How to Complete a STEP Form for Progression to UK Foundation School
How to Complete the STEP Form
The STEP Form incorporates a solemn declaration by a university undergraduate student doctor in the UK that they are, in essence, fit to move to the Foundation School to pursue the UK’s post-graduate Foundation Programme for doctors (namely the F1 year, and subsequently the F2 year), and that they have disclosed any material matter that a foundation school might reasonably need to know before accepting the student onto a foundation programme.
In doing so, a student is declaring that they have disclosed all material facts that could affect their further training, or that indicate whether a student will require extra support or special arrangements, such as reasonable adjustments in the workplace.
(A similar system of checks applies to anaesthesia associates and physician associates who seek registration with the UK. F2 programme applicants usually have to complete a STEP form, too.)
The Purpose of a STEP Form
The STEP form is used to ensure that a student is properly supported as they transition from the student doctor role into the professional status of doctor (with provisional GMC registration) in an approved programme of training.
The 2025 guidance states:
“All applicants to the Foundation Programme are encouraged to make full use of the Supporting Trainees Entering Practice [STEP] process by completing the relevant form. This process is intended to support the transition from undergraduate medical education to postgraduate training and employment as a doctor. The STEP form is completed in advance of the start of the programme to allow Foundation Schools and employers time to identify suitable adjustments, if necessary, and prepare for the arrival of doctors by ensuring appropriate support mechanisms are in place.“ (UK Foundation Programme 2025; italics added for emphasis)
The Supporting Trainees To Enter Practice (STEP) form is divided into several sections, which include: general information, information about the student’s health, welfare, personal performance and skills, professionalism, and a declaration of truth. See the UK Foundation Programme’s guidance on data to disclose on the Step Form: What Information Should I Declare on the Step Form?
The Foundation School Director (FSD) will explain where to send the STEPS form. A medical school clinical advisor or other university official will countersign the STEPS form. The FSD will send a copy to the Foundation Training Programme Director (FTPD) and subsequently to the student doctor’s educational supervisor, if needed. The form might also be sent to the occupational health department of the new employer. These disclosures are made with the student’s consent.
Among other things, the completion of the STEP Form document requires candid, sufficiently detailed disclosure so that the deanery, employing hospital or other institutions can assess a student’s suitability to advance in their training.
A failure to provide sufficient details, or to hide a detail, could become a probity matter that bars the student from moving on to the next stage of their training. Further, a false declaration could lead to concerns being raised about the student’s fitness to practise and become a permanent bar to progression, or cause a delay in their progression.
In some instances, a student may have encountered personal difficulties in relationships, difficulties in managing their health, or underperformed in their studies at times. A student, when completing the STEP Form, will need to summarise their personal history and their take on things.
The GMC requires medical schools to operate within a specified disclosure model under the GMC’s Promoting Excellence policy, which holds (Paragraph 121 Requirement R2.17) that
“Organisations must have a process for sharing information between all relevant organisations whenever they identify safety, wellbeing or fitness to practice concerns about a learner, particularly when a learner is progressing to the next stage of training”
Where there have been past or ongoing issues of potential concern, a student may need to write a reflection on any suboptimal conduct, misconduct, or health condition that has affected their conduct, attendance, studies, or interactions with others.
A student should bear in mind that the GMC may also, at some point, receive a statement from their university relating to the student’s history. Therefore, the GMC may well have some data to compare the student’s disclosures to them. Any anomalies will likely be identified and lead to formal GMC enquiries. This could then delay the student’s progression to obtain provisional registration, while the GMC enquires about the mismatch of information.
The GMC writes:
‘The Supporting Trainees Entering Practice (STEP) process is designed to support medical students during their transition from medical school to employment as a doctor in training, in the first year of the Foundation Programme (F1). It is separate from the process of applying for registration with the GMC.’ (Professional behaviour and fitness to practise: guidance for medical schools and their students (GMC Publication))
The GMC
As part of the separate application to the GMC for provisional registration, the GMC will need to determine that a student applicant is fit to practise in the widest sense, including considerations of health, probity and conduct, competence, attitude, suitability, insight, ability to express an apology where appropriate (going to their ability to form insight and meet the duty of candour requirements), and their frankness about any difficulties that they have been encountered during their university years, before being admitted.
The GMC will, in some instances, receive a copy of the STEP Form, to (in part) formally assess a doctor’s suitability and fitness to practise to become a provisionally registered doctor. This is in addition to any forms completed for provisional registration. There should, therefore, be no anomaly or mismatch between the details included in any GMC Online application for provisional registration and the details that are included on the STEP Form when applying for the foundation programme.
Whether or not the GMC sees a completed STEP Form, due to disclosure requirements on the GMC’s application and disclosure forms, for those seeking provisional registration, the GMC may require a student to provide more information about matters they have included on their application form for provisional registration. The way a student responds to such a request will inform the GMC about the student’s overall suitability to progress to provisional registration. A student should not minimise past concerns or mislead the GMC, as that is likely to cause the GMC to ask more questions and raise a probity concern.
The GMC will especially scrutinise matters that may go to the fitness to practise of the student doctor before granting provisional registration. If a student is in doubt about what to include on a STEPS Form or GMC Form, they should seek advice. A failure to disclose relevant matters consistently on the forms could create a problem.
Where, in the past, a situation of poor judgement, poor performance, or poor behaviour has occurred, the student will likely need to explain this (in detail) to the GMC, and show how they have learned from it, perhaps also by attending some courses of remediation and showing insight in a detailed reflection.
The student will also likely need to provide the GMC with a testimonial (character evidence) where there has been a potential misconduct issue or ill health that has caused behavioural concerns. (See, by way of example, GMC Form I&I1 for testimonials, and the GMC Form CX1 for health disclosures. Both are part of the application process for provisional registration.)
Where a doctor has a long-standing health condition, they may be entitled to extra support in the workplace. The GMC policy advises Foundation Schools:
‘Organisations must make reasonable adjustments for disabled learners, in line with the Equality Act 2010. Organisations must make sure learners have access to information about reasonable adjustments, with named contacts.’ (R3.4 Promoting excellence: Standards for medical education and training – GMC Publication 2015 )
A student should not feel uncomfortable about making disclosures on the STEP Form. It is there to enable them to be supported, in a structured way, and is a process supported by the GMC, the deanery, and the local clinical unit on which a newly qualified doctor will work.
Conclusion
Completion of the Step Form is a milestone in the career of a doctor. It is essential to complete the form accurately and with sufficient detail that the Foundation School can support the newly qualified doctor in the workplace. Being an F1 doctor is a stressful role in and of itself, and the greater the support that can be provided locally, the lower the risks of sub-optimal conduct or lack of resilience coming to bear, which in turn could cause avoidable harm to patients.
If you are a student doctor who needs assistance with completing a STEP Form for a move to a Foundation School, or in providing further evidence and submissions to the GMC by way of application for provisional registration, contact Doctors Defence Service on 0800 10 88 739 in strict confidence and without obligation.