Frequently Asked Questions

Induction booklets are updated annually and contain important information about your lead employer, health education team, annual/study/parental leave entitlement, ePortfolio, salary and useful contacts. Please review the current induction information provided by the Health Education Team.

Register with the RCGP as a GP Registrar. This is an online process (with a fee) that provides access to your training portfolio. This will automatically create you a FourteenFish account and you should receive an email with instructions. Please log in to FourteenFish with the same email address you used to register with the RCGP. This process can take a few weeks so please register as soon as possible.

When starting on a hospital rotation, the hospital trust should contact you in advance of your start date to provide you with more information about the trust as well as the induction process. They can also be contacted directly via email correspondence: chelwest.doctors.induction@nhs.net. If starting on a GP placement, one of the TPDs will send an email introducing you to your GP Trainer. The email will include details of the practice you are to be placed at.

You should then contact the GP Trainer directly to enquire about induction processes and timetables.

The GP LEO (Lead Employer Organisation) should be your point of contact, not West Middlesex Hospital. The GP LEO for West Middlesex is the Royal Free Hospital team. Contact details are provided in the current GP training induction information as well as the Address Book.

Please email Anatolia Pasvantis (see the Address Book for contact details) for an application form and further information. There is a very long waiting time for a permit, with those who live the furthest given priority. However, the Trust may be able to provide trainees with a discounted patient car park daily rate, as well as a free permit for evenings, nights and weekends for those who work on-call shifts.

Yes. The WhatsApp group for West Middlesex trainees can be joined using the link shown in the private Trainee Area. There are also groups for specific training years, LTFT trainees and IMG trainees.

We receive a number of requests of this nature from trainees who feel that some of their allocated hospital rotations duplicate previous experience. Unfortunately, the allocation and duration of rotations are outside the Scheme’s control. We usually operate at maximum capacity each year, which means there are no unallocated or spare rotations available for trainees to move into. Trainees will therefore normally be expected to undertake the rotations allocated and authorised by the HET.

Commuting distance and travel time would not normally be considered exceptional circumstances, as accepting a place on the Scheme carries an expectation that trainees are willing and able to travel across the full geographical area covered by the Scheme.

Current GP trainees will spend longer in primary care than trainees have ever done in the past. Nationally, the GP programme has seen a shift to increase the time trainees spend in primary care to 24 months out of the 36 months of training. This additional time in primary care is the most relevant experience a trainee could have on the route to becoming an independent GP. Furthermore, during your GP placements you will have one session (half day) per week for self-directed learning.

Trainees often use these sessions to gain experience in fields they feel they lack knowledge. Some examples of what recent trainees have done include sitting in on clinics for specialties, joint clinics with Psych trainees, going out with the community palliative teams etc. You will have to arrange this yourself, but your GP Trainers are very experienced and will, in all likelihood, be able to connect you with clinics/consultants.

Failing that, the TPDs can also provide advice on who you can approach to arrange these. This would allow you to use your self-directed learning time to address any learning needs you have identified.

Trainees with previous experience beyond foundation level may be able to shorten their GP training by applying to the combined training pathway. This application is usually reviewed at your Annual Review of Competence Progression (ARCP) after your first 12 months. If successful and contributing time is approved, usually a maximum of 6 months is deducted from your ST2 year. However, acceptance onto a combined training programme is at the discretion of the HET local office or deanery.

To qualify for combined training, you must have an eligible training/employment history and you will need to demonstrate that your experience is relevant to GP training by mapping your capabilities to the GP curriculum. Applicants wishing to be considered are expected to have indicated this on their GP training application form already. Further information about eligibility/application is available from the RCGP Combined Training Pathways guidance.

All West Mid training practices and their locations are listed on the GP Practices page, with an interactive map to help you explore them.

Your GP placements will be auto-allocated during your ST1 and ST2 years. It is impossible to provide a choice for every GP placement as there are too many variables that need to be considered when placing trainees. Where possible, you will get the opportunity to rank your top three choices for your final 12-month placement in ST3.

Historically, most trainees have been allocated one of their preferred choices for ST3 but unfortunately it is increasingly difficult to guarantee this for every single trainee. You can be reassured that there are no bad choices and that the training standard across all practices is monitored and maintained to a high level.

Many Schemes across England have moved to auto-allocating all trainees (including ST3) but we aim to maintain ST3 choices for as long as it remains feasible to do so within the constraints of the programme structure.

