Dr Helen Johnson is Foundation School Director for the East of England and a consultant in obstetrics and gynaecology, and she sits on the GMC’s Welcomed and valued steering group, which helped us update the guidance that is now open for public consultation.

Here she writes about the difficulty of transitioning between medical school and foundation training, and what this means for doctors with health needs.

I am, by clinical practice, a consultant in obstetrics and gynaecology. I have had a keen interest in medical training and education throughout my career. I’m particularly focused on improving the transition points in training, whether that is medical school to foundation training, or higher training to consultant.

Having worked in foundation training for many years, it is clear that this is a huge transition for many, with difficult adjustments to be made at a time when family and friendship groups may be distant. This can be tricky to negotiate for trainees with no other commitments and no health issues, but it’s obvious to me that it’s even more likely to be a difficult time for trainees with added responsibilities or health requirements.

Although I was a newly appointed Foundation School Director when the Welcomed and valued steering group formed, I was delighted to be able to take part.

My key interest is working with medical schools to support trainees with health conditions across this transition. We have a process called pre-allocation where medical students can ask to be placed in a specific foundation school due to their own health requirements, a caring role for a close family member or a caring role for children.

By chance, the pre-allocation meeting at my local medical school follows the medical school’s consideration of adjustments for examinations. This year, I attended both meetings and it was clear that for at least one of their students, taking a bespoke approach to transition in advance would be really useful. This allowed us time for proper assessment and planning and we were able to remove some of the unknown elements of approaching foundation training.

Early dialogue between medical schools and foundation schools

Every other month, I attend the Foundation School Directors group, which is a meeting of the Foundation School Directors/Deputy Directors from all the foundation schools in the four countries of the UK.

On discussion with this group, we very quickly agreed that there would be benefit in coordination between foundation schools and medical schools earlier than at pre-allocation meetings, or when the official transfer of information is released, which sometimes only happens the week before the doctor is due to start foundation training.

We agreed that as we are a cohesive group, the local Foundation School Director would be able to initiate the process regardless of which foundation school the medical student eventually chose.

Working with the Welcomed and valued steering group and the medical schools’ representatives has let us collaborate on this much more quickly than gentle evolution might have achieved. This is a real positive for today’s medical students who can have confidence that their needs are considered, and also for the health profession, as a more timely tailored approach will allow us to support trainees through one of the most crucial stages of their career. Talking with our trainees who have experienced both the old and new systems, they are all very positive for the future.

Adjustments for assessments

One of the key steps to completing foundation, and in particular moving from a provisional to a full licence to practise, is completion of the foundation assessments. What adjustments can and should be made for trainees with health needs has been hotly debated at the Foundation School Directors group and at the Welcomed and valued steering groups.

We hope that the position we have reached in the draft guidance is felt to be a fair balance between requirements and adjustments, and we are keen to hear your views.​

Respond to the GMC’s consultation on its guidance for educators and employers on supporting disabled learners or those with health conditions by 20 September 2018 to have your say