My Experience

My experience with the UKFPO has been an exhausting one.

June- August

I applied for the UKFPO back in June/July. I thought it would be difficult to obtain the documents for eligibility ( especially the Dean’s Statement but thankfully my medical college in Pakistan was quite helpful and quick to respond. (I can not thank the student affairs office enough!)

I called the UKFPO on several occasions and I contacted them via e-mail , checking up with them to see if all my documents were in order and if they had received my application online via Oriel. I did so because I knew anything could go wrong. And unfortunately, it did.

August – September

I was told all the documents seemed to be in order, however, when I checked my Oriel status on the day when they announced eligibility outcome, I was told I was not deemed eligible and I would be removed from the process. It felt like a cold bucket was splashed on me. After the shock faded, I realised the reason was that the Oriel software did not upload my IELTS score. I contacted the UKFPO and I ended up filing an appeal (I must have attached 5 supporting documents, i.e. my telephone log to the UKFPO, screen shots of my e-mails, IELTS report copy, screen shot of the Oriel page and who knows what else). It took a month for the result of the appeal to come back, it felt like forever. But thankfully the committee understood my situation and granted me the appeal.

Soon after, the Oriel display changed , and it felt great to see the “congratulations” message appear along with options to continue my application.

September – October

The next step was to pay for my CSA exam, which I had financially saved for.

I made the payment early and e-mailed/called the UKFPO to confirm if they received the payment. I was notified a few days later that I would be sitting for the exam on Day 2, Cycle 1 (meaning the morning batch, Cycle 2 means afternoon batch). I also received the “UKFPO Clinical Assessment Handbook” which contained a lot of the information I posted on my website.

The courses

I decided to take time off from work and dedicate 2-3 weeks for the CSA. I was struggling to decide between the Samson Course, PLAB Right , Common Stations and Dr Swamy.

I remember contacting CommonStations (dr Hamed). After a few attempts, I spoke to Dr Hamed. I respect him tremendously and wanted to know his input. He mentioned he didn’t provide the CSA course but that I could attend his PLAB 2 course which has similarities to the CSA. He did say that I could also attend Dr Swamy (his competitor) who provides the CSA course. My respect for Dr Hamed grew ten fold, as he was thinking about my well being and not about “the competition”.

I did want to choose a CSA specific course. I wanted to be spoon fed (if I’m being honest), but also wanted to come into contact with colleagues whom I could practice with.

I remember calling Samson PLAB academy for the CSA course and was told 20-25 candidates had already signed up by that time. Not bad, I thought. But when I read reviews and spoke to some people, they mentioned the course was poorly organised in previous years and I was told there was not much information they learned there that was helpful to the candidates. However, I was told they did find great study partners. This is what I was told.

So, I chose to attend PLAB RIGHT and Dr Swamy after careful consideration.

September – October

PLAB RIGHT was a 2 day (weekend) course run by Dr Suriya, a NHS Psychiatry Consultant and very nice person in general. It was held in the academy which was a 40 mins bus ride from Liverpool Central. There is a dorm connected to the academy which was very convenient. There was also a common kitchen area and the people were very friendly. The academy also holds PLAB 2 courses and has a separate mannequin / practice room.

Anyway, there were 3 other students who attended the course.  The course was in part taught by Dr Suriya, in part by a NHS senior nurse and also by a FY2 doctor who previously passed her CSA exam. The course cost 300 pounds but I feel it was worth the money.

Right after PLAB RIGHT, I grabbed the train to Manchester. I ended up staying at an AirBNB accommodation (thanks Selena for the wonderful stay!), and after 4 days or so moved in to another accommodation with some other doctors. I attended the Swamy Academy but unfortunately they were not doing the CSA course this year. I was left to attend the PLAB 2 course but was kindly provided with previous course material. I used them as my guide. The course itself was a nice refresher but because I had previously attended CommonStations for PLAB 2, it felt like a repetition. Dr Swamy and the teachers were great. Also, I met a group of doctors who I became close with. With some of them, I would study until 12am at their accomodation.

Two weeks before the CSA, I also applied for the Foundation Program (FP) and the Academic FP (AFP). I remember the AFP required me to write 200-500? word essays on 3 different categories for one application, and 5 200-500? word essay for another AFP application. I remember just scribbling something 1-2 days before the deadline and submitting the application.

