Currently, if a trainee leaves the specialty programme, or works part-time, their post cannot be replaced.
Recruitment in England is currently only allowed at ST1 level and doctors taking up these posts must have worked in O&G for less than 24 months.
A recalculation of the number of posts required is needed alongside the reality of budget reductions. There are certainly workforce concerns of training an excess of specialists who cannot find consultant posts, but currently recruitment is not taking into account the loss of available staff due to attrition, more maternity and paternity leave and increasing part-time work patterns, as well as the increasing diversity of O&G services.
The RCOG proposes allowing a hybrid model of recruitment, maintaining run-through posts from ST1 but allowing alternatives as well. Options would include recruitment at ST3 or later as well admitting more doctors into ST1 to replace those working LTFT or out of programme, recognising that there is significant attrition in the first two years. The model chosen would depend on the needs of local schemes and the availability of applicants at different stages of training. Recruitment at ST3 or later would replace trainees who had left the scheme and so would not increase the overall number of doctors being trained for future consultant posts.
An increase in flexibility of numbers would allow trainees time out of training for research, specific skill acquisition, global health work and family commitments, and would improve retention. Training schemes should be able to factor this into their recruitment numbers, with slight expansion, in order to allow out of programme activities more readily.