[Editorial] Time for preference - informed foundation programme allocation?

Successful completion of the Foundation Programme Year 1 is a General Medical Council (GMC) requirement which newly qualified doctors must achieve in order to gain full registration for licence to practise in the UK. We present compelling evidence that both sections of the UK Foundation Programme allocation process, consisting of the Educational Performance Measure (EPM) and Situation Judgement Test (SJT) scores, are not fit for purpose. The ranking process drives competitive behaviours amongst medical students and undermines NHS team-working values. Furthermore, data from 2013-20 shows UK minority ethnic students consistently receive significantly lower SJT scores than white students. The current process in the UK allocates lower ranked students, who often need more academic and social support, to undersubscribed regions. This can lead to vacancies in less popular regions, ultimately worsening health inequality. A preference-informed allocation process will improve trainee access to support and help retain trainees in underserved regions. We aim to summarise the flaws of the current system and report of a potential radical solution.