I have wanted to take a year out and travel since perhaps my 3rd year of university (so 4 or 5 years now). I regret not having had a gap year and don't feel ready to step onto another conveyor belt of training that would mean anything from 2-7 more years before another break appeared. So after finishing FY2 seemed to be the perfect time to take the longed for gap year.I personally have chosen to travel for most of the year and take a break from clinical practice altogether but there are a lot of different options if you don't feel ready to apply to a training programme just yet.
I'll outline the options that I am aware of and/or have personal experience with.I'll then highlight a few things that it may important to know which I have only discovered since actually starting my year out!
You can follow in my footsteps - step away completely from clinical practice and take a year to travel, try a new hobby, take a non-medical course etc.
One of my friends has elected to find a full time locum post for a 6 month period and will then travel after this. This is a good option if you want stability and a definite income for 6 months and then have the freedom to do whatever you want for the rest of the year. The downside is that the pay for these posts tends to be at internal locum rates with the Trust you work for and so are not as lucrative as ad-hoc locums. She found this post by contacting a couple of Trusts near where she lived and asking if they had any posts available. She also managed to negotiate the pay a little so don't be afraid to ask!
I have another friend who has chosen to do a surgical fellowship for the year. This is another great option if you feel you need more experience in an area, want to bulk your CV out for applications the next year or simply don't think you are ready to apply for a training programme yet but want to stay in full time employment.
Becoming more and more common is to travel to Australia or New Zealand and work out there for a year. I am afraid I don't know much about the process involved here so can't give any advice but I do know that quite a few people from my cohort have chosen to do this option.
Probably the most popular choice is to do ad-hoc locum shifts to finance travel or other activities throughout the year. The majority of people taking a year out that I know are following this option. They have joined a locum agency and will pick up shifts here and there (mostly A&E) to make money to enable them to travel for long periods of the year.
Now to tell you the things that I have learnt so far:
When signing up to locum agencies, make sure you do it a couple of months before you want to start work. People told me this and I didn't really believe them until I ended up not being able to get a couple of shifts at the start of August because I was waiting for my CRB and occupational health report to come back! Be organised and sign up early!
The easiest and most common type of locum work is in A&E if you are just looking to make money. It's easy to step into one shift there and leave again. The problem is that you need to have done A&E during foundation years to be able to locum in it. Therefore if you think you want to go down this route after FY2, really do try to get an A&E job in those 2 years as it will make life much easier. There are still locum shifts in other specialties but most people agree that locuming in A&E is the best.
Whatever you choose to do, remember that you need to be able to return to the UK for interviews in Jan-Feb time and you may not receive the dates for the interview period until quite late. For GP applications the stage 2 computer test can be done in a couple of cities abroad but I'm pretty sure most specialties need you to come to the UK for the interviews.
If you choose to take a year away from clinical practice entirely you need to be able to explain the career break at interviews. I am lucky that I am applying for GP and their interview process involves clinical scenarios so I won't be asked about my career break in the same way that someone at e.g. core medical training interviews may be asked. If you choose to locum with travel combined, the same will apply but the main thing is that if you are taking the gap year for whatever reason, that you have an answer prepared.
Firstly, everyone on the GMC register with a licence to practice needs to go through revalidation. In order to do this, you need to have yearly appraisals which are 'controlled' by your designated body. During foundation years this is all sorted for you and your designated body is your local education and library board. If you take a gap year, your designated body will change and it is your responsibility to find out who it is and update it on the GMC website (The GMC have a handy tool to help you work out who it should be).
This then means that if you wish to work as a locum throughout the year (or in a 6 month post or as a clinical fellow) you need to have an appraisal during your year out as part of revalidation. If you are part of a locum agency then they should be able to arrange this for you but it is your responsibility to gather all of the information you need to prove that you are still fit to practice and are continuing professional development etc.
The other option which the GMC highlighted was available in my situation was to relinquish my license to practice but stay on the register and so avoid the need to participate in revalidation and therefore yearly appraisals. This would work for me as I am not practising as a doctor for the year and so do not need my license to practice. As far as I can see at the moment it just involves a lot of paperwork to restore your license before starting work (and it is essential to have that restored before starting any kind of clinical work). This would not be an option however if you are going to be doing any clinical work throughout the year as you need a licence to practice to do any sort of doctoring in the UK.
The GMC have the option for reducing the cost of their annual retention fee. Therefore if you are going to be working as a locum but perhaps only here and there and just earning enough to get by you may qualify for a 50% discount. If you earn less than approximately £32000 then you can apply for a 50% refund for the year!
I'm sure I will come across other bits and pieces as the year progresses but at the end I will try to give a further update on anything else I learnt or any unexpected hurdles I came across. If I do decide to go down the route of relinquishing my licence to practice I'll also try to give an overview of what that involved and how easy it was to restore it again!
UPDATE: I have now written about my experience restoring my license to practise at the end of my gap year!
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