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Less Than Full-Time training (LTFT)

Conclusions

Overall, reassuringly, the differences between LTFT and FT trainees were small for all indicators.   Albeit the differences were small, LTFT trainees did, however, have lower scores for 11 of the 14 indicators.  In 2 indicators LTFT trainees scored higher and in 1 indicator, Behaviours Experienced, there was almost no difference.  Although the differences may have occurred by chance they suggest a trend towards LTFT trainees being less satisfied with their training than FT trainees.

The lack of difference for Behaviours Experienced – behaviours by others eroding professional confidence or self-esteem, is a positive finding as it suggests that LTFT trainees feel just as valued as FT.

LTFT trainees appear to find that their Gynaecology training is less satisfactory than FT trainees with the differences much less marked for Obstetric training.

There is a larger focus in the earlier training years on developing obstetric skills to prepare for the responsibility of running a labour ward without direct supervision.  Gynaecological skill development may consequently be compromised and the overall scores for both FT and LTFT trainees for gynaecology indicators compared with obstetric indicators reflect this.  It is probably no surprise then that LTFT trainees report even lower scores than FT trainees in gynaecological training both for general and procedural skills.  The question set includes questions about specialist clinics and gynaecological procedures. If the clinics or operating lists are held on days that the trainee does not work then opportunities will be more limited.

In terms of professional development, the non-clinical / non-technical skills that trainees are expected to develop are often acquired outside of the ‘normal’ working day.  Trainees may come in before work starts to deliver teaching, or stay late / work at home to undertake audit or research work.  For those trainees who are LTFT because of caring responsibilities or fixed activities that occur outside of working hours the potential to complete the above tasks may be compromised.  Rota gaps with pressure to provide service commitments on a unit as well as the need to maximise clinical experience may leave little opportunity for such activity to occur in the normal working day.   In the same way as for specialist clinics and operating sessions, management, governance and audit meetings may occur on a non-working day for LTFT trainees.

An LTFT trainee may find it harder to gain independence and clinical responsibility as the length of time taken to build trust with colleagues may be longer as the trainee is there less frequently.  Assuming LTFT and FT trainees rotate at the same time each year, by the time the TEF is completed LTFT trainees will be likely to feel less confident having worked for a proportionately shorter time in a unit than a FT trainee.

 

Recommendations

To investigate ways to improve access to gynaecological training, general and procedural.