Foundation Programme Application: The 2026 Guide: IMG guide for UK practice (2026)

Key points

Foundation Programme (FP) allocation uses a combination of SJT score and Educational Performance Measure (EPM).
The SJT is a standardised situational judgement test — preparation is possible and worth doing.
Your FP application determines your deanery and rotation for 2 years — take it seriously even though it feels automatic.

The Foundation Programme is the first step for most doctors starting their career in the UK. For UK medical students and eligible IMGs, the FP application through Oriel determines which deanery (geographic area) you are allocated to and which rotation jobs you do during FY1 and FY2. The process feels bureaucratic, but your score directly determines your choices — higher scores mean earlier picks in the allocation process.

Step 1 — Understand the scoring system

Your total score is the sum of your SJT score and your EPM (Educational Performance Measure). The SJT is a standardised test taken by all applicants on the same day. EPM points come from your medical school (decile ranking, additional degrees, publications, prizes). Most of the score variation comes from the SJT — it is the component you can most directly improve.

Step 2 — Prepare for the SJT

The SJT tests professional judgement in clinical scenarios. The two question types are: ranking (rank 5 actions from most to least appropriate) and multiple best answer (choose 3 best actions from 8 options). Preparation involves: practice questions (Oxford Assess, Pastest SJT, HEE practice papers), understanding the professional values framework (patient safety > professional duty > personal interest), and timing practice.

Step 3 — Maximise your EPM score

Check your medical school's EPM calculation process. If you have time: additional degrees, publications, and prizes can add points. If you are close to a deadline, focus on what you can control — ensure your decile ranking is correctly submitted and any eligible achievements are documented.

Step 4 — Rank deaneries strategically

You rank deaneries in preference order. Research each deanery: teaching hospital access, specialty exposure, geographic preferences, accommodation costs, and training reputation. Talk to current FY doctors in deaneries you are considering. Your rotation preferences within a deanery are requested separately after allocation.

Step 5 — Submit on time and check everything

Oriel applications have strict deadlines. Late applications are not accepted. Check: personal details match your GMC record, all supporting evidence is uploaded, and your deanery preference list is complete. Missing a deadline or having a name mismatch can delay or derail your application.

IMG eligibility for Foundation Programme

IMGs can apply to the Foundation Programme if they have a 'right to work' in the UK, have passed PLAB (or equivalent), and have GMC registration (or are eligible to register). IMG applicants go through the same Oriel process as UK graduates. Check the UKFPO website for the most current eligibility criteria, as these can change year to year.

The SJT is not 'common sense'

Many applicants assume the SJT is just common sense and do not prepare. This is a mistake. The SJT has specific scoring conventions (e.g., escalation to a senior is almost always correct, patient safety always trumps convenience, documentation matters). Without practice, you will score below your potential. 4–6 weeks of regular SJT practice can meaningfully improve your score.

Official resources

UKFPO — Foundation Programme applicant guidance

Oriel — Online Recruitment for UK medical training

HEE — SJT practice materials

Official Sources

UKFPO — How to apply to the Foundation Programme

UKFPO — Situational Judgement Test

Your learning path

Save your place and choose what comes next

Work through this guide (5 steps)

Use the actions from this article to track what you have worked through.

Step 1 — Understand the scoring system
Your total score is the sum of your SJT score and your EPM (Educational Performance Measure). The SJT is a standardised test taken by all applicants on the same day. EPM points come from your medical school (decile ranking, additional degrees, publications, prizes). Most of the score variation comes from the SJT — it is the component you can most directly improve.
Return to this section
Step 2 — Prepare for the SJT
The SJT tests professional judgement in clinical scenarios. The two question types are: ranking (rank 5 actions from most to least appropriate) and multiple best answer (choose 3 best actions from 8 options). Preparation involves: practice questions (Oxford Assess, Pastest SJT, HEE practice papers), understanding the professional values framework (patient safety > professional duty > personal interest), and timing practice.
Return to this section
Step 3 — Maximise your EPM score
Check your medical school's EPM calculation process. If you have time: additional degrees, publications, and prizes can add points. If you are close to a deadline, focus on what you can control — ensure your decile ranking is correctly submitted and any eligible achievements are documented.
Return to this section
Step 4 — Rank deaneries strategically
You rank deaneries in preference order. Research each deanery: teaching hospital access, specialty exposure, geographic preferences, accommodation costs, and training reputation. Talk to current FY doctors in deaneries you are considering. Your rotation preferences within a deanery are requested separately after allocation.
Return to this section
Step 5 — Submit on time and check everything
Oriel applications have strict deadlines. Late applications are not accepted. Check: personal details match your GMC record, all supporting evidence is uploaded, and your deanery preference list is complete. Missing a deadline or having a name mismatch can delay or derail your application.
Return to this section

United Kingdom · Applications · Article 10 of 11