Everything you need to know about less than full-time (LTFT) training, including general advice for LTFT trainees and answers to frequently asked questions.
General advice for LTFT trainees
- Take time with your educational supervisors to plan your training to achieve specific objectives in each post
- Think about the skills you need to acquire to make yourself a good candidate for a consultant post, especially if you’re tied to a specific geographical area (you may need to travel if the training you desire isn’t available locally)
- Keep adding to your CV by attending appropriate courses, undertaking audits and administrative duties and participating in your department
- Your deanery website will contain information about local arrangements for LTFT training
To contact the RCOG, please email the Policy Coordinator (Quality) Tania Chambers at email@example.com or call +44 20 7772 6294
LTFT training is defined in European law (EC directive 93/16/EEC) as training that meets the same requirements as full time training, from which it shall differ only in the possibility of limiting participation in medical activities to a period at least half of that required of a full-time trainee.
All trainees (male and female) can apply to train LTFT, at any stage during their training.
If you want to train LTFT, under EU law you must show that you would be unable to train on a full-time basis for well-founded individual reasons. Most local education and training boards (Deanery/LETBs) have an Associate Dean who manages LTFT training and determines whether requests are for well-founded reasons.
COPMeD (Conference of Postgraduate Medical Deans of the United Kingdom) categorises reasons for LTFT training requests into two groups:
Doctors in training with:
- Disability or ill health (this may include those on in vitro fertility programmes)
- Responsibility for caring for children (men and women)
- Responsibility for caring for an ill or disabled partner, relative or other dependent
Such doctors are professionally disadvantaged by circumstances and less able to fulfil their potential on a full-time than on a part-time basis.
Doctors in training with:
- Unique opportunities for personal/professional development (e.g. training for national/international sporting events, or a short-term extraordinary responsibility such as a national committee)
- Religious commitments (e.g. training for a particular religious role with a significant time commitment)
- Non-medical professional development (e.g. management/law/fine arts courses, diplomas in complementary therapies)
Other well-founded reasons may be considered, dependent on the particular situation.
Deaneries/LETBs use these criteria to assess eligibility for LTFT training. Category 1 applicants have priority and Deaneries/LETBs will support all such applicants. Non-medical interests will be assessed on their individual merits and access to category 2 applicants is dependent on individual circumstances and funding availability.
If your application is refused, you have the right to appeal. If you don’t meet the eligibility criteria, your Deaneries/LETBs may be able to offer careers advice or discuss alternative career pathways.
The General Medical Council (GMC) requires that trainees undertake no less than 50% WTE (whole-time equivalent). In very exceptional circumstances, your LETB may agree to an absolute minimum of 20% WTE for a specified period. For more information, please read the GMC position statements on LTFT training.
The RCOG strongly encourages those who want to train LTFT to work at least 50% WTE to ensure educational progress; any less than this is likely to result in skill retention only, not progression through the O&G specialty training curriculum (especially for practical procedures).
Pay needs to be negotiated with your employer. It is based on the total number of hours worked each week and how many of them are out of hours. If you wish to train LTFT at more than 50–60% WTE, you’ll need support from your Deanery/LETB and local Trust, and this will depend on available funding and gaps in rotations.
There are 3 options for LTFT training
- “Slot sharing” is the most common with 2 trainees sharing 1 slot.
- These posts are usually funded at 60% so each person can work six sessions and have some overlap (e.g. to attend departmental teaching sessions).
- LTFT in a full time slot is becoming more common with the increasing numbers of unfilled training posts.
- This allows the possibility of working more than 60% if a Trust agrees to fund it. There is no defined maximum but it would rarely exceed 80%.
- Supernumerary post. If neither of the other 2 options is possible then your Deanery/LETB may consider placing you in a supernumerary post for a short period of time. However, owing to financial constraints this is becoming increasingly difficult for LETBs/Deaneries to accommodate, even for reasons of ill health, and there can be additional problems with payment for out-of-hours duties.
Previously these posts had to be approved for training on an individual basis but as GMC approval is now granted to a complete O&G programme rather than individual posts, training within a supernumerary post should be recognised, provided training capacity isn’t exceeded.
First, see your Deanery/LETB’s Associate Dean with responsibility for LTFT training (or your Postgraduate Dean) to discuss your reasons for wanting to train LTFT and to check whether funding is available. You may experience difficulties because of financial constraints within Trusts, and your Deanery/LETB may not be able to insist on placements. It can take some time to arrange a LTFT post, so the earlier you start discussions with your LETB, the better.
You’ll also need to contact your Deanery/LETB's O&G Training Programme Director, who’s responsible for managing the rotations within your Deanery/LETB and who will be aware of the potential capacity to take on a LTFT trainee.
If you have any problems, please contact the RCOG’s LTFTAdvisor email the Policy Coordinator (Quality) or call +44 20 7772 6294.
You can request LTFT training when appointed to the training programme. You don’t have to disclose this at interview, but you should discuss your plans in confidence with the Postgraduate Dean in advance, to allow a post to be established as quickly as possible. Appointment committees are not allowed to take LTFT training requests into account – appointment is on merit alone. A suitable training slot will then be found if possible although unfortunately there is no obligation for a LTFT post to be found for every applicant even if you are deemed eligible.
You can request to convert to LTFT training at any stage during your training. Your Deanery/LETB's Associate Dean for LTFT training will need to confirm your eligibility, and your Deanery/LETB and employing Trust will need to approve the funding arrangements.
Once you’ve organised a LTFT slot your timetable will be arranged with your Trust’s College Tutor, Training Programme Director (TPD) and Deanery/LETB College Advisor. You will need to follow the local policy for each LTFT placement as these have to be agreed not only by the TPD and Trust College tutor but also by HR and the finance department in the Trust in which you are placed.
