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. All aspects of the job plan should be provided on a pro-rata basis, including 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 e.g. 80% of full time. This results in a pro-rata extension of training time.

2. Slot-share

Normally this means two trainees sharing a single 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 LETBs 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 does not necessarily mean that slot share partners must be of the same level or even, in some cases (normally in Core Training), the same surgical specialty.

3. Job Share

A 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. 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 theoretically ideal as they would cut down on the immense amount of paperwork and organising required from the trainee but there are very few of these in surgery as it can be difficult to arrange regular take-up of these posts.

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 be lengthy and so should be started as early as possible. 

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 with responsibility 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 LETB.