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More and more doctors have responsibilities outside of their training - from businesses to families to property portfolios. Therefore, many opt to train less than full-time (LTFT).
What is LTFT (less than full-time training)?
LTFT is reduced working hours for doctors arranged with their training programme. Now, ANY doctor in training can apply for less than full-time training. Prior to this, you had to meet special circumstances and be in a specialty training programme. In 2020, it was agreed that junior doctors would be also be able to train less than full-time, following negotiations between the BMA and the NHS. Trainees in England will no longer need to meet specific criteria such as caring responsibilities, health reasons, or religious grounds to qualify for the right to work LTFT. But whether their application will be successful is still dependent on the employer.
The aims of LTFT training are to:
promote work/life balance and wellbeing.
retain more doctors in the workforce rather than them having to take time off from working altogether.
promote career and personal development.
LTFT trainees will still end up working the same hours as the doctors on standard training programmes, including the same number of on-calls, out-of-hours duties, and portfolio requirements.
Working LTFT as a junior doctor (F1/2)
Working LTFT can be a great way to improve your work-life balance during the foundation programme and applies to individuals in many situations. Obviously, this means your training will take longer so there are pros and cons to consider.
How long will it take me to complete foundation training if I work LTFT?
LTFT junior doctors can work a minimum of 50% and up to 80% of the whole-time equivalent.
So, if you work at 50% - you will complete F1 in 2 years instead of 1.
However, if you work anything more than 50% you will complete FY1 slightly out of sync with your full-time colleagues (so longer than 1 year) but within the 2-year mark. It is possible to start your F2 post at any changeover point (they usually take place in August, December, and April) but this will obviously depend on job availability. Therefore, if you're thinking about working more than 50%, you may find that you have to take a trust-grade job or do some locum shifts to fill time before starting F2 with the rest of the cohort.
An example of how long it would take you to complete F1 can be found in the second column in the table below. The whole time equivalent is 12 months and the percentage you work determines how much longer it will take you.
For specialty doctors, apply the same rule but to the length of your respective training programme. So, if you were a GP trainee on a 3-year full-time training programme working 60% of the whole-time equivalent, it will take you 5 years (60 months) to complete training instead, subject to satisfactory progression.
How do I apply?
Deaneries/training programmes usually only approve applications that are based on need. Once they assess your eligibility, they will determine whether they have the capacity to employ someone less than full-time. Applications will fall under 3 categories:
Category 1: Trainees with health conditions and caring responsibilities
Personal ill-health or disability
Responsibilities for caring for children
Responsibility for caring for ill/disabled partner or another dependent/relative
Category 2: Trainees with unique opportunities or commitments outside of medicine
Doctors with unique opportunities for personal or professional development outside of medicine e.g. competitive sports on a national or international level, management courses, art courses, etc.
Doctors with short-term extra commitments e.g. serving on BMA committees/other national committees.
Doctors training for a religious role that requires a certain amount of time commitment.
Category 3 (coming into effect from August 2023 for the Foundation programme):
Any well-founded reason, including for their well-being or through personal choice
Important to note:
Category 1 applicants have first priority.
Applications in Category 2 or 3 are dependent on individual circumstances and the availability of suitable training placements. If your application is refused, you can appeal, but, the overall training capacity of a training programme and service commitment will have to be taken into consideration.
Most deaneries/training programmes require 3 months’ notice for an application to work LTFT and you will need to indicate the percentage you want to work. The possible percentages you can choose from may vary so you'll need to check your HEE/deanery office before making an application.
Applications are usually considered quickly and will be either approved or declined by the deanery. If approved, the deanery should notify your trust that you have approval to work LTFT.
Types of LTFT post
There are three types of LTFT post:
Slot share (usually 50% or 60%)
Part-time in a full-time post (50% – 80%, creates rota gaps)
Supernumerary
In reality, most LTFT posts at foundation level are 'part-time in a full-time post'.
How much will I be making?
You will be making less than a full-time foundation doctor (<£2500/month) depending on what percentage you work. E.g. 50% work = 50% income. However, I'd argue you could make this money on your days off through your extra-curricular commitments or through locums.
You can sign up to do locums within your hospital’s substantive staff bank, an NHS Trust, or a locum agency that advertises shifts across hospitals in the area. However, if you are doing an excessive amount of locum shifts (you may have to declare your locum work), your deanery may want to discuss your LTFT status and can revoke it.
Specialty trainees
Trainees in all specialties will also be able to work less than full-time under Category 3 (personal choice) from August 2023 (currently only available for Emergency Medicine, Obstetrics & Gynaecology, and Paediatrics).
By August, all specialties will allow trainees to work LTFT under Category 3 whereby trainees can undertake an unspecified period of time as LTFT Category 3 at percentages of 60% or greater.
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