Flexible training in surgery

Trainees can apply to work less than full time (LTFT) either at the point of applying through national selection or at any point after being awarded a national training number (NTN). There are no specific eligibility requirements other than having a well-founded individual reason to work LTFT.

To apply for LTFT training you will need to gain support from your training program director (TPD) and complete an application with your local deanery/LETB. For more information on the process of applying for LTFT training please refer to the JCST website. Any agreed changes to your training percentage will affect your certification date, as such, you will need to keep JCST informed of any changes.

The requirements for less than full time training are available in the NHS Employers publication Principles underpinning the new arrangements for flexible training. Please email careers@rcseng.ac.uk for advice and information on less than full time training in surgery.

Flexible training working patterns

Less than full time training must constitute at least 50% of the weekly programme of full-time trainees. Normally, flexible training constitutes between 50% and 80% of full time with pro-rata on-call. Any agreed changes to your training percentage will affect your certification date, as such, you will need to keep JCST informed of any changes. All aspects of the job plan should be provided on a pro-rata basis, including on-call.

There are five main options for flexible training working patterns:

1. Part-time working reduced hours (PTFTS)

This is ideal for those who want to work at a higher percentage of full time e.g. 80% of full time. This results in a pro-rata extension of training time.

2. Slot share

This typically means two trainees sharing a single job, though it is possible to be more creative, for example three people sharing two jobs. Unlike the now out-of-favour job share (where two trainees share one contract, a salary and the on call rota), in slot shares, trainees get a contract each, an ability to work 60–80% of full time (some local education and training boards or LETBs limit this to 60% of full time). The funding is provided from the deanery.

In order to organise a slot-share there must be agreement between the trainees and trainers that appropriate training can be obtained for both trainees. This does not necessarily mean that slot share partners must be of the same level or even, in some cases (normally in Core Surgical Training), the same surgical specialty.

3. Job share

A job share is when a single position and contract is divided between two trainees. If you are not eligible for Less Than Full-Time (LTFT), it is possible to apply for a full-time post with a job share partner, and this partner does not have to be a trainee. Job share opportunities may arise, whereby the Trust to which you are rotating can employ an SAS surgeon, or someone out of training, to share the responsibilities of the post.

4. Permanent part-time posts

These are often favourable due to the reduced paperwork and organising activities done by trainees These posts are typically more scarce, but they are still a possible option.

5. Supernumerary

In this kind of post, you work as an extra person in an existing unit, therefore sharing the operating with a full-time trainee. These posts have become rarer due to their expense and perceived reduction in training quality. Where there is funding available, there is a requirement to demonstrate that there is excess training capacity in the unit. It is vital to ensure that the post is approved for training before taking it up.

Process

The process for entry into flexible training can take some time, so we recommend giving yourself plenty of time with it. First, contact your Assigned Educational Supervisor (AES) and Programme Director to highlight your plans and to discuss your needs. Separately, contact the associate postgraduate dean who is responsible for flexible training in the region to let them know of your plans and discuss options. Once flexible training has been agreed in principle, you will need to contact the Joint Committee on Surgical Training to ensure the agreed timetable is suitable for training.

Your intended post needs prospective approval for training from the GMC. However this will probably be in place already for full-time and permanent part-time posts so is not an issue for reduced sessions or slot shares as these use established full-time posts. While the programme directors may find a post for you, or suggest a slot share partner, in surgery it is usually necessary to find a slot share partner yourself. Use any contacts you have to find a slot share partner and consider asking the Programme Director or the Deanery/LETB.

Less Than Full Time (LTFT) Training in Surgery: JCST Policy Statement

Less Than Full Time (LTFT) training has been available for some time, however the experiences of LTFT can vary widely. A number of issues have been identified which contribute to low levels of satisfaction among trainees. The survey was carried out by the Association of Surgeons in Training (ASiT) and British Orthopaedic Trainees Association (BOTA). These include variable attitudes among trainers, fellow trainees and employers, as well as worrying reports about bullying and harassment. Difficulty accessing elective and emergency training opportunities also contribute to low levels of satisfaction.

The JCST Policy Statement includes a vast number of recommendations to improve LTFT trainee satisfaction. The full policy statement is available here.

Are you considering less than full time training? Hosted by Felicity Meyer, our free members webinar will shed light on guidance and rules surrounding flexible training and working.

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