Flexibility in training

Less Than Full-time Training (LTFT)

To apply for LTFT, an anaesthetist in training needs to hold a national training number (it is possible to apply during the recruitment process) and be able to demonstrate that full-time training is not practical for them for 'well-founded individual reasons'.  If this is for health reasons then an Occupational Health review is essential.

Applications for LTFT are made to the Deanery, following discussion with the educational supervisor, College tutor, and the training programme director (TPD); each school of anaesthesia has leads for LTFT at trainee and consultant level. The percentage of full-time hours that anaesthetists in training can work is agreed between the anaesthetist, the TPD, and the deanery. The College advises working at a minimum of 60 per cent as this supports career progression well.

Options for working LTFT include:

  • slot share – more than one anaesthetist in one slot on the rota and/or programme
  • in a full-time slot – reduced hours in a full-time post
  • Supernumerary – additional post but within training capacity; rare and requires (prospective) GMC approval.

For further information, each school of anaesthesia has leads for LTFT at trainee and consultant level; each hospital also has a Champion of Flexible Training. Contact the College's Membership Department to discuss subscription fees during periods of long-term leave and LTFT.

An updated copy of the A to Z guide for LTFT will be published here soon. In the meantime, please see a copy of the new TPD guide – although written for TPDs this guide may be of interest to anybody involved in LTFT.

As at November 2015

In 1993 the EU Directive (93/16/EEC) stated that hospital training on a part-time basis should be at least 50%. In 2005, Article 22 of EU Directive 2005/36/EC changed this by deferring the decision on minimum percentage for part-time working to the competent authorities in each individual member state, as long as ‘the overall duration, level and quality of such training is not less than that of continuous full-time training’. PMETB, as the UK competent authority at this time, chose not to set a minimum basis for LTFT training.

In 2011 the General Medical Council, as the current competent authority, undertook a review of the minimum percentage for LTFT and concluded this should be 50% and that only in exceptional circumstances should training be undertaken at less than 50% of full time.

In anaesthetics it remains unusual to train for any length of time at 50%. For a trainee who requests LTFT training at <50%, the College would recommend that their RA and/or TPD contact the College Training Directorate and Bernard Johnson Adviser to discuss how training is to be delivered in so few hours.

The College recognises and values the contribution made by LTFT trainees to the specialty. College data indicates that the majority of LTFT trainees work 60-80%. The evidence suggests that this part-time training supports career progression and a healthy work-life balance.

The College continues to follow the advice from ‘Principles underpinning the new arrangements for flexible training 2005’ that LTFT training be undertaken on a pro-rata basis, including OOH as this  remains an essential component of the anaesthetic training programme:

  • An opportunity to experience and develop clinical decision making
  • An opportunity to learn when to seek advice
  • A reflection of professional anaesthetic practice

Advice for CT1 Trainees considering LTFT Training

Commencing as a novice anaesthetic trainee on a 50-60% LTFT basis is extremely stressful for both trainee and department. There are very few who start an anaesthetic career on a LTFT basis.  Information gathered at the College suggests that many of these trainees have failed to gain their Initial Assessment of Competence by 6 months. The College Training Committee recommends that, if at all possible, the trainee should gain their initial 3 month competencies on full-time basis and then revert to LTFT training once this has been achieved.

Useful documents and links:

Out of Programme

  • Training or Research (OOPT/R) - some or all of this time counts towards training time.  Requires prospective approval by the Deanery, College, and GMC.  Reports must be submitted to the College on return to training.  Please find a copy of the application form below.
  • Experience (OOPE) - working in clinical practice that does not count towards training time. On return to training the anaesthetist must inform the College of the OOPE dates (email notification is acceptable)

  • Career Break (OOPC) - time out that does not count towards training.  On return to training the anaesthetist must inform the College of the OOPC dates (email notification is acceptable).

OOPT/R Application Form

Select here for an application form to apply for Out of Programme Training or Research

OOPT/R Report Form

Select here for a report form for Out of Programme Training or Research

Returning to training

Anaesthetists may be away from their normal working environment for many reasons and these periods of absence can extend from months to years. A return to training package should be designed with the educational supervisor.

Prior to planned leave (eg parental leave) it is important for the anaesthetist to meet with their educational supervisor to complete an interim progress report and make a return to training plan.  The HR department should also be informed.

A personal return to training package can include:

  • KIT days or SPLIT days; these can be used for a reintroduction to clinical practice
  • a period of supervised practice prior to resuming on call commitment
  • a simulation return to anaesthesia course eg GASagain, School run courses.

On return to training, the anaesthetist should inform the Training Department so that we can recalculate a completion of training date.

Health Education England is working with the British Medical Association's Junior Doctors Committee, GMC, NHS Employers, and the Academy to address 10 key issues to enhance junior doctors working lives.

Flexibility in training is an important part of this work.