Resources: foundation doctors

The foundation doctor should be proactive in managing their continuing education and career development and must take responsibility for detailing all achievements and progress within their e-portfolio.

To achieve this, the foundation doctor needs to understand:

The educational supervisor (ES), clinical supervisor (CS) and placement supervision group (PSG) are/comprise senior professionals who are there to provide guidance and support for foundation doctors. The CS and ES will meet regularly with the foundation doctor to discuss and agree objectives and review progress. More details of the ES, CS and PSG are provided below.


Initial appraisal and educational agreements

When foundation doctors start in a new placement, they must arrange an early meeting with both their educational and clinical supervisors, ideally, before the placement commences. This is the responsibility of the foundation doctor. If the foundation doctor is having difficulty in arranging this meeting, the Foundation Training Programme Director (FTPD) will provide a back-up mechanism to ensure that this meeting takes place.

The meeting is an essential starting point for negotiating the educational goals and discussing learning opportunities, the assessment process and use of the e-portfolio. The goals should take into account individual learning needs and personal circumstances.

The educational agreement and related learning plan must be recorded in the e-portfolio.


Meetings with the educational supervisor

In the first session with the educational supervisor, the foundation doctor may wish to discuss aspects of the curriculum. This might include:

The foundation doctor and the educational supervisor should also agree a timeline for the undertaking and recording of achievements, and should agree the times and dates for subsequent meetings.

Meetings with the clinical supervisor (CS)

In addition to departmental induction, the named CS will meet the trainee at the start of each placement to agree educational objectives for the placement and to identify the members of the PSG to the trainee.

The clinical supervisor will normally meet with the foundation doctor at the mid-point of the placement to review progress and again at the end of the placement as part of the assessment process. The supervisor or trainee may arrange additional meetings as required.

When engaged in reflection, supervised learning events, formal assessment or self-assessment, foundation doctors may refer to the 'descriptors' for examples of how they might demonstrate that their achievements meet or exceed the minimum expected level of performance in each of the foundation professional capabilities. Educational and clinical supervisors are there to help if foundation doctors experience any difficulties with this.

The end of placement reports by the clinical supervisor (CS) and educational supervisor (ES) are also used to indicate whether the foundation doctor is on course to achieve the required outcomes by the end of the year of training.



Foundation doctors should familiarise themselves with the assessment section in the curriculum.

Assessment of performance is based on observation of the foundation doctor in the workplace. Formal assessments include the team assessment of behaviour (TAB) and end of placement reports by the clinical supervisor (CS) and educational supervisor (ES), and the educational supervisor's end of year report. F1 doctors will also need to provide evidence of their ability to perform core procedures as mandated by the General Medical Council (GMC).

The clinical supervisor's assessment will be based on multiple observations of the foundation doctor's practice and progress in the workplace. In addition to their own observations the CS will draw on feedback from doctors and senior healthcare professionals in the placement supervision group (PSG).

There is an expectation of professional development during each placement. The foundation doctor's performance will be judged according to whether it is appropriate for the stage of training and will reflect whether their achievements in the foundation professional capabilities suggest that they are on course to meet or exceed the minimum expected level of performance in each of the foundation professional capabilities in order to be signed off at the end of the year of training.

The foundation doctor should recruit an appropriate number and mix of appraisers for the TAB. A satisfactory TAB is dependent not only on the comments received but also on receiving sufficient responses from an appropriate spread of assessors. Trainees should request their TAB feedback in a timely manner to ensure sufficient responses.

Comments from the TAB should be discussed with the educational supervisor who will help the trainee reflect on and provide guidance on resolving any areas of concern.


Minimum expected level of performance during the F1 and F2 years

By the end of each year of foundation training the foundation doctor's achievements in each of the 20 foundation professional capabilities (foundation programme training outcomes) must meet or exceed the minimum expected levels. By demonstrating this, the foundation doctor will have demonstrated achievement in the key aspects of clinical and professional medical practice. When considering the provision of evidence, foundation doctors may find it helpful to refer to the general expectations descriptors' indicative examples of clinical and professional accomplishments set out in the 'descriptors'.

Remember that performance is reviewed according to the stage of training, for example less will be expected of a doctor in their very first placement than a doctor in the same placement at the end of F1. A satisfactory clinical supervisor (CS) and educational supervisor (ES) end of placement report will indicate that, by the end of the year, they expect the foundation doctor's practice in each of the 20 foundation professional capabilities (foundation programme training outcomes) to meet or exceed the minimum expected levels of performance.

At the start of the foundation programme, foundation doctors should concentrate on achieving the F1 sign off by ensuring that they are able to provide evidence that their professional and clinical practice meets or exceeds the high level performance indicators for each of the 20 foundation professional capabilities. This evidence might be based on the indicative examples and general expectations set out in the accompanying 'descriptors'. Alternatively the foundation doctor and their trainers may provide examples of their own. It is essential to recognise that it is neither expected nor necessary for a trainee to provide evidence of every 'descriptor'. F2 doctors are expected to perform at a higher and increasingly independent level. All foundation doctors should consider further professional and clinical development and work towards achievement of F2 outcomes from the outset.

The foundation doctor who demonstrates excellence may well achieve and exceed the minimum expected levels of performance across all 20 foundation professional capabilities, and beyond, well within the two-year time frame. However, the foundation doctor cannot pass an ARCP before finishing a full year in F2 placements.