Through my PLAB RIGHT colleague, I came into contact with another study group at Manchester University ( thanks Majid for organising it!) just 5-6 days before the exams. It was just a 2 day revision course and we were all sitting for the exams. There were 2 medical students who were very helpful and kind for taking the time out to revise with us (hey Nick and Leon). We revised mainly physical examinations in groups.

Three days before the exams, I moved to the Britannia Hotel, (sort of) close to the exam centre. I spent the next 3 days there. I thought I would need 1 night to adjust to the new setting and I wanted 1 to sleep properly the night before.

25th October 2017

I couldn’t sleep very well the night before the exam. I remember closing the notes around 7 pm, had a meal and just relaxed. It took a long time for my adrenaline to come down. I remember at one point waking up at 2 am and not being able to go back to sleep until 3 am!  I woke up at 6 am. Got ready and took my luggage downstairs to check out and left it at the reception area. Grabbed an UBER and reached the exam centre within 10 minutes. Finding the right entrance was a problem…remember its entrance no 15!

I entered no. 5? and had to walk for 10-15 minutes but reached the right entrance by following the orange labelled board. A number of other students were downstairs waiting. I went upstairs to the 1st floor, asked someone for the way, and was told to go straight (please see the CSA section for more details). I sat down on a table where there were a few nervous doctors laughing with each other. The exam was meant to start at 8 am but ended up starting at 9 am ish since they were preparing the examiners and simulators. (again further detail is in the CSA section).

The exam experience was in a way similar to the PLAB 2. There was a hall and stations on each side. The consultation rooms were mostly small, except for 1 station. The examiners and simulators were nice. They smiled a lot. The atmosphere while giving the exam seemed easier. Some even chatted with me after I was done. I felt the time just go by. But not all the stations were easy.

After a 10 minute rest at the end of Cycle 1 (and a quick bathroom break for me), we proceeded with Cycle 2 which was in the Ward. It was meant to simulate a proper hospital atmosphere with ward beds and the patients were real patients . It felt quite realistic.

My last station was my rest station, and I felt so relieved. I spoke to one of the organisers and I just had the biggest smile on my face. We had a quick 10 minute chat and after that the final bell rang. We were rounded up and led to the other section of the hospital where we were isolated but later given our phones back and allowed to leave. I knew I made mistakes but I felt I did well enough to pass for sure.

I stayed the night in Manchester with my colleague. I ended up leaving the next day and hated saying goodbye to my new group of friends.


I went back to work soon after, and I remember looking at my Oriel Dashboard and noticed I had been given a decibel (EPM) score of 34 (out of 50). A 34 is the lowest score one can obtain. In my case, I scored 2nd high percentile range during my medical training. Also I did a Masters degree which is 4 points. I contacted the UKFPO and informed them of the mistake. They corrected it the next day , changing it from a 34 to a 44!!  Massive difference! I asked them to inform all of the Deaneries to which I had applied of the change and they did.

The next day, on 2nd November, I received an interview offer (shortlisted) for the AFP program in Wales, for which I had applied for! I was over the moon… I was telling colleagues and friends. Within hours of receiving the e-mail, I received 3 – 4 e-mails around 5 pm, stating that my application had been withdrawn. I was confused. It must be an error, surely. I opened the e-mails one-by-one, and it stated I failed the eligibility. My heart started to sink. In a state of confusion, I opened my Oriel and the Dashboard page had changed, with fewer options. On the top, it said

“Eligibility Status:  Withdrawn

Eligibility Reason: Failed clinical assessment”

I was in shock. It felt for those minutes I had gone deaf. I remember calling the UKFPO office, and speaking to a lady. I asked her if this was a mistake. After all, we were told at the exam center the general pass/fail result was not supposed to come out for another 3-4 days. And the full report wouldn’t come out for another 2 weeks!

She replied “I’m sorry. But you have failed the exam. It’s confirmed.”

I was in a daze. After all, this exam only takes place once a year.

The next 2 weeks were a blur. Should I just go back to Pakistan and quietly do my housejob? I spoke to my colleagues and asked them to arrange some internship back in Pakistan. They were absolutely lovely in trying to help me (my dear sister, dr Seeraz & my dear roommate thank you again) obtain a job in Pakistan. I also remember frantically applying for Ireland as their internship deadline was in the next few days.

I slept poorly, woke up thinking “what happened?”. I did not feel like going to work, couldn’t fall asleep… I was mentally a wreck.

Then came the 15th of November. The date when the CSA report was supposed to come out. I checked my e-mail box every 10-15 minutes. I waited…and waited….and waited….

