My Experience with the New Deanery Allocation System for Junior Doctors in the UK
The UKFPO announced last year that it would be making some major changes to the foundation programme starting 2024 and I was part of the first cohort to be affected by these changes. Before delving into my experience, let’s walk through a brief background of what has changed and what this means for future junior doctors.
The Old System
The first major change made by the UKFPO was the removal of the Situational Judgement Test (SJT) which was an examination done by all final year medical students. The second was the removal of the Educational Performance Measure (EPM) which was a measure of your performance in relation to others within your medical school cohort (i.e. your decile). These two factors were used together to give you a score that would determine your rank. This meant that the better your grades were, the higher you would rank and the more likely you would be to get your top choice.
The New System
Similar to the previous system, each student ranks all 18 deaneries in order of their preference but rather than the SJT and EPM being used to determine your rank, a computer generated system is used instead. This means that if you have been ranked lower, you are less likely to get your top choice irrespective of your grades and performance.
My Experience with the New System
Deciding what order to rank all the deaneries was probably the most difficult part of the process. With the SJT and EPM gone, there was no basis to help with deciding the likelihood of being able to get into a competitive deanery as it was now free game for all. My friends and I had multiple conversations and dilemmas when ranking the deaneries. “Should we risk putting London first?”, “What if we don’t get our first choice and fall all the way to the 18th?”, “What if we end up leaving England?” . These worries have now all been proven to be valid as there are people who ended up getting their least preference and ending up in another part of the UK.
Amongst all these worries and risks, I still decided to give myself a fighting chance by putting London as my top deanery. Believe me when I tell you we all went back and forth with our preference rankings and probably changed our minds a thousand times before the deadline! Some may ask why London? It is the most expensive city in the UK, there are poor locum shifts for doctors if any, and the cost of renting is outrageous. With that in mind, London is still the biggest city in the UK and a land of unwavering opportunities both within and outside of medicine. It is a city where you will never run out of things to do, and I would have some sort of support system as most of my old friends currently live there.
My final preference list
Alas, we received the email confirming that our deanery allocations had been released. I could not explain why but I had a gut feeling that I would not get London and I was strangely ok with it. Many hours had gone by when I finally decided it was time to see the verdict. I read the words “Your allocated Foundation School is Trent.” I had been allocated to my fourth preference! There was a mixture of emotions and thoughts going through my mind – A sense of relief as I wouldn’t have to deal with London rent prices and the cost of living, but also feelings of worry, slight disappointment and fear of the unknown. East Midlands is unfamiliar territory to me but I guess this is nowhere near the furthest I have had to move.
Official allocation email from the UKFPO
My Advice for Medical Students
As redundant as it may seem, make sure you have some sort of strategy! It’s not worth putting all the competitive deaneries in your top 10 and risking getting your 18th preference. You need to firstly think about what factors are most important to you both for your life within and outside of work. Most people prioritise moving back home but, if you’re an international student like me, you most likely do not have that to consider. Think about whether you want to live in the same city or if you want a fresh start in a new environment. Some factors you might want to consider include cost of living, diversity/community, access to transportation and proximity to major cities. In terms of work life, some people may prefer to prioritise hospitals that are known to offer a specialty that they are interested in, better teaching quality, or regions where you can get research opportunities and publications more easily.
Once you have decided which factors you would like to prioritise, research which locations are most aligned with your preference and make sure you have at least one with a lower competition ratio to avoid being shipped away to the other side of the UK! There are many online threads on Reddit and The Student Room of people discussing their experiences, what to expect, and the pros and cons of each deanery.
While these tips may give you a higher chance of getting your top preference, or at least one that you wouldn’t hate, it is ultimately down to UKFPO’s random number generator so there will still always be a chance that you could end up in your least preference. I hope this article at least helps slightly when the time comes for you to make your decision and as cliché as this may sound, always remember that no matter where you end up, everything happens for a reason!
(p.s. I created a notion template to help me rank my preferences. You can find the link here :) )
Some Useful Links:
Author: Ramat Abdulkadir - Final year medical student at Aston Medical School