On this page we provide guidance on supporting inclusion and equity in foundation education and training for supervisors and Foundation Training Programme Directors (FTPDs).
The curriculum
The UKFPO consulted widely and openly and took advice from an expert in equality and diversity when producing the FP Curriculum. The curriculum states the expectation of equitable treatment of all foundation doctors.
We have stated the need for reasonable adjustments to be made in the demonstration of physical skills so that doctors with disabilities who are unable to perform them will not be automatically prevented from progressing, and highlighted the provision of extension to training time for doctors requiring it, including those with health problems.
Supporting foundation doctors
All doctors matter, and we should offer tailored and bespoke support to individuals. It is widely recognised that some doctors can be disadvantaged because of systemic barriers and social inequity. This can be true of doctors with protected characteristics, those who have entered medicine via widening access arrangements, those who have trained in non-UK medical schools and those undertaking Less Than Full Time (LTFT) training.
All foundation doctors have a big transition starting the programme and:
- will not necessarily be familiar with experiential learning in the context of service provision
- be daunted by the professional responsibility of the post graduate role
- find that shift working may also undermine their resilience
- some foundation doctors are far from their social networks and need time to build new supportive relationships
Supporting ED and I
All doctors may have concerns with any of these issues, but some doctors, particularly those already at risk of disadvantage, may feel some of these more acutely, or have additional concerns.
By recognising the benefits of diversity of experience brought by our foundation doctors, as well as recognising and cooperatively working to remove systemic barriers and social inequity, we can fully support all our foundation doctors.
We must value and encourage diversity and reach a state where we have ‘normalised a culture of openness’ about the backgrounds of doctors who enter our training programme, for example inclusivity becomes business as usual.
Be a supportive supervisor
Supportive supervisors should:
- be up to date with training in equality and diversity, with an awareness of differential attainment, unconscious bias and bystander training
- actively seek to support your trainees, particularly if they are in a group that is likely to be at risk of disadvantage
- remember, for those with a health concern, the supportive roles of occupational health in providing reasonable adjustments
- actively seek peer or near-peer support for international medical graduates, with their permission. This may be available in some local education providers as inclusivity leads/champions. Supervisors may wish to set this up with the help of the DME.
- meet foundation doctors at induction and know (and offer) your local resources
Supportive meetings
Foundation doctors have time for self-development and supervisors can encourage them to meet for a mid-point review, particularly in the first post. Use this time to sensitively explore any difficulties they may have had settling in, but also positive experiences of what has helped.
It can be helpful to offer regular meetings after induction in the first placement, not just at the mid-point review. Consider offering a weekly or fortnightly informal meeting (for example, for ‘coffee’), and make the foundation doctor aware that you are just a phone call or email away.
This may be extremely supportive in those early weeks of foundation, especially for foundation doctors who are far from their social networks and are less likely to have built new relationships. Being explicit that this type of support is available may be of great help.
Examples of supportive questions include:
- Do you have any specific concerns around starting the foundation programme, or accessing the support you need?
- How can I help you and signpost the support we have available locally and regionally?
- Are there any issues outside of work I can help with?
Foundation doctors accessing support
Foundation doctors may think the support that is on offer is strictly about work or training and may be less inclined to bring up issues outside work that we know impacts on work. For example, there is literature that shows how simple things like securing accommodation, opening a bank account or getting children settled in school, can impact on the learning and development of resident doctors at the start of the year; and some may subsequently struggle to catch up.
Where appropriate, ask around recognising different cultural and religious days and whether there are any reasonable adjustments or support needed related to fasting, praying or time off.
Where appropriate, ask around recognising wider support roles foundation doctors may have, for example childcare or carer roles, and how this might impact on work, and what reasonable adjustments or support may be explored.
Supporting inclusion and equity webinar
See below recording of the ‘Supporting inclusion and equity’ webinar, held 13 July 2021.