Sample return-to-training scheme, for trainees returning to clinical practice after a period of absence
This scheme and accompanying return to training form (Word document, 83 kb) were developed by Health Education Wessex and adapted with permission for the RCOG. Please note that individual LETBs and deaneries may have their own agreed return to training schemes for local use.
Trainees may be absent from training and active clinical practice for a number of reasons, such as maternity/paternity leave, research, ill health, etc. Expecting trainees to immediately return to full duties, including on-call work, after a prolonged period of absence (and potentially in a new hospital) has implications for patient safety. Therefore, when managing a return to training, it’s important to promote patient safety and quality of care while also giving the trainee the opportunity to regain their confidence and previously acquired skills quickly and safely.
Both the length and nature of the absence, together with the doctor’s stage of training and individual needs, will all affect how quickly and safely they can return to training. Therefore, this return to training scheme is designed to be flexible to take into account individual needs.
The Academy of Medical Royal Colleges (AoMRC) return to practice guidance suggests that an absence of 3 months or more may affect skills and knowledge, and recommends an assessment on return to practice. The RCOG supports the AoMRC recommendation that a return to training process should apply to any trainee who has had a prolonged absence of 3 months or more. Any trainee who has been absent for a period of time may use this scheme, but any phased return to training plan devised by local occupational health or human resources departments should take preference.
Before returning to training
Once the timeframe for returning to training is known, the trainee should meet with their Educational Supervisor for an initial review – see section 1 of the return to training form (Word document, 83 kb). The aim of this meeting is to agree an individualised plan for return, accommodating any specific concerns, learning needs and required assessments. This should all be recorded on the form.
The initial review should take place 6–8 weeks before the estimated date of return, to allow enough time for the trainee to be incorporated into the rota. However, this should be flexible to take into account the trainee’s individual needs and circumstances.
For the majority of trainees, a supervised period will probably be required. However, for shorter absences when the trainee has maintained active clinical practice, the supervised return period may not be necessary. Good evidence of this must be recorded on the return to training form and the lack of supervised period agreed with the College Tutor/Training Programme Director.
On the trainee’s return to work, there should be a period under direct supervision, including any on-calls, during which workplace-based assessments should be performed.
After this supervised period, the trainee and Educational Supervisor should meet at a return review – see section 2 of the return to training form (Word document, 83 kb) – to discuss the trainee’s progress, review the assessments, address any concerns and arrange any further targeted training.
If the trainee and Educational Supervisor are satisfied with progress, the trainee can be signed off on section 3 of the return to training form (Word document, 83 kb) and return to normal duties.
The supervised period can be extended if necessary – see sections 4 and 5 of the return to training form (Word document, 83 kb).