Special circumstances is the standardised national process that ensures applicants who need to train in a specific region are treated in a fair and consistent way.

Important: Special circumstances or reasonable adjustments?

Special circumstances are different to reasonable adjustments.

Applicants who require reasonable adjustments to attend interview or take up a training post should ensure that they state this on their application form and make contact with the lead recruiter as soon as an interview invitation is received to discuss their requirements. Reasonable adjustments will not be managed through the special circumstances process.

Eligibility for special circumstances

Any applicant who falls into one of the following eligibility criteria can apply to have their circumstances taken into consideration, allowing them to be pre allocated into a post, subject to it meeting the requirements of entering GP training:

  • Criterion 1: The applicant is the primary carer for someone who is disabled, as defined by the Equality Act 2010.
  • Criterion 2: The applicant has a medical condition or disability for which ongoing follow up for the condition in the specified location is an absolute requirement.

Applying for special circumstances

Applicants wishing to be considered for special circumstances pre allocation should ensure that they state this on their application form and submit the required form and supporting evidence by email.

Requests for consideration of special circumstances received in any other way will not be accepted.


Download the Special Circumstances application form

Supporting evidence

Applicants wishing to be considered for special circumstances should complete the criterion appropriate special circumstances application form and forward this, together with the following supporting evidence, as a single scanned document, as soon as the application has been submitted to [email protected].

Applications and evidence not submitted in the correct format will be returned to applicants, with a request to resubmit in the correct format. Evidence submitted in the incorrect format will not be accepted.

Criterion 1: Applicant is the primary carer for someone who is disabled

You must supply all of the following.

  • Written statement on headed paper from a general practitioner or social services professional, confirming your role as primary carer for this person, together with confirmation of the disability, dated within 6 months of the application date.
  • Care plan on headed paper from a general practitioner or social services professional, dated within 6 months of the application date. Where an official care plan is not available, details of caring responsibilities and activities should be provided, attested by the general practitioner of the person who is being cared for.
  • Proof of current address, for example a driving licence or utility bill dated within 3 months of the application date.

Criterion 2: Applicant has a medical condition or disability

You must supply all of the following.

  • A report by the current medical specialist treating your condition or Occupational Health physician, dated within 6 months of the application date, in which they will be required to:
    • describe the current medical condition or disability
    • describe the nature of the ongoing treatment and frequency
    • explain the reasons why the follow up treatment cannot be delivered elsewhere in the UK
    • explain the impact transferring care elsewhere would have on you
  • Proof of address, for example a driving licence or utility bill dated within 3 months of the application date.

Where more than 1 applicant has caring responsibilities for an individual, a joint application can be submitted, with a single set of evidence. Both applicants must be named as main carers in the evidence.

Applicants undergoing fertility treatment together, and applying in the same recruitment round, can submit a joint application. Both parties must be named in the supporting evidence.

Special circumstances applications will be reviewed by a national eligibility panel and a decision on whether the application has been successful will be communicated to the applicant.

Where the applicant is unhappy with the decision of the national eligibility panel, they are permitted to submit an appeal to the national appeals panel. Appeals must be based on new evidence being submitted. The decision of the national appeals panel will be final.


Applicants who have been approved as having special circumstances will be pre-allocated into the region of their choice, subject to the following criteria being met.

  • Applicant is deemed appointable at interview/selection centre.
  • Applicant is ranked highly enough to receive an offer, for example if there are 10 posts available, the applicant will need to rank in the top 10.
  • Applicants will also be considered to have ranked highly enough, where there are applicants ranked above them who would not be eligible to receive an offer due to limited preference choices and preferred posts being unavailable.
  • Where Locum Appointment for Training (LAT) posts are being appointed through the vacancy, the applicant must rank higher than the lowest ranked National Training Number (NTN) offer in order to be pre-allocated on the basis of approved special circumstances.
  • The region the applicant wishes to be allocated to can fulfil all requirements of the curriculum for the specialty for which they have applied.

If all of these conditions are met, the applicant will be pre allocated into the preferred region, before the main offers algorithm is run. Applicants are not guaranteed their preferred programme/post within the preferred region. Special circumstances applicants will be offered the highest ranked post within that region that they would have been offered, had the normal offers process run. Where applicants with special circumstances would not have been offered a post in the preferred region, they will be pre allocated one of their ranked programmes within that region.

Where applicants with special circumstances do not rank highly enough to be offered a post in the first round of offers they will be placed on a reserve list, pending more posts becoming available or offers being declined. There is no guarantee of matching special circumstances applicants to preferred locations after the first round of offers has been completed. An applicant without special circumstances who has accepted a post in the preferred location of an applicant with special circumstances will not be displaced to allow allocation of the applicant with approved special circumstances.

When ranking preferences, applicants with approved special circumstances must ensure that they only rank programmes/posts that they are willing to accept and undertake. Applicants will be allocated based on these preferences. If it is not possible to pre allocate an applicant with special circumstances, they will have opportunities throughout the recruitment process to amend their preferences, should they wish to be considered for appointment in another region.
When selecting post preferences, applicants must ensure that they meet the eligibility for those posts.

Carry over of approval

Applicants who are approved for special circumstances, but who are not made an offer in their preferred region can carry over their approval to later recruitment rounds within the same recruitment year.

The special circumstances application form will need to be completed, but there is no need to submit further supporting evidence, providing that personal circumstances have not changed since the application was originally approved.

Offer exchanges and enhanced preferencing

Applicants can have a change in circumstances for any number of reasons in the time between programme or post preferences being made and offers being released. To assist applicants in this situation, flexibility around preferencing is available.

For applicants who have accepted or held a post, there will be an option to select upgrade options which not only include those posts/programmes that were originally ranked higher than the offered post, but also those that were ranked lower.

Please note: Any changes to preferences made between the offers algorithm being run and offers being released will not be considered until the next offers match is run.

Applicants who have not been made an offer will also have the opportunity to amend their programme/post preferences throughout the recruitment process. Specialty recruitment leads will advise applicants when preferencing is open for amendments to be made. Applicants wishing to amend their preferences must ensure they undertake this as soon as possible, once advised that preferencing is open, as recruiters will need to close these again before the next round of offers is processed.

These processes will continue up until the upgrading deadline in each recruitment round (see recruitment timeline for exact dates).

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