A full-time GP trainee normally works 10 sessions per week, made up of:

• 7 clinical sessions, including clinical administration
• 1 tutorial session
• 1 self-directed learning (SDL) session
• 1 VTS half-day release teaching session

This equates to 40 hours per week. The seven clinical sessions should usually comprise approximately 75% patient-facing work and 25% clinical administration.

The three educational sessions are protected educational time. Although these activities do not necessarily have to take place as uninterrupted four-hour blocks, the overall balance of clinical and educational time should be maintained across a normal working week.

Your timetable should also include sufficient protected time for debriefing and any mandatory breaks. LTFT trainees have the same overall proportions applied on a pro-rata basis.

It may be possible to agree a condensed working pattern, but this is not an automatic entitlement. Any arrangement needs to be agreed between you and your training practice.

A condensed timetable must still meet the requirements of GP training. This includes preserving the appropriate balance between clinical and educational activity and ensuring that the total required working hours are completed.

The timetable must also accommodate mandatory breaks. A 30-minute paid break is required when working for more than five hours, and a total of 60 minutes is required when working for more than nine hours.

Requests should therefore be discussed with your GP Trainer and practice so that a timetable can be developed which is both educationally appropriate and workable for the practice.

Trainee working in a hospital post are expected to continue with their scheduled clincial duties when no Scheme teaching is scheduled.

For trainees in a GP post, your VTS half-day remains protected educational time even on weeks when no Scheme teaching session is scheduled. The time should therefore be used for other educational activity rather than being converted into routine clinical work. The activity should be agreed appropriately and should support your identified learning needs. It might take place within your practice or involve an external educational opportunity.

West Mid provides more teaching sessions than the minimum required nationally. We normally have teaching on 40 out of the 52 weeks of the year.

Self-directed learning, or SDL, is protected educational time intended to support your independent professional development. It only applies during GP posts as their is no contracted SDL for hospital posts.

For a full-time GP trainee, this normally represents one four-hour educational session each week. The activity should relate to your individual learning needs and does not have to take place within your GP practice.

Trainees often use SDL to pursue learning opportunities that are not readily available during their routine placement, such as attending specialist clinics, spending time with other healthcare services, completing relevant educational activities or addressing specific learning needs identified through their portfolio or supervision.

SDL is educational working time and should not routinely be converted into additional clinical activity.

Full-time trainees are normally entitled to 27 days of annual leave per year.

This increases to 32 days after five years of continuous NHS service.

If you believe your previous NHS employment means that you qualify for the higher entitlement, you should contact GP LEO and ask them to confirm that your previous service meets the requirements for continuous NHS service. Once confirmed, you should share this confirmation with your Clinical Supervisor and/or current placement so that the correct annual leave entitlement can be recorded.

Annual leave is calculated pro rata for trainees working less than full time.

Bank-holiday entitlement is calculated pro rata for LTFT trainees.

Because bank holidays do not fall evenly across the working week, your normal working pattern may mean that you are scheduled to work on either more or fewer bank holidays than your proportional entitlement.

Where your working pattern means that you receive fewer bank holidays than your pro-rata entitlement, the unused entitlement should be added to your overall leave allowance.

Conversely, if your normal working days mean that you happen to benefit from more bank holidays than your calculated entitlement, you should not normally be required to work additional hours to “make up” those bank holidays or have them deducted from your annual leave.

Trainees are expected to engage in some Urgent and Unscheduled Care (UUSC) work during their GP posts. Hours worked during these sessions form part of your overall working time and should therefore be accounted for within your timetable.

The equivalent time is normally taken back as time off in lieu (TOIL) from clinical working time at your training practice. Where possible, TOIL should be taken reasonably soon after the UUSC shift so that your working hours remain compliant and you do not routinely exceed the expected working week.

You should give your practice reasonable notice of your UUSC shifts and resulting TOIL requirements. Our handbook suggests approximately four to six weeks’ notice where possible.

With agreement from your GP Trainer, it may sometimes be possible to accumulate a number of UUSC hours and take the TOIL at another agreed point during the placement.

Trainees have an additional allowance of five days of professional leave for appropriate professional activities that sit outside the normal training curriculum.

Examples include involvement with professional organisations such as Royal Colleges, Faculties or the GMC, attending meetings as a GP trainee representative, and activities associated with applying for NHS jobs.

