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Out of programme (OOP)

Taking time out of programme (OOP) can be beneficial for your educational and professional development and career, as well as being interesting, enjoyable and personally rewarding. This section of the site provides information about taking time OOP, whether for research, clinical training outside your deanery’s training programme, clinical experience or for a career break, including how different elements of training count towards CCT as part of OOP training or research.

General RCOG regulations for OOP

Out of hours work

The RCOG doesn’t support the out of hours element of OOP as counting towards CCT, as out of hours work is generally indirectly supervised clinical work.

Daytime clinical exposure

At all ST levels, the RCOG considers daytime clinical duties as counting towards CCT on a pro rata basis. However, ideally the exposure should include the breadth of clinical duties expected in a general O&G training post, at the level expected for the individual trainee (e.g. general gynaecology and antenatal clinics, delivery suite cover, etc.). Time spent only in a specialist clinic is unlikely to be supported as counting towards CCT, except in the context of an ATSM for ST6/7s (see below).

ATSM exposure

If you’re an ST6/7 and planning a period of OOP within which you might complete an ATSM, the time spent undertaking the ATSM may count towards your CCT (completing one ATSM during a period of OOP would count for approximately 3 months towards your CCT). The RCOG will assess this on an individual basis.

You would need to treat this as OOP training (OOPT) and would have to seek prospective approval from the GMC, with RCOG support. Your home deanery would need to confirm their support for you to undertake an ATSM during OOPT and firm arrangements would have to be in place before you took up the post, with a preceptor confirmed.

Taking time out of programme (OOP)

You can take OOP in one of the following categories:

  • Out of programme for clinical training (OOPT)
  • Out of programme clinical experience (OOPE)
  • Out of programme research (OOPR)
  • Out of programme for a career break (OOPC)

To find out how to apply for OOP, please read the guidance on applying for OOP.

Out of programme for clinical training (OOPT)

OOPT involves clinical training outside of your deanery training programme, where the time will count towards award of CCT/CESR. You'll need prospective approval from the GMC, with confirmed approval from your Postgraduate Dean, deanery Specialty Training Committee/local School of O&G and the RCOG, via the Chair of the Specialty Education Advisory Committee (SEAC).

You’ll need to plan well in advance – allow a minimum of 6 months to gain appropriate GMC approval.

OOPT may include full or part recognition of time spent developing additional clinical skills or time spent training in another country. However, the training must be supervised and undertaken within a programme with a quality management system that satisfies GMC requirements. OOPT can also encompass part recognition of daytime clinical training in general O&G within a period of formal research.

The amount of time the RCOG will recommend as counting towards CCT/CESR will be individualised and based on the proportionate time spent undertaking relevant clinical duties. It will depend on the perceived contribution of the clinical components towards your individual overall competency progression.

  • For time to count towards CCT, you’ll need to participate in general daytime O&G duties. This is especially true for trainees up to and including ST5 level.
  • If you’re a senior trainee (ST6/7), you may plan to complete an ATSM during a period of OOPT. The time you spend undertaking the ATSM can count towards your CCT (one ATSM will count approximately 3 months towards CCT; this will be assessed on an individual basis). You’ll need prospective approval from the GMC and support from the RCOG.
  • For trainees at all levels, out of hours duties in general O&G don’t count towards CCT.

If you wish to undertake subspecialty training in another deanery, this is classified as OOPT, but you don’t need prospective GMC approval. 

Out of programme clinical experience (OOPE)

Taking time out of programme for clinical experience (OOPE) may:

  • Benefit you as a trainee (e.g. working in a different healthcare environment or another country)
  • Help support the health needs of another country (e.g. working for Médecins Sans Frontières or VSO, volunteering overseas or supporting global health partnerships

With OOPE, there’s often no formal training supervision, or the training is within a programme that doesn’t meet GMC quality management requirements. This experience doesn’t count towards CCT and therefore doesn’t require GMC approval.

However, you do need approval from your deanery Specialty Training Committee/local School of O&G and your Postgraduate Dean, as you’ll need confirmed leave of absence and an agreement that you can return to your current training programme on completion of your OOPE.

Out of programme research (OOPR)

Taking time out of programme for research (OOPR) isn’t a formal optional element within the GMC-approved curriculum for O&G. However, many trainees gain valuable research experience OOP, either undertaking full-time research leading to a postgraduate degree (PhD or MD) or working as a research fellow (with the research post often including a clinical component).

Time allocated for OOPR doesn’t normally exceed 3 years and trainees in their final year of training won’t normally be granted OOPR (this is a deanery decision).

If your OOPR post doesn’t include any significant daytime duties in O&G, the time won’t count towards CCT/CESR and you don’t need GMC approval.

However, if your OOPR post includes a daytime clinical component, you may wish to consider this for time counting towards CCT. You’ll need prospective approval from the GMC, your deanery Specialty Training Committee/local School of O&G and your Postgraduate Dean.

  • For the time to count towards CCT, you’ll need to participate in general O&G daytime duties. This is especially true for trainees up to and including ST5 level.
  • If you’re a senior trainee (ST6/7), you may plan to complete an ATSM during a period of OOPR. The time you spend undertaking the ATSM can count towards your CCT (one ATSM will count approximately 3 months towards CCT; this will be assessed on an individual basis). You’ll need prospective approval from the GMC and support from the RCOG.
  • For trainees at all levels, out of hours duties in general O&G don’t count towards CCT.

Out of programme for a career break (OOPC)

Taking time out of programme for a career break (OOPC) means stepping out of your training programme for a designated, agreed period of time:

  • To pursure other interests (e.g. domestic responsibilities, work in industry, developing skills in other areas)
  • For health reasons (e.g. being a carer, suffering a prolonged period of ill health)

OOPC requires prospective approval from your Postgraduate Dean. Having your deanery’s approval means you’ll be secure in the knowledge that you can rejoin the training scheme in the future. You can agree the timing of your return at the outset, or negotiate it once circumstances allow. Please bear in mind that it may not be possible to organise an immediate return, as this will be dependent on the availability of a ‘gap’ in the programme that matches your current year of training and experience.

Contact us

If you have any questions, or want more information, please  or call +44 20 7772 6294.