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
- 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.
- 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.
- 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).
- Royal College of Anaesthetists. Flexibility in training, 2020. https://
rcoa.ac.uk/training-careers/training-anaesthesia/flexibility-training
(accessed 2/7/20).
- 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).