Professional leave can therefore include time required for job interviews or to undertake an assessment associated with an NHS recruitment process, such as the MSRA.

Professional leave is separate from your ordinary annual and study-leave allowances.

Study leave opportunities are categorised as mandatory, optional or discretionary. HET has published lists of approved mandatory and optional courses. Any additional training that you wish to attend which is not included on these lists falls into the discretionary category.

Mandatory training is normally provided through half-day release teaching or within the workplace. It does not usually incur additional cost and should not normally require additional study leave. The residential event is included within this category.

Optional training should be approved by your Educational Supervisor and should demonstrate that it meets an identified individual learning need. You should also obtain approval from the rota coordinator to confirm that patient care will not be compromised by your absence.

Discretionary training is considered on a case-by-case basis. Trainees are expected to explain the relevant curriculum learning need, discuss the proposed activity with the TPDs at an early stage and ensure that their portfolio is up to date. Further guidance on making a case for discretionary study-budget approval is available from HET.

Trainees may take a maximum of 30 days of study leave per training year. Between 15 and 17 of these days are allocated to GP VTS teaching sessions and residential events. This means that approximately 13 to 15 days per year remain available for other educational activities.

Study leave entitlement is calculated pro rata for trainees working less than full time.

The Study Leave Flowchart provides a useful summary of the overall study leave process. Further guidance, including information about claim limits, is available through the HET Study Leave Information pages.

Once your study leave has been authorised, reimbursement is claimed through the GP LEO Sel-Expenses system. You will need to submit the authorised approval form, proof of payment or receipt, and your certificate of attendance. GP LEO provides information about setting up and using your Sel-Expenses account through its regular trainee communications.

The expectation is that your available study leave allowance is divided broadly evenly between your two six-month posts. In practice, this means you would normally be expected to use around half of your annual available study leave during the first post and the remaining half during the second.

You should not normally plan to take substantially more study leave in one post and then reduce it in the other. Any unused allowance from the previous post or previous training year is lost.

There may occasionally be exceptional circumstances where you need to carry forward a small amount of study leave — for example, a day or two — in order to attend a specific educational activity. This would need to be discussed and agreed directly with the Clinical Supervisors responsible for each post.

Start by checking that your training information is correct, including your current post, review period and named Educational Supervisor. Some of the information shown in your portfolio comes from your formal training record, so if something is wrong it may need to be corrected at source rather than edited directly in FourteenFish.

If you need to add or amend information that is editable within FourteenFish, use the appropriate portfolio controls and check this against the information you have been given by the GP School. If the underlying training information is incorrect, or a section of the portfolio appears to be locked and you cannot amend it yourself, contact the Health Education Team (HET) through the Address Book. They can check the training record and arrange for it to be corrected where necessary.

It is worth sorting out any discrepancies early in the placement. Incorrect dates, posts or supervisor details can cause avoidable problems later when assessments, ESRs and other reviews are being completed.

Your Clinical Supervisor (CS) is primarily responsible for supervising and supporting you within your current placement. They see your day-to-day clinical work, provide feedback and contribute evidence about how you are progressing in that post.

Your Educational Supervisor (ES) takes the broader, longitudinal view of your development across GP training. They review the evidence in your portfolio with you, help you identify learning needs and complete your Educational Supervisor Review.

In some placements the same person may act as both CS and ES, but the two roles are still different: the CS focuses mainly on your current placement; the ES looks across your overall educational progress. Only your ES needs access to your ePortfolio as they will be responsible for reviewing and assessing your entries.

RCGP guidance on Clinical and Educational Supervisor reviews

A Clinical Supervisor’s Report (CSR) is completed by your Clinical Supervisor and summarises your progress and performance in a placement. It provides important evidence for your Educational Supervisor.

An Educational Supervisor Review (ESR) brings together the evidence in your portfolio and considers your overall educational progress. Your Educational Supervisor completes the review with you and makes a judgement about your progress against the GP capabilities.

The Annual Review of Competence Progression (ARCP) is the formal review process that considers your training evidence and decides whether you can progress to the next stage of training, require additional support or have completed the required competencies.

A useful way to remember the sequence is: placement evidence → CSR → ESR → ARCP decision.

RCGP guidance on CSR and ESR

Used carefully, generative AI can support learning and reflection, but it should help you think rather than do your thinking for you.

Appropriate uses include asking AI to challenge your assumptions, suggest reflective questions, identify perspectives you may not have considered or help you organise thoughts that you have already generated.

