Preferencing
Compare programmes by training reality, not reputation
There is no defensible national ranking. Use official school and Oriel information, then ask current trainees how the advertised programme works across its hospitals.
Route and rotation footprint
Confirm which subpreferences are Core, ACCS or mixed; hospital sequence; DGH and tertiary balance; cross-site travel; placement length; and whether an ACCS order is fixed or variable.
Novice training and IAC
Ask whether novices start together, how lists and tutorials are protected, the usual supervision model, simulation access and what happens if more time is needed before the IAC.
On-call design
Compare when trainees join the rota, resident senior cover, obstetric and ICU responsibilities, cross-site work, night frequency, consultant response and recovery time. Rota labels alone do not reveal workload.
Case mix and specialist access
DGHs can provide high-volume general practice and graduated autonomy; tertiary centres add complex specialties. Ask how the programme ensures breadth rather than assuming one setting is always better.
Exams and educational time
Check Primary FRCA teaching, study leave, simulation, local pass support, educational development time and how rota gaps affect attendance. Ask how the 2027 exam transition is being supported.
LTFT and practical life
Compare placement length, slot sharing, on-call, childcare and commuting. Geography matters because fatigue after nights and frequent hospital changes can outweigh a prestigious name.
Research, QI and trainee voice
Look for accessible trainee research networks, QI supervision, academic pathways and a resident committee that can show changes it achieved. Opportunity matters more than the number of projects advertised.
From understanding to practice
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