School Student
What's surgery like?
Organisation
All trainee doctors can apply for less than full time training and all applications should be treated positively. There are, however, strict eligibility criteria.
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.
There are 5 main options:
1. Part time working reduced hours (PTFTS). This is ideal for those who want to work at a higher percentage of full time. For example; 80% of full time. This results in a pro-rata extension of training time.
2. Slot-share. Two trainees sharing a job, though it is possible to be more creative for example 3 people sharing 2 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 Deaneries limit to 60% of full time), and 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 used to mean that both trainees had to be within the same specialty and at the same level. However, with the onset of ST and CT training slots, there may well be the opportunity to provide training within a single unit, for trainees who have significantly different requirements. Two slot-share trainees may work very well together if they are at different training levels, since this reduces competition for knowledge and cases
3. Job Share. As above, the single position and contract is divided between two trainees. If you are not eligible for 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. In most cases, the flexible training office will not (unlike a slot share) be able to provide extra money – so the salary will be one, split between two. Job share opportunities may arise, whereby the Trust to which you are rotating can employ a Trust or Staff Grade doctor, or someone out of training, to share the responsibilities of the post.
4. Permanent part time posts. These are theoretically ideal as they would cut down on the immense amount of paperwork and organising required from the trainee. There are very few of these in surgery – regular take up of the posts is hard to arrange. It is regionally-variable: there are some posts in the Northern Deanery however in West Midlands and London they have moved away from this idea.
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 do not exist in some Deaneries 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 e.g. training lists with no existing middle grade present. Educational approval and GMC approval is essential prospectively.
Process
The process for entry into flexible training can be lengthy and so should be started as early as possible.
First, contact your Assigned Educational Supervisor (AES) and Programme Director. Separately, contact the associate postgraduate dean with responsibility for flexible training in their deanery region, who may not be a surgeon, or have had many surgical flexible trainees.
Once flexible training has been agreed in principle, you will need to contact the College or the Joint Committee on Surgical Training to ensure the agreed timetable is suitable for training.
Your intended post needs prospective GMC approval, however this will probably be in place already for full-time and permanent part time posts (hence 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 and possibly a likely consultant / unit to suggest working for. A consultant who has previously had a flexible trainee successfully is a good start. Use any contacts you have to find a slot – share partner, including forums such as the College Member’s section and the “not just a surgeon” forum. Also consider asking the Programme Director or the deanery.
