Training less than full time – why you will never look back | Association of Anaesthetists

Training less than full time – why you will never look back

Training less than full time – why you will never look back

Specialty training in anaesthesia is hard. Long hours, frequent night shifts, a stressful job, notoriously tricky exams, the large amount of continuous CPD required to be competitive, the endless forms to get signed off. Training takes time, and it’s hard to have a life outside of work while trying to be a good trainee. Maintaining hobbies, spending time with friends and family, and looking after our wellbeing are fundamentally important, but all can suffer during training. The effects of fatigue, burnout and low morale have been well documented [1, 2]. But surely it doesn’t have to be like this? Whilst we await a new curriculum – supposedly less onerous – we mustn’t forget there is another way. Sometimes we are so busy with our heads down, just trying to get through training, that we don’t realise the answer may have been there all along. Although not the answer for everyone, less than full time (LTFT) training can be a fantastic way to take control and restore your work-life balance.

Why I decided to train LTFT (by PT)

Like many other young doctors, I thought that I’d be able to cope with the sleepless nights of new parenthood because I was used to working in busy hospitals with regular night shifts. However, I didn’t realise that having a new baby would change our lives so drastically. It was like being on call permanently: no breaks; no end of the shift; and no fresh team to hand over to. It was exhausting.

My older son was three months old when I started my ST3 post in anaesthesia. I was a new father, a new registrar and had to revise for the Final FRCA. Our plans as a family relied on me passing my exams before my wife, a GP trainee, took hers.

The idea of working LTFT had never crossed my mind until I was chatting with a consultant at work. She had trained LTFT, and suggested it as an option for me. I spoke to a few other trainees who had already reduced their hours before making the decision to go for it myself. A few months later, I started my next rotation at 80% full time, and my wife went back to work after her maternity leave at 60% full time, both of us LTFT trainees.

What are the good things about working LTFT?

Working 80% has improved my work-life balance so much: it gives me a fixed day off every week to be at home with my family, while allowing me enough time at work to keep up my anaesthetic experience. I’m conscious that my kids will only be young once, and so I feel fortunate to have the opportunity to spend time with them now. I’ve noticed a significant improvement in not only the quantity, but also the quality, of time spent with them. For example, I have recently been teaching my son to play the ukulele and we have been plane spotting at the airport. Having a bit more time off has been good for my health too, as I am now able to exercise more regularly and I’ve even had time to try my hand at some new recipes. On top of all that, I now feel fresher while I am in the hospital and not tired all the time.

What are the challenges of working LTFT?

People worry about the reduction in pay, but when you look into it the figures are not as bad as you might think. Another common perception of working less is that you might not feel like part of the team anymore, but I’ve not found this to be the case. Training also takes longer, but it doesn’t necessarily add excessive time; I started working 80% halfway through ST3, and that has only pushed my CCT date back by just over a year. Once or twice, I’ve looked at my colleagues who continued working full time and are now in the last few months of training, and I wish I was finishing with them. But the feeling passes quickly as I remind myself that my life circumstances are different, I enjoy my time away from work, and ultimately there is no race to become a consultant.

Am I happy with my decision to train LTFT?

LTFT has been a hugely welcome change to my family. It has allowed the pace of training and life in general to be much more manageable and enjoyable. I have never looked back, and would encourage anyone to go for it!

Want to find out more? The Association of Anaesthetists and RCoA have lots of information about LTFT training on their websites [3, 4]. They have published jointly a guide for training programme directors [5], which trainees could usefully read. The latest version of the A to Z of LTFT training in anaesthesia and intensive care medicine will be published soon on the Association and RCoA websites, so keep an eye out for it!

Peter Tsim
ST5 Anaesthetics, East Midlands School of Anaesthesia 

Roopa McCrossan
Honorary Secretary and LTFT Lead, Association of Anaesthetists Trainee Committee
Locum Consultant in Anaesthesia, Freeman Hospital, Newcastle

@RooMcCrossan

References 

  1. McClelland L, Holland J, Lomas JP, Redfern N, Plunkett E. A national survey of the effects of fatigue on trainees in anaesthesia in the UK. Anaesthesia 2017; 72: 1069-77. 
  2. Looseley A, Wainwright E, Cook TM, et al. Stress, burnout, depression and work satisfaction among UK anaesthetic trainees; a quantitative analysis of the Satisfaction and Wellbeing in Anaesthetic Training study. Anaesthesia 2019; 74: 1231-9. 
  3. Association of Anaesthetists. Less than full time training explained, 2020. https://anaesthetists.org/Home/Wellbeing-support/Careersupport/ Less-than-full-time-LTFT-training (accessed 2/7/20). 
  4. Royal College of Anaesthetists. Flexibility in training, 2020. https:// rcoa.ac.uk/training-careers/training-anaesthesia/flexibility-training (accessed 2/7/20). 
  5. Royal College of Anaesthetists and Association of Anaesthetists. Less than full-time training. A guide for training programme directors in anaesthesia and intensive care medicine, 2020. https://anaesthetists.org/Less-than-full-time-training-for-trainingprogramme- directors (accessed 17/7/20).

LTFT top tops

  1. If you want a certain fixed day off, ask for it
    Most LTFT trainees have the same zero-hours days (or non-working days) each week, mostly to facilitate childcare arrangements. This is normally an informal arrangement between an individual trainee and their department, it is not a contractual requirement. 
  2. Find out the full timers’ total hours and working pattern
    LTFT trainees work a pro-rata share of what full time trainees work. For example, if the full time trainees work 48 hours average a week, a 60% trainee will work 28.8 h average per week (48 x 0.6 =28.8). Out of hours work is also pro-rata, a 60% trainee must only work 60% of the night shifts, weekends and long days. 
  3. Monitor your hours closely
    Keep a spreadsheet of your rostered shifts and total up the hours. Your average hours should be the appropriate pro-rata share. If your hours aren’t correct, act sooner rather than later and speak to your rota maker. 
  4. Monitor your rota pattern closely
    Zero-hours days post-call follow the same pattern as for full time trainees. For example, if a full-time trainee has Monday and Tuesday off after working a weekend, the LTFT trainee should also have these days off in addition to their normal off-day. 
  5. Professional subscription discounts
    Some organisations offer a LTFT membership discount. Check each organisation’s website or contact them for details. The Association’s LTFT discount can be accessed via this link: https://anaesthetists.org/Home/ Membership/Benefits-of-membership/Change-in-circumstances.