Identifying the work activities performed by doctors in the Foundation Programme

What were the key findings?

  • Foundation Programme doctors fulfil different functions and perform different activities in different settings. For example, GP placements involve activities quite distinct from hospital-based placements.
  • There are tensions between the three main roles of a Foundation Programme doctor. As a ‘support’ who keeps the ward functioning; as an ‘independent practitioner’; and as a ‘learner’.
  • Some common activities of Foundation Programme doctors are not set out, or not set out in detail, in our curricular requirements. These include some practical procedures (notably arterial blood gases and nasogastric tube placement), end of life discussions with patients, and ‘professional skills’. There are as integral to routine work (task prioritisation and making a ‘job list’).
  • One quarter of activities specified in our curricular requirements are 'rare'. Performed by less than 25% of Foundation Programme doctors. Many of these are practical procedures. They include taking basic observations or giving intramuscular injections.
  • These activities are rare for Foundation Programme doctors. Because they are usually undertaken by nurses or because they are seldom needed at all.
  • It may still be important that Foundation Programme doctors are able to carry out at least some of these activities, eg in emergencies.
  • Acknowledge the variables of the Foundation Programme year 1 role. This may help graduates adapt to a fluid role when they begin practice.

Why did we commission this research?

The Foundation Programme is a two-year generic training programme for doctors. After completing undergraduate education, they explore how current requirements for outcomes and procedures relate to the activities performed by Foundation Programme doctors. The research aims to provide an evidence base for determining whether the competencies set are appropriate.

The research will be important for the next review and revision of our required outcomes and practical procedures. It will support the research and evidence we have obtained through the preparedness for practice of UK graduates research.

What did the research involve?

Researchers used a mixture of methods to gather the information. This includes questionnaires, focus groups, and telephone interviews. Supporting the research were Foundation Programme doctors, nurses, supervisors, senior clinicians, and senior non-medical Trust management.

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