The program was first proposed by England’s Chief Medical Officer, Professor Sir Liam Donaldson in 2002 in his document Unfinished Business and replaces the old Pre-Registration House Officer year and the first year of the Senior House Officer grade.

Introduced as part of a series of initiatives under the Modernising Medical Careers (MMC) umbrella, the program aims to ensure that foundation doctors develop and enhance their clinical and generic skills at the same time as exploring a range of career options.