Five pm came, and I still didn’t receive my report. I received messages though from colleagues telling me they scored well and still failed. Not only was I confused, but it seemed everyone was confused.

The next day, I called the UKFPO and emailed them, asking them why they had not sent me my report. By now it felt the UKFPO had created a giant mess. They soon replied and sent me my report. I went over my report, and I was more confused now than before. I met all the passing criteria. I actually did really well with a lot of praise from the examiners. Soon after, I spoke to other colleagues, some of them scoring as high as 80% and received remarks such as “could not have done better”, ” you will be an excellent F1 doctor”, etc.

I was baffled.

Did they fail me because the over all pass mark was too high (the marking scheme is VERY confusing an ambiguous)? Were there examiners who raised serious concerns regarding my performance?

I called the UKFPO again and asked them on what grounds they failed me since I could not find the reason. The lady at the other end of the phone also couldn’t find the reason. She said she would contact the Exam Coordinator and get back to me as soon as possible.

I started to prepare my Appeal letter. For the next 5 days, my life was eat, breathe, write and re-read. Again, I was consumed. I wanted to know why I failed. More importantly, I wanted the mistake to be corrected.

On 21/11/17, around 4:30 pm, I received an email from the UKFPO.

My mind went blank. I opened the e-mail. There were only 2 lines, but I couldn’t understand what was written. It was like my mind shut down on me. After staring at the screen for 10-15 seconds, I shook my head and told myself to snap out of it. The letter read as follows:

“Dear Adnan,

Further to data checks regarding the recent UKFPO Clinical Assessments, the result that you were given on 2 November 2017 is incorrect.

 We are, therefore, delighted to inform you that you have passed the assessment.”

…I was over the moon! I called, texted, emailed as many people as I could!

But soon after, I started thinking….what if the UKFPO changes it’s mind again? Also, I noticed the UKFPO did not offer an apology. But for me, this did not matter.

Thankfully, 2 other colleagues who initially were told (like myself) that they failed, ended up passing. I couldn’t have been happier for them and myself.

The UKFPO has made 3 major mistakes with my application thus far and caused me great anxiety. They are only human beings but the high level of trust I had in their diligent process was shaken. (Always double check results for yourself! The UKFPO is not perfect.)

I checked my Oriel account today and my application has been reactivated. I am due to attend the AFP interview in December 2017 (fingers crossed) and the SJT is scheduled for January 2018.

All is well in the world again… for now…

The AFP interview in Wales was not what I had expected. I watched preparatory videos on youtube thinking it would give me a good idea.

The interview itself was held at the Hospital University campus and was divided into 2 OSCE stations, i.e. the “Clinical Station” and the “Academic Station”. The 1st “clinical station” was 10 minutes long. I was expecting to be asked the management of an acute condition or possibly a chronic one. There was a panel of 3 consultants who were very nice and smiled throughout. After a quick introduction I was asked who in my eyes was a good leader and why. I was caught off guard…”Did I miss read the board outside…is this the Academic station?” I thought. I gave the best answer I could at the time.

The next question threw me even more off guard which was asked by my other interviewer “So you don’t have an official medical school to represent you, who represents you then?”. The interview lasted all but 5 minutes with me. I walked out of the room confused and with regret that I wasn’t more prepared.

After a quick break, I entered the “Academic Station”. There were about 5-6 doctors sitting in a small room. I could tell some of these doctors were Consultants (if not all) and I remember feeling claustrophobic. Just like in the 1st station, there was a table separating me from them. Here I was asked about what I had done, how I had been involved in research, the difference between research and an audit, why I wanted to get into the AFP program, how i would manage my work load as a AFP doctor. This station went MUCH better since I was not going to let any question have the best of me.

Despite my best efforts however, I knew I did bad in the 1st station.

I was also called for a AFP interview in Birmingham. But after having had time to think it through, I did not want to return to the clinic only to be distracted by the responsibilities of research and non-clinical work. It will be a difficult battle as it is to find my way initially. I want to be the best I can be at what I do first. I thus did not attend the Birmingham AFP interview.

I ended up changing my Deanery preference to West Midlands after rethinking my goals.

January – March

In January, the result of the AFP came out and I did not make the cut. I was not surprised. It was still be another 2 months before Foundation Program Primary List Allocation would be announced.

