NHS Education for Scotland Logo

Scotland Deanery

Home of medical and dental excellence

Trainee information

Delayed Start Information

NHS Education for Scotland – Scotland Deanery

2022 Updated Guidance on Delayed Commencement of Training Programmes related to COVID-19


The Scotland Deanery considers that trainees affected by the COVID-19 pandemic should be given flexibility to delay the start of their training programme in certain circumstances which are beyond their control.

The Deanery approach is that those who have accepted an offer for a training programme are considered to be within the Deanery’s scope and that every effort should be made to support them commencing in training at an agreed delayed date. The Deanery will consider all requests for a delay in commencing training for up to three months from the planned original date of commencement of training. Exceptionally, this may be extended for up to a further and final three months, i.e. a total maximum duration of six months (with the exception of trainees as described in Section C).

Each trainee’s circumstances will be considered on an individual basis, but the following reasons for delayed commencement to training may apply:


  1. Primary Medical Qualifications (PMQ) (two-year foundation programmes)

 Due to COVID-19 disruption, not all applicants may qualify from overseas medical schools in time to obtain provisional registration and commence their foundation training programme on the scheduled start date. If this is the case, the trainee should contact the foundation school to advise of a potential delay to commencing training.  Delayed starts will be considered to allow these applicants to meet the qualification and registration requirements.

        2. General Medical Council Registration

 The General Medical Council has re-instated sittings of the Professional and Linguistic Assessments Board (PLAB) test and the Deanery believes there is sufficient capacity to allow timely completion. If, however, an individual finds this is not the case a request for a delayed start may be made. PLAB is a prerequisite for obtaining GMC registration for many overseas applicants (https://www.gmc-uk.org/registration-and-licensing/join-the-register/plab/coronavirus---information-for-plab-candidates).

Whilst trainees cannot be permitted to commence training without GMC registration, if there are no other reasons that would be expected to affect GMC registration, the Deanery will consider delaying the start of their training programme to allow applicants to meet the registration requirements.

        3. Training competences

During the pandemic, many junior doctors have been redeployed to assist with the NHS response to COVID-19. This may result in some trainees being unable to complete all the required competences of their current training programme before the end of their post.

Where a trainee at the Annual Review of Competency and Progression (ARCP) has been given an Outcome 10.2 and an agreed action plan to extend the training time to complete these competences in their current programme, the Deanery will support a delay to the start of the next programme of up to 12 months on the proviso that the trainee achieves an outcome 1 or 6 in this time period. This will also apply to trainees who are currently in a programme elsewhere in the UK and who have an agreed extension to training time.

Trainees who have not had an ARCP (N13 code) but have an agreed extension due to COVID-19 related issues will also be able to ask for their circumstance to be reviewed.

Trainees who have been shielded or have been absent due to ill health as a result of the pandemic and therefore have not completed all competences will also be considered for a delayed start. Where an agreed plan has been drawn up at the last ARCP, the delayed start will be calculated to accommodate this.

Factors Which Should Not Delay Training Commencement

Immigration Restrictions

The UK Home Office (Visas and Immigration) have confirmed amendments to their processes which apply to the majority of trainees. In most cases this will not impact start date and are not factors for delaying training. Specific Home Office Coronavirus guidance can be found here - https://www.gov.uk/guidance/coronavirus-covid-19-advice-for-uk-visa-applicants-and-temporary-uk-residents

Student Visas (formerly known as Tier 4)

Applicants for two-year foundation programmes can submit their application for their Student visa to the UK Home Office, but there are likely to be delays in the processing of applications. The guidance states that trainees can commence in post if:

  • They have been given a confirmation of acceptance for studies (CAS)
  • They have submitted an application before their current visa expired and provide evidence to the sponsor
  • The Trainee starts the role listed on the CAS
  • The Trainee has a valid Academic Technology Approval Scheme (ATAS) certificate - if applicable.

In cases where students have had their sponsorship removed as a result of their course ending early, this will mean that they will have to wait for their new visa. If they are outside of the UK, this may also affect their ability to return to the UK.

Skilled Worker Visas (formerly known as Tier 2)

The Home Office have confirmed that due to the Coronavirus (Covid-19) rules, trainees will be able to commence in post whilst awaiting their Biometric Residence Permit (BRP). This is on the basis that they have:

  • Been assigned a Certificate of Sponsorship (CoS) and they are applying under the Health and Care visa 
  • They have submitted their application before their current visa expired and can provide evidence to the sponsor
  • The trainee starts the role listed on the COS 

NES, as the sponsoring body for trainees, will submit applications for trainees requiring a visa who are joining a training programme and are managing the process to extend visas for current trainees (where required). It is therefore expected that trainees should be able to join the programme without delay unless travel restrictions apply.

Please note, the above applies to those who are currently on a UK visa. Individuals who are applying for their first UK working visa cannot start without their new Biometric Residence Permit. This rule also applies to those in the UK on a visitor visa.

To confirm, the above is correct at the time of publishing and based on current Home Office legislation. 

Career Break

Requests for career breaks are available for individual trainees who have specific needs. There will be applicants whose circumstances have changed as a result of the pandemic. For example, they may have been affected by a bereavement or have additional carer’s responsibilities. These trainees will be able to apply for Out of Programme – Career Break to allow this and will be supported by the Professional Support Unit to maintain contact with the Deanery during this time.

Process for requests for a Delayed Start

For all non-statutory, COVID-19 related requests for a delayed start, the trainee should contact their programme administrator listed here who will ensure that the relevant Postgraduate Dean/Associate Postgraduate Dean/Assistant GP Director reviews the request (administrators will provide trainees with a form to request a delayed start). Once agreed, the programme administrator will advise the employment board HR contact.

In general, trainees who require to significantly delay their start date in foundation training in Scotland will commence at the time of the second rotation at the beginning of December although this will be reviewed on a case by case basis. Commencement dates for other trainees will be agreed on a case by case basis.

 To assist in the review, trainees will be asked to provide evidence and the following is suggested:




Immigration restrictions



Evidence that application for Confirmation of Acceptance for Studies (CAS) or Certificate of Sponsorship (CoS) has been submitted to NES HR.


Training competences


ARCP outcome / email from Training Programme Director confirming that trainee has been adversely affected by COVID19


General Medical Council Registration


Evidence of PLAB booking for the tests

Administrators should log the requests and outcomes and if agreed, amend the start date on TPM and alert the lead employer contact.

Refusal of a Request to delay Commencement of Training Programme

While the Deanery will make reasonable efforts to support trainees who wish to delay commencement, these requests may not always be supported. For example, a request may be declined if to do so would cause severe service or training disruption, which could not be sufficiently mitigated.

Request for a Delayed Start to Training Programme – intended start August 2022



This page was last updated on: 12.05.2022 at 14.03