The F3 Year.
Author - Mat Daniel
There has been a well documented steady decline in Foundation doctors, entering straight into training, with only 35% of F2s entering specialty training in 2019. Instead many are opting for a year out of the traditional training, termed an “F3” year. What are their reasons? Research suggest
-Stress and exhaustion
-Specialty indecision/Career uncertainty
-A loss of autonomy over their lives
The Foundation years are likely to be the toughest of anyone's career, but things do get better. There are lots of options for what to do in the F3 year, including
-Trust grade post
-Doing nothing medical at all
People have different reasons for doing the F3 year, and I think it is important to align what you do in the F3 year to the reasons why you are doing the F3 year in the first place. For example, if you are looking for more freedom and flexibility, then locuming would be a good choice. If it's to deal with stress, exhaustion, or burnout, then a relatively easy job might help you build resilience and recover (alongside professional help to manage the stress). This could be a clinical role, or a 9-5 educator role, but do check what stress the jobs have as there is no such thing as a stress-free job, there are just different types of stresses. If you are not sure what to do career wise, then locuming can be a way to taste different specialties, as can a rotating trust grade post (and have a look at my choosing careers page). The F3 year might also be a good time to explore non-traditional career pathways, or do a course in something unrelated to medicine.
Whatever you do, you are likely to find yourself more valued than as an F1/F2, because of the additional skills and experience that you bring to the role that you do. And at some stage in the F3 year you will start to look at the next steps, so the year is also a good one to develop yourself without the pressure of having to meet ARCP requirements inherent in training; this might be research projects, audits, or courses, or something else that will help you with the next step in your career.
People often worry about the fact that they are taking 'time out'. I'd see this in a completely different way - as getting more experience (either career-related experience or life-related experience). Indeed, before Modernising Medical Careers came along, it was quite normal and positively encouraged to spend time exploring the breadth of medicine (I can see how getting doctors to GP / consultant level as quickly as possible benefits doctors and patients, assuming those people are well trained, but the people that probably benefit the most are the politicians who promise more GPs / consultants). You will be a GP or consultant for the best part of 30 years, so what is the problem with taking a year or two to develop yourself! Time is very much on your side, and I personally don't see any need to rush one's career when a year invested into discovering who you are and what you want can be so worthwhile and set you up in a good way for the rest of your professional career. Think growth mindset rather than fixed mindset. So the key for me is to use the F3 year wisely, and this comes back to knowing what are the reasons for taking the F3 year in the first place.
Church H, Agius S. The F3 phenomenon: Early-career training breaks in medical training. A scoping review. Medical Education Online 2021
Hollis AC, Streeter J, Van Hamel C, Milburn L, Alberti H. The new cultural norm: reasons why UK foundation doctors are choosing not to go straight into speciality training. BMC Med Educ 2020; 20(1): 282
Rizan C, Montgomery J, Ramage C, Welch J, Dewhurst G. Why are UK junior doctors taking time out of training and what are their experiences? A qualitative study. Journal of the Royal Society of Medicine. 2019; 112(5): 192-199