Sunday 31 July 2011

Seph : Special Circumstances and FPAS

[Several years on from this post and I have successfully applied for Special Circumstances to stay where I trained. For more up to date information please see]

Some more on the Foundation Programme! Don't ever say that we're not thorough... Here is another guest post by Seph which looks a little more closely at applying for special circumstances within the application process (specifically, reasons you need to stay in your 'home' - read medical school - deanery to work). Thanks Seph =)
In order to tie in with Flo's series on FPAS, I want to write a little bit about special circumstances. This is a process by which you can try to demonstrate that you have a particular need to have a job in a particular foundation school (and deanery). If you are successful, you are allocated to that school ahead of the general allocation process.
I should mention at this point that I did not get special circumstances, because I didn't apply in time, because I assumed I didn't qualify. I was then advised to apply on the basis that I would be more mentally stable if I didn't have to move across the country. Which I would have been. So: make no assumptions! If you think you might benefit from it and you can think of some justification, apply. At the least, email your med school's pastoral support person (particularly if they know you) and ask them what they think.
So, to qualify for special circumstances you need to a) have children, b) be a carer, c) have a medical condition (physical or psychological) or disability for which local follow up is an absolute requirement. There are also educational special circumstances which we will discuss in a minute.
Obviously point c is the more relevant here, and the one under which I tried to apply. Note that their idea of an absolute requirement varies – it may be that your area has a better speciality service than others, it may be that you are used to a psychiatrist or a therapist and would not benefit from being transferred, it may be that you have a surgeon who is taking an interest in your care. It doesn't matter what the reason is as long as you can justify it and get either an OH doctor, a specialist or (at a pinch) your GP to back you up. They have to write a report explaining about your condition, your ongoing treatment and follow up and – importantly – why said treatment has to be local. If you are going to apply, therefore, you need to discuss this with your chosen doctor well in advance and get them to write the letter well in advance so you've got it to hand in. Get your ducks in a row, as soon as you can. If you can get more than one letter backing you up, so much the better, and do it now. It is also worth noting that you can only do this is if you're applying to remain in your current deanery. You can't claim that you need local follow up somewhere else in the country.
Educational special circumstances is a slightly different deal. If you have special educational needs, your medical school will discuss with you what would be the best environment in which to carry out your foundation training. I should point out that the wording of this part suggests that this also includes an assessment as to whether you can “adapt to the working environment”. Make of that what you will. Anyway, your medical school can then put you forward for pre allocation to a particular foundation school.
Applying for special circumstances requires just a short form and the backup stuff. The form and the relevant guidance can be found on the Foundation Programme website at The guidance document is pretty good, written in reasonably plain language and fairly straightforward. As these things go.
Special circs is not a certainty. Your application will be reviewed by a local and a national panel and your score still needs to meet the “national allocation criteria”, whatever that is. It won't guarantee you a job, either. You also can't link applications if you apply this way. However, it doesn't hurt (unless you're planning to link) and you might be eligible even if you don't strictly meet the above criteria. As I said above, if you can think of something that would medically justify your need to remain in your own deanery, give it a go.
Good luck!

Do you have experience of applying for special circumstances for the foundation programme? Would you like to write a guest post about any aspect of disability/chronic illness and medicine? Leave a comment or email disabledmedic[funny at thing]hotmail[dot]co[dot]uk


  1. 'As with many things, including applying for various benefits, you are in a much better position to apply if you have a supportive GP/specialist who will write you a good letter'.

    For DLA, I wrote a letter to my GP listing things I was not doing most days (like getting dressed and cooking proper meals), and he sent it on more or less as was, with some extra GP long words. My GP tries really hard with benefits though.

  2. That's really good. I think some people find that it helps their GP to understand when they are asked to write these kinds of letters, because they ask questions or get information from you that they wouldn't normally have