It should not be used to invent clinical experiences, manufacture evidence or produce a reflection that does not genuinely represent your own thinking and learning. You must also protect confidentiality and must not enter identifiable patient information into an AI system unless its use has been specifically approved for that purpose.

Whatever tool you use, you remain responsible for the accuracy, professionalism and authenticity of what you submit to your portfolio.

RCGP guidance on generative AI in GP training and WPBA

There is not one fixed West Mid ESR deadline that applies to every trainee. The GP School will email each cohort with the relevant ESR and ARCP deadlines for that review period.

ST3 deadlines are often earlier because the final review needs to fit with completion-of-training processes. ST1 and ST2 deadlines are usually later, but the exact dates can vary from year to year.

Always work to the deadline you have been sent for your cohort. If you cannot find the email or are unsure which deadline applies to you, contact the Health Education Team (HET) rather than relying on a previous year’s date.

Being less than full time does not mean that your ARCP happens less frequently.

All trainees are required to have an ARCP once each calendar year, irrespective of their LTFT percentage. The ARCP reviews your progress and the evidence within your portfolio over that period.

Your training may take longer overall when you are LTFT, but you should still expect an annual ARCP throughout your programme.

Most portfolio requirements are adjusted pro rata according to your LTFT percentage.

For example, if a particular requirement for a full-time trainee were 36 activities over a year, a trainee working at 60% would normally be expected to complete approximately 60% of that requirement.

However, requirements that must be renewed annually are not reduced simply because you are LTFT. Mandatory training such as BLS and Adult & Child Safeguarding must still be completed annually.

You should therefore use your portfolio and Educational Supervisor meetings to ensure that both your pro-rata evidence requirements and your annual mandatory requirements remain up to date.

All GP trainees can apply for less than full-time training (LTFT). The application process differs according to the reason for the request.

For reasons including parental responsibilities, disability or ill health, and caring responsibilities, applications can be made throughout the training year, normally with a 16-week notice period.

Applications for reasons such as wellbeing, unique opportunities, religious commitments, non-medical development or career-development flexibility are made during specific application windows.

Trainees should discuss their intention to apply for LTFT with the TPDs before submitting their application. LTFT GP trainees can currently work at 50%, 60%, 70% or 80% whole-time equivalent (WTE). Clinical and educational time is then adjusted proportionately. You can also use our Less Than Full-Time Training calculators to explore how LTFT may affect your training journey, placements and timetable.

LTFT Application Form with current application windows

LTFT trainees normally need to complete a minimum of 12 months whole-time equivalent (WTE) in hospital posts as part of the requirements for CCT.

Because hospital rotations normally change at fixed points in August and February, LTFT trainees cannot routinely move between hospital and GP posts as soon as they reach their required WTE experience. For example, a trainee may complete the required 12 months WTE part-way through a hospital rotation but still need to remain in that post until the next normal changeover date. As a result, LTFT trainees may spend a slightly greater proportion of their overall training programme in hospital placements than a full-time trainee.

You can also use our Less Than Full-Time Training calculators to explore how LTFT may affect your training journey and whether additional hospital posts may be required based on your individual circumstances.

If you have concerns about your hospital timetable, each Trust should have a named LTFT Champion who can provide support.

If your start date will be impacted by parental or extended leave, please make the TPDs aware so we can update our records. Even if your start date is deferred, you should still complete any required placement preference process by the relevant deadline. For future parental leave requests, you will need to inform the TPDs, GP LEO and the Health Education Team through the appropriate channels.

You can also use our Less Than Full-Time Training calculators to explore how time out of training affect your training journey and CCT date.

The PGMDE support service provides information on common training programme issues and allows trainees to raise individual enquiries. Trainees may also use the relevant trainee self-service systems for programme and personal information.

This is coordinated via GP LEO. You should discuss your request with your Educational Supervisor or TPD, who can help arrange an Occupational Health assessment through the relevant referral process.

The OH report remains confidential and TPDs do not automatically receive it. If adjustments are agreed, please share the relevant outcome with the TPDs so that appropriate future clinical and educational supervisors can be informed and your training remains compliant.

There is specific support for International Medical Graduates, including IMG-focused induction and guidance. IMG trainees should make sure they are included in relevant mailing lists and support groups and should identify themselves to the West Middlesex TPD team so that appropriate support can be offered.