Coaching Application Form

The Coaching service provides information and individual support to clinical trainees and professionals working within the NHS in patient facing or support roles. This support is free and confidential to doctors and dentists training in London and the South East.

One of our advisers will be in touch within 5 working days to discuss how we can support you.

Your application will be treated in the strictest of confidence.

We recognise that most people approaching the Coaching Service are not in need of an urgent response, but occasionally people who contact us are extremely distressed about their career, and the wider issues affecting it such as health and relationships, and need somebody to respond quickly. If this is your situation, then we would like to draw your attention to the following resources that are available:

www.lpmde.ac.uk/professional-development/php-hee

From the 1 Oct 2015, a new programme, Practitioners Health Programme, Health Education England, London (PHP HEE London) will be available or those who need urgent advice re wider issues around their career. Please note that this is not an emergency service; trainees requiring emergency support should contact their GP, A&E or Urgent Care Centre.

KSS Foundation Trainees

From 2^nd August, KSS Foundation trainees should access support services via the KSS’s own Professional Support & Wellbeing Service. Please head to https://kss.hee.nhs.uk/kss-foundation/current-doctors-in-training/careers-and-wellbeing-support/ for more information.

It's easy to apply for 1:1 support: simply complete the Careers Unit application form below:

Title *

First name *

Last name *

Email Address *

Address *

Post code *

Gender *

I self-identify as

Telephone Number *

Professional registration *

Profession *

Other profession

Stage of training *

Other stage

Position/Grade *

Other position/grade

Job title *

Medical or dental specialty? *

Medical

Dental

Specialty *

Other specialty

Ethnicity *

Specify ethnicity if not above

LETB *

Other LETB

Do you consider yourself to have a disability? *

Yes

No

Prefer not to say

Trust *

Other trust

Place of Primary Qualification *

UK

IMG (International Medical Graduate)

What is your current training position? *

In training

In training within 3 months of taking an OOP

Taking an OOP

Returned to training within the last 3 months (potentially as part of a Supported Return to Training Programme (SRTT)

Please indicate any preferred dates/times and/or dates for first appointment *

What do you hope to achieve or clarify through accessing 1-2-1 coaching? *

Please tell us about your main concerns or reasons for for applying to the 1-2-1 coaching service *

Please provide any other details which may help in allocating you to a suitable coach *

From 2024 our normal process is not to telephone triage 1-2-1 Careers and Coaching applications. However if you feel this would be beneficial to you please tick the box below and you will be sent an appointment time.

Telephone triage

How did you hear about the Coaching service? *

Have you accessed or applied to any other services in PSU? *

Consent Type *

If you have been signposted to Careers by another PSU service listed above, please indicate whether you understand and consent that a further triaging conversation can be bypassed, and a coach will be allocated to contact you to arrange the first appointment

Confirmation *

By clicking here you will confirm that you have accepted the terms of our privacy statement.

What is your current training position? *

In training

In Training - Within 3 months of taking an OOP

Taking an OOP

Returned to training from OOP within last 3 months (potentially as part of a Supported Return to Training Programme (SRTT)