start by putting the jobs in the hospitals closer to you at the top for commuting purposes

  • You may be staying in the same region you went to university and already have preferred hospitals from your experiences on placement 

  • You might be going to a completely new area and want to be in hospitals closer to the city centre; or alternatively prefer a quieter region! 

  • It is worth checking to see if rotations are in the same hospitals or how often you have to change hospitals for rotations for continuity of experience as well! For the most part F1 and F2 tend to be at different hospitals, but furthermore can change hospitals within years depending on type of specialty as well.

Type of hospital: teaching vs DGH?

  • Teaching hospitals tend to be larger in inner-city and include more niche tertiary services as well which will open up a wider variety of rotations.

  • District general hospitals (DGH) tend to be smaller, sometimes rural, which can be more supportive starting out, easier to get to know other F1s and could open up more opportunities for self-development

  • To get a balance of both, you could also look at jobs which give you experience in both types of hospitals rather than just one!

Specialties of interest

Balance of specialties

Rota intensity for work-life balance

Job satisfaction


So does the rotation order of foundation jobs really matter?

There are different opinions on this. Technically no, because at the end of the day you will get to do all 3 of those rotations in one year no matter what, but there are some factors you might want to consider. Click each dropdown to find out more:

Portfolio head-starts

  • If you already have settled on a specialty you might want to have it earlier on to confirm your interest and also get started on portfolio for that job e.g. start an audit cycle so you can close the loop later in the year or log theatre hours

Pros to starting on medicine/surgery

  • You might want to specifically start on medicine or surgery to expose you to on-calls sooner and gain skills earlier on to build on as you progress through F1. It’s worth mentioning that you will only get to shadow your first rotation before starting, after that you will go straight into each rotation with brief inductions so the transitions may be harder for example if you started with psychiatry then going into a surgical block.

Time for adjustment

Enjoying Summer

Christmas/ New Year's


Tools to help you with ranking


  • Using Excel or Google Sheets is probably one of the most popular ways to rank jobs as your list of jobs will already be downloaded as a spreadsheet and you can colour code certain rotations or hospitals to help you rank jobs easily.

  • Here is a useful guide on conditional formatting so you can do this more automatically to highlight cells that contain certain text rather than going through manually and highlighting yourself. You may want to assign certain rotations a value from 0-3 and so the higher overall value of jobs the more likely it contains more of your job preferences.


Automated ranking tools

Pen and paper

Whatever method you use to rank, make sure to give yourself time to review a couple of times before you add them in on Oriel - sometimes a fresh night’s sleep can give you a different perspective! It is wise to rank ALL of the jobs in the deanery group you have been allocated to increase your chance of preferred choices.

We hope you find this advice useful and all the best for your future job allocations! We will be updating our application guides across aspiring medics, medical students and doctors content this year - do not hesitate to reach out for blog requests!

Written by,

Dr Ellen Nelson-Rowe,

Melanin Medics Blog Lead


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