All over the country there are final year medical students who have, for the last week, been preoccupied by a set of five questions that will determine where they will work for the first two years of their medical careers.

Yup. Only five questions. Doing poorly results in you ending up in the back end of nowhere – or worse still, ending up nowhere at all. Doing well promises you a golden opportunity in your favourite foundation school.* Of course, the job you get in that foundation school is still something of a lottery prize but what the hell, job’s a job, right? Even if you do end up working on one of the islands, at least you get paid. Realistically, that’s a luxury.

Foundation schools map of the UK

Therefore it is with a mixture of dread and relief that I finished my first (and second, and third and fourth etc.) drafts of my FPAS answers today, copied them into my application form, checked them all again, checked everything else again, twice, and finally clicked ‘submit’. It’s out of my hands now. I have done all I can to secure myself a post near my girlfriend, friends, and family. D-day is December the 8th, when I discover to which foundation school I have been allocated. These questions, and my answers to them, will quite literally change my life and it’s quite literally terrifying!

You may ask what sort of questions these all-important life-determinants are, and so I shall give you an example. In 200 words, answer:

Two essential attributes of a foundation doctor are to deal effectively with challenge and to demonstrate initiative. Describe a clinical case in which you have been involved and use this example to demonstrate how you possess both of these qualities. How will you apply what you have learnt from this experience to your work as a foundation doctor?”

Each of the 5 questions is worth up to ten points. If you come up trumps with the best medical degree marks you can have, it is worth a maximum of 40 points. If you have a PhD, it is worth 5 points. An unclassified degree is worth 1 point. The maximum mark is 100 points. It doesn’t take a genius to work out that the arbitrary marking of these questions can easily be worth more than a decade of studying, which to me is sounds a little silly. In fact, it’s so silly they are going to replace it with an hour-long exam which is going to be worth more than any medical degree ever was. It is yet to be seen if that will constitute an improvement (although it will make it harder for people to cheat)

Sigh. Now imagine sorting through 1059** answers to the above question, all written by intelligent people, all with access to the same job specification, and all having the same resources on professionalism. How would you distinguish between those people fairly?

How on earth would you distinguish between all those people fairly?


I am lucky in that I stand a very good chance of getting a job, even if it isn’t exactly where I might have wanted it. Don’t get me wrong; I am grateful for that. It just seems a shame that after five years of work my future is determined by a paltry five 200-word paragraphs. Five drops in a sea of tens of thousands of near-identical paragraphs, washed across the country in a month and deciding the fates of thousands of people.

Thought for the day.

*although with ‘Scotland’ being a single foundation school, that doesn’t necessarily mean you’ll actually end up anywhere near where you wanted to be. Besides the point.

**Based on the 803 available posts in the South Thames foundation school, with a competition ratio of 132%.


4 responses to “FPAS

  1. I have seen this all over statuses, lately, followed by the eventual “submitted :D” -thank you for explaining what it means…! Although I don’t quite get the points system.

    Fingers crossed for you!

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