Global Health Fellowships / Time Out of Programme
Introduction.
London General Practice supports requests from GP Trainees for Time Out of Programme (OOP) as outlined in the recommendations of the Gold Guide (1) and Step On Step Off Training (SST) (2).
We recognise that OOP enhances GP clinical experience by encountering different working practices. We also support the recommendation of the Crisp report (3) that encourages educators to facilitate training and work experience overseas for GP Trainees. It sees applications for OOP, as opportunities for excellence and anticipates that the experience provided by OOP will enhance GP Trainee competencies(4+5).
Further OOP guidance is available in the linked downloads.
Global Health Fellowships
It is recognised that GP trainees gain enhanced skills and competencies from working overseas in poorly resourced settings. To support this development London General Practice offers Global Health Fellowships(GHF) to GP trainees who have satisfactory completed ST2 with ARCP Outcome1.These are advertised to trainees in November of their ST2 year
The GHF have been developed in collaboration with in-country partner agencies and include
The following posts:
St Francis Hospital Katete Zambia. saintfrancishospital.net
The Thakurpukur Cancer Centre and Clinics Kolkata India.sgccri.org
Calcutta Rescue Kolkata India. calcuttarescue.org
Soft Power Health Jinja Uganda.www.softpowerhealth.org
Gurkha Welfare Trust Nepal. www.gwt.org.uk
Rural hospitals and clinics in South Africa, Namibia and Malawi with ProTalent (tracey@proappoint.co.za)
The aim of the GHF programme is to enhance GP training. By working in poorly resourced and challenging environments GP Trainee’s can gain confidence as well as consolidate and develop clinical, managerial, leadership, cultural and educational skills. Many of which are beneficial and transferable to the NHS.
GP Trainee’s bring added value to the GHF posts through the competencies developed in the ST1 and ST2 years. Experienced trainees committing to jobs from six months to one year is an expressed need of developing countries to help achieve sustainability. This period is seen as the minimum time necessary to profit from preparation, gain relevant expertise and achieve mutual benefit.
GHF job descriptions as well as the experiences of previous GHF are available on the linked downloads.
Induction and Mentoring
Before starting a GHF, GP trainees have the opportunity to attend induction sessions and Global Health training workshops. These provide opportunities to explore job skills and responsibilities as well as administrative issues such as visas, work permits etc. Trainees who have previously undertaken GHF also participate.
A peer support network is also available as well as mentorship from past GHF GPs. The mentors share issues that arise in preparation, any difficulties faced whilst overseas and offer support on return.
Self-Construct Time Out of Programme
We support trainees who construct their own clinical posts overseas as well as in the UK. We also support full time research and Masters programmes as well as Public Health and NHS Management and Leadership jobs. Diplomas will also be approved if they constitute training that precedes relevant clinical experience.
Opportunities are also available under Step On Step Off Training (SST) guidance to take Time Out of Programme for self-construct posts between ST1 and 2. However Trainees must meet the eligibility criteria of satisfactory completion of ST1 with ARCP Outcome 1. Applications will not be approved if they interrupt secondary care posts other than for statutory reasons as this has implications in relation to certification and funding.
OOP applications must be finalised and approved at least six months before the start date, so that Training Programme Directors can ensure the organisational needs of their schemes are appropriately addressed.
Information about GP trainees who have undertaken self construct posts are available on the linked downloads.
MRCGP ePortfolio
While on Time out of Programme you are not required to complete the full e portfolio, instead you are requested to post a summary report of your work and competencies gained. You are also encouraged to add reflections to your learning log. The report is used as the basis of a six monthly Educational Supervisors review. Information from these reviews assist in mentoring, monitoring and evaluation.
Administrative matters
Employment contracts will be the responsibility of the trust/organisation that supports the GHF/ OOP not London General Practice.
Through the NHS England Global Health Fellowship Volunteer Programme you may be eligible to claim £1000 per month upto six months including costs of flights.However these stipends are now under review.
For OOP outside the UK, work permits, visas and medical registration will be the responsibility of the trainee, including costs.
To prevent difficulties in restarting work back in the UK, you are required to maintain your GMC registration while overseas. In general whilst working abroad your NHS pension contributions will stop and will resume automatically on your return.
Further information can be found in BMA publication Volunteering abroad (6) and HEE Guidance for working overseas (7).
Please discuss your OOP application,prior to submitting via the Portal,with Dr Patrick Kiernan GHF/OOP Programme Director (patrick.kiernan@nhs.net)
Downloads
Application form - General Practice Global Health Fellowship
OOP Study of Impact on Trainee Skills
Report of a Year in Zambia Dr Natallie Burrard-Lucas
Job Description Calcutta Rescue - Kolkata India
Job Description Palliative Care Kolkata India
Job Description Gurkha Welfare Trust
References:
1. Gold Guide Reference Guide for Postgraduate Specialty Training in the UK. Section 3.143 to 3.176. 10th Edition 2024
2. Step On Step Off Training. https://www.nwpgmd.nhs.uk/sites/default/files/Step%20on%20Step%20off%20p...
3. Global health partnerships: the UK contribution to health in developing countries. Lord Crisp. 2007
4. Evaluation of effect on skills of GP trainees taking time out of programme (OOP) in developing countries. Kiernan P. et al. Education for Primary Care (2014) 25: 12–17
5. Evaluating the NHSE Global Health Fellowship Programme. Chilala and Trotter. The Bridge,Hughes Hall,University of Cambridge. 2023
6. Volunteering abroad as a doctor. BMA 2022. https://www.bma.org.uk/advice-and-support/career-progression/volunteerin...
7.Health Education England. Guidance for Trainees Planning to Work or Volunteer Overseas. HEE.NHS.UK Dr. Robin While 2017
Dr.Patrick Kiernan March 2025