This article has been written with final year medical students in mind, deciding where to go for foundation training. As an FY2, it is one of the questions I get asked most by medical students. You might already have a clear idea of where they want to be, but if you don’t (or just want some advice/reassurance) then keep reading!

Context: I have spent both years of my foundation training in a district general hospital (DGH) in the North East of England after studying at the University of Glasgow. My jobs have included geriatric medicine, trauma and orthopaedic surgery, anaesthetics, general practice, emergency medicine and general surgery.

Disclaimer: All opinions are completely my own and everyone will have different experiences and opinions regarding foundation training.

Deanery/area

• You may have certain factors or responsibilities meaning you have to stay in a certain place for foundation.
• If you don’t have any commitments to an area, why not try somewhere new? As someone who took the leap moving somewhere else (a different country even) and living with strangers, I am so glad to say it has been an immensely positive experience. I can’t speak for everyone but in my case I am so glad I stepped outside my comfort zone and moved to a new city.
• What’s important to you? Shopping? Nights out? Hill walking? Good weather? Great music scene? Future career opportunities? – have a look at what different areas have to offer and decide what works best for you.
• How competitive is it? This shouldn’t be as much of an issue with removal of the scoring systems for F1 placements, however it may be something people are still concerned about. At the end of the day if you really want somewhere, I would go for it without worrying about how competitive it is. Someone has got to get it!
• Finally, remember foundation is only for 2 years. If you love somewhere, great! If you don’t love it, I’m sure you will make the most of it and do something you would prefer once those 2 years are up. There is some scope for inter-deanery swaps however this is not something I have personal experience of.

Hospital

• Do you want to stay in the same hospital for both years? Are you happy to move around? Are you willing to sacrifice a longer commute to a smaller (but perhaps friendlier) DGH or would you prefer to be in a larger tertiary centre with lots of specialties and opportunities?
• Have a think about these things and make a decision based on your personal priorities. As mentioned earlier, there is no ‘right’ answer, it will always just be a balance of what matters most to you.
• I personally work at a smaller DGH in a relatively deprived area. It is around 45 mins commute (depending on traffic) but I love my colleagues and peer group.
• I live much closer to a large tertiary centre who have opportunities in specialties I am interested in pursuing, which my DGH does not offer.
• It takes a bit more effort however it is still possible to experience different hospitals and specialties if they are not offered at your trust. You can arrange taster days, seek out projects and make contact with specialties you are interested in.
• So all in all, it is not the end of the world where you are placed. They will all have more and less favourable aspects!

Jobs

• Have a chat to people already at the hospital, it might be good to learn what departments offer more or less support than others.
• That being said, everyone’s experiences are so individual so don’t let another person’s opinion put you off. I loved some of my placements that other people hated and didn’t enjoy rotations that everyone else raved about.
• Most foundation posts will combine more popular and less popular placements, so I wouldn’t go searching for perfection. You might spend 4 months on a specialty you are not interested in but in return get 4 months of something you love.
• What matters to you? If you are very academic and want to get some exams done during foundation you may want to have more relaxed placements so you can revise. If you like getting involved and learning as much as possible on the job then you may choose something more fast-paced.
• Some people know exactly what they want to do in the future and choose their placements to supplement this. If you don’t know, I would advise getting a good mix of different specialties, both community and hospital based. This way you can try as many things as possible and gain experience in different areas.
• There are certain programmes such as the priority programme and the academic programme which are separate to general foundation training. You apply for these earlier in the application process and they often come with additional perks like extra qualifications or study time.
• Each deanery offers something different so make sure to do your research and find out what is right for you.

Other

• How do you pick annual leave?
• Do you get study time?
• Do you have friends/family/good support network nearby?
• How much do you get paid?

All of these questions are quite generic but may vary slightly between different areas. If they are important to you it might be beneficial to consider them before making your final decision.

Finally, good luck! Wherever you end up it’ll all work out. We will speak more in future articles about having a good work-life balance, seeking out help & support and taking care of yourself during foundation years to make sure you get the most out of your placement.