On the 8th of March at 00:00 at night the allocations became known. Of course I was sleeping and thus only noticed to 46 whatsapp messages in the morning. I went to Oriel, strangely relaxed, and I noted I was matched to the “primary list match”!

I was allocated to my 2nd preference, the West Midlands South Deanery!

It took some digging but I was finally able to find out that I scored 33 in my SJT and a total score of 77. I was just happy I didn’t score less. The SJT for me was a wild card that could have taken me down hard. Luckily it didn’t.

On the Allocation/Match tab of the Oriel website, I was now asked to rank 167 programs in terms of priority. These programs were for the whole 2 years of the FP, at mostly different hospitals spread throughout the Deanery. The big question was do I try to go for University Hospitals in big cities or the Country Hospital which are in the middle of nowhere but have a supportive team. I asked GP’s, ST3’s, FY2’s, family, uncles and aunties. I googled websites for opinions. Every had their own take. At the end, I want to be a GP. Which rotations would make me a good GP and which ones would not?

I started to prioritize rotations like Pediatrics, Obs& Gynae, respiratory medicine, cardiology, acute medicine and GP surgery.

I tried to avoid certain hospitals I knew that had bad critique on a quick google search.

I had 10 days to rank these programs and having ranked them. On Monday 19 March at 12:00 lunch time, the list was automatically submitted.

At the same time on the 9th of March, the referee collection process also started.

Early on in the process, as a FY1 applicant, you need to name 2 Referee’s/ Reference’s that can vouch for you. One has to be from your medical school and the other someone who can judge your clinical competence (a Consultant or GP). For doctors that have graduated years ago, it is a bit tricky and stressful to find these 2 referees. I emailed a few people but I was lucky early on to find my Obs&Gynae professor, Professory Nabia Tariq who filled out the Referee form early. She was magnanimously gracious and heart-warmingly encouraging. I will be in her debt always for her blessings.

I was also fortunate enough to get my 2nd referee form submitted early and signed off by a wonderful doctor.

I received an email both times, verifying that my Referee’s had submitted the forms.

Next step? Wait again. Until the 5th of April. That is when I will know where I will be placed.

April – June

By 5th April the primary list and allocations were announced. I qualified for West Midlands South and was happy with my placement. It was during this time we had to choose out of list of hospitals and programs where we would liked to be placed. I had to sort through 167 programs and rank them from most preferred program to least. The deadline was 10 days, and it is a confusing process. Do I mark based on the city location? Or according to the rotations? I eventually went for program placement and ended up with my 6th highest preference. I was quite happy with that.

Next was the TOI, the “transference of Information”. This is the last UKFPO document that was asked of us. It is a form which the medical school is asked to fill regarding any concerns (health or educational) they might have had. The deadline for this was the 31st of May 2018. My medical school was amazingly fast in completing the form and sending it back to me.

Next, the pre-employment checks were also started. This meant the Trust would start to process all the paper work and start inviting doctors for interviews, occupational health checks and signing contracts. It took them quite a few weeks to get in contact with me. But I suppose they had a lot of doctors profiles to handle. So expect the process to be a little slow. My colleagues who were allocated to different Trusts received their welcome letters and paperwork at different times. Some had their ALS course in June while others were given a date of July 23rd (like myself).

In either case, it was an exciting day. 1st I went for my occy health appointment which went smoothly. Next was the appointment with the Programme Director which was an informal interview. I asked if I could do 2 weeks of shadowing rather than 1 and my Programme Director was more than happy with that. Then next was the signing of alot of paper work at the HR department. This took 30 minutes if not more and was a bit tedious. And last but not least, lunch with the other 3 candidates who also came on the same day (we were split into different batches on different days) and we met 2 of the FY1 doctors. One was very friendly while other was quite pre-occupied and quiet. It was an overall good experience.

In the next few weeks, we received e-mails regarding log in user names and passwords for the ALS course and a date for the exam itself.

I also emailed the PSA team regarding giving the exam. They recommended I contact my HR team (educational department of the HR team) since this is arranged by the Trust. I am still waiting to hear what will happen with regards to that.

The HR team also asked if I wanted accommodation. I said yes but that I would not be guaranteed a room in a shared accommodation as it was 1st come first serve. Out of possibly not finding a place, I separately went and looked for an apartment and found one for 500 per month with an attached bathroom (en suite). There are cheaper options (up to 360 for shared doctors accommodation) but I wanted the security of having a place 5 minutes walking distance from the hospital.