The 'F3' Year: Taking Time Out of Training - Part 1

The race to reach the top of the tree in Medicine is one that can be relentless.


Many of us have engaged the zeal, determination and relentless drive (traits which are required to reach the medical summit) at various stages of our educational life. From Secondary School, we pressed on and pressed hard, jumping over every barrier placed in front of us – whether it was achieving your expected grades, to passing entrance exams and interviews; jumping straight into medical school or finally arriving there by way of BSc.


Even when the euphoria of passing your finals deteriorates into stress and toil as you meander through the first few weeks of foundation training, your innate drive will likely begin to pressure you into thinking forward towards the next big hurdle you need to jump over in your career – the process of specialty training applications and making the difficult decision of which specialty you will be entering into.


For some, they have the special grace to have known what specialty they want to pursue a career in. But it also appears that a growing number of people come to the end of their foundation years with no real consensus regarding what specialty to choose, with the path forward appearing even more fuzzier than it did at the start of F1! Only 43% of junior doctors in 2017 entered straight into a UK specialty training programme on completion of F2,which is a substantial decrease from 71% in 2011.This drop in numbers can be partly explained by the rise in popularity of the option of taking an ‘F3 Year’.


Why the rise? There are many potential reasons. For some, they may have reached that period in F2 where specialty applications take place none-the-wiser as to which training branch they want to enter, or undecided as to even whether they want to pursue specialty training at all. Some may not get their desired training post/job and have nothing concrete planned for the next year. There are those who have been burnt out by F1/2, those who have become disenchanted with the system as they’ve waded through the thick mud of red-tape and poor working conditions which can be found in various corners of the NHS. There will be those who have encountered physical or mental health issues, or have more extra-curricular responsibilities which they want to address.


SO WHEN?

Should you take a break after medical school? Well truth-be-told it’s advisable to jump straight from medical school into foundation training. Not only is it the well-worn path, and one taken when you arguably have the greatest amount of general medical knowledge you’ll have in your life (keyword:arguably); but the support of medical schools in helping you cross that threshold into foundation training and help you get those training wheels off and hit the ground running cannot be underestimated. The additional support of your peer group is also important, for F1 can be daunting and heavy and particularly stressful and great comfort can be taken knowing that you are in a group of people having similar experiences. Also remember that you need to complete F1 year to complete your provisional registration with the General Medical Council (GMC) and attain your full registration and become eligible to practice independently.


It is rare to take a break between F1 and F2, as such a break can be extremely tricky to arrange and the vast majority of posts are applied for as an F1/F2 combination rather than as separate entities. In saying this, there are some Foundation Schools that allow for F2 year to be spent abroad or offer support to take an interim break between F1 and F2. It’s best to ask the powers-that-be at your Foundation School to consider what options are out there.

This all brings us to the most practical and most popular period where people take a break – time after completion of F2. Colloquially termed ‘F3 year’ it’s a time where you can constructively spend time deciding on your next steps with enough tools in your armoury to help you on your way. By this point, having completed F1 previously you will be fully registered with the GMC and you will have a broader base of knowledge and more experience in medicine.


At this point you will also have a better idea of the realities of working day-to-day in the NHS on the ‘shop floor’. You will have a better idea as to what you personally hold up as most important in your life. Did you find the sensation of FOMO (Fear Of Missing Out) too difficult to take while you were stuck on heavy rotas and missing weddings and birthdays? Did you come to realise that work/life balance and spending time with loved ones is more important to you than you originally thought? Did you flourish during your endless on-calls, or did you pray fervently that your on-call shifts would whizz on by? Did you discover that Grey’s Anatomy sold you a dream of what medical/surgical life really is like, or do you now see yourself ready to take on your mantle as the next Dr House?


‘F3 year’ is even a misnomer – some people take two years out, or even more time out of the picture. Some may not even return to medicine. While taking a training break is most common after completion of F2, another natural break presents itself after completion of core training in the non-run-through specialties like medicine and surgery. These breaks are a time where people shift through their thoughts and feelings, as it is common to experience doubt over your originally preferred specialty or even your choice of career!

https://www.bma.org.uk/advice/career/applying-for-training/out-of-programme

https://specialtytraining.hee.nhs.uk/Recruitment/Person-specifications

Dr Jermaine Bamfo

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