Investigating inequalities of study leave in the UK foundation programme

The UK Foundation Programme bridges the gap between medical school and specialty training and should be designed to provide opportunities that make Foundation Doctors (FDs) competitive. These opportunities are afforded in part through study leave. Health Education England (HEE) guidelines detail study leave allowances, but the specifics of what study leave can be used for differs regionally. We investigated differences in study leave across Foundation Schools by comparing individually published guidelines.

FDs in each Foundation School were used to identify the 2024-2025 study leave guidelines in their respective Foundation School and completed a survey. These data were then independently verified by two authors.

Every Foundation School was compliant with minimum HEE guidelines on study leave. Some Schools allowed twice as many taster days (five versus ten). Every School allowed leave for specialty exams, conferences and courses in Foundation Year 2 (FY2), but limited Schools allowed this in FY1. Most Schools had an undefined study budget, but London allowed up to £1,000, whereas Yorkshire and Humber provided funding only in exceptional circumstances.

Every Foundation School complies with HEE outline guidance for study leave utilisation. However, large geographical discrepancies remain in the level of funding provided to FDs and the majority of leave is limited to FY2, leaving only 106 days for this to be useful towards specialty applications. This highlights a shortfall in the opportunities provided to early career doctors and may impact their ability to make successful applications postfoundation training.