Your LTFT training programme should be comparable to that of a full-time trainee and must include the following clinical sessions on a pro-rata basis:
- Antenatal clinic
- Labour ward
- Gynaecology clinic
- Operating list
- Special interest (e.g. colposcopy, ultrasound) – this should rotate so you experience the various subspecialties in O&G
- Postgraduate education/audit/administration
It may not be possible or appropriate to include all the basic clinical sessions at all stages of training. You may have a modular timetable, with a block of time spent focusing on gynaecology, then a similar period focusing on obstetrics. Other timetables have components occurring in alternate weeks. There does not need to be a rigid arrangement as long as the totality of training is balanced. You should attend a proportional amount of postgraduate education sessions compared with your full-time colleagues.
You should try to have some continuity in your training (e.g. attend a gynaecology clinic/operating list with the same consultant).
You shouldn’t be used as just an extra pair of hands in your department, but equally you shouldn’t be able to cherry-pick sessions.
As a LTFT trainee, your on-call work should be proportional to that of a full-time trainee within your department, including weekend and night duties. Similarly, the number of ‘off’ sessions should be pro-rata. Your out-of-hours work should reflect the type of working pattern in your department (i.e. on-call rota) and must be discussed with the Human Resources department to ensure compliance with the ‘new deal’ defined in HSC 1998/240.
As a LTFT trainee, you should rotate between units in your training programme and spend a similar proportion of time in teaching and district general hospitals as full-time trainees. However, it may not be possible for all units to accept LTFT trainees and some rotations may pose geographical problems for trainees with domestic commitments. Although most Deaneries/LETBs will try and take geographical issues into account when arranging placements some compromises may be required in order for you to receive a full breadth of training.
You should regard rotation positively, as it will broaden your experience and increase your employment opportunities, as you’ll become known in several departments.
Assessment of training time is calculated pro-rata. Assuming that assessments of progress are satisfactory, the calculations are as follows:
|Number of paid sessions worked each week/proportion of weekly hours||Equivalent time in training years for 12 months in LTFT post||Time needed to complete training year||Minimum period in training to achieve CCT|
|5/50%||6 months||24 months||14 years|
|6/60%||7 months 1 week||20 months||11 years 8 months|
|7/70%||8 months 2 weeks||17 months 1 week||10 years 3 months|
The College recognises that LTFT trainees often undertake additional work, research, administration etc. outside contractual hours. However, this is limited by legislation (Annex 1 of EC93/16/EEC), so it’s important that your weekly timetable accurately reflects your workload and that you seek additional sessions if appropriate.
The November 2012 GMC position statement on time out of training states that any absence of 14 days or more in a 12-month period has to be reviewed at the next ARCP to ensure your CCT date doesn’t need to be extended. Therefore, as of April 2013 it’s no longer possible to count 3 months of maternity leave towards CCT.
Trainees often stop working night shifts in late pregnancy before going on official maternity leave. It’s important to discuss such arrangements early with your College Tutor and rota coordinator. It may be feasible to swap some night duties for weekend day shifts. Usually this time should continue to count towards CCT, but it‘s the Deanery/LETB’s responsibility to decide this on a case-by-case basis.
Similarly, it’s recommended that trainees undergo a period of supervised ‘return to work’ training following maternity leave, but this wouldn’t routinely lead to an extension of CCT unless there are problems with acquisition of competences. In this instance, any decisions about the CCT date would be made at your next ARCP, together with the assessment of your progression through training.
For more information about breaks in training to do with pregnancy, please read the RCOG’s advice for trainees on working during pregnancy and maternity leave.
Like full-time trainees, LTFT trainees may need to move Deanery/LETB during training, and can apply for an inter-deanery/LETB transfer (IDT) for ‘well-founded personal reasons’. As of August 2013, there’s a national system for IDT applications. It can take some time to arrange an IDT, and this will depend on a LTFT slot becoming available in the new Deanery/LETB. You should discuss any requests as early as possible with your Postgraduate Dean.
You should be assessed at appropriate intervals, judged on an individual basis. At a minimum, you should meet with your Educational Supervisor every 6 months. You will have an ARCP each year as the assessments must be performed every 12 months even if you are not working full time. It’s important to note that the requirements in the RCOG training matrix refer to a full training year and so progression over 12 months in a LTFT position will be assessed pro-rata.
You will have an ARCP each year as the assessment is annual and must be performed every 12 months even if you are not working full time. It’s important to note that the requirements in the RCOG training matrix refer to a full training year and so progression over 12 months in a LTFT position will be assessed pro-rata. When one consultant signed OSAT confirming competence is required you will need one for each training year but it is sensible to make sure you have at least one of those that are required before your ARCP even if the training year is not complete. You will need to complete the TEF annually and you should have at least one completed TO2.
If the extension relates to clinical experience or training requirements (e.g.ultrasound skills) it will be pro-rata. If the extension is because of a requirement to pass an exam it will be the same length of time as that given to a full time trainee as the time required to achieve this will be the same for all.
As there is no time limit for ATSMs which are competency based you will ahve the entire duration of your time in ST6 and ST7 to complete the required ATSMs.
In exceptional circumstances, it may be that the theoretical course has been completed more than three calendar years prior to the completion date of the ATSM due to less than full time training, maternity leave or sick leave. In such circumstances the educational supervisor for the ATSM should liaise with the regional ATSM preceptor for the Deanery/LETB to ensure that there have not been any significant changes in the theoretical courses for the specific ATSM and then inform the Head of School/Chair of DSTC of the Deanery/LETB. If the Head of School/Chair of DSTC is in agreement with allowing a ‘time expired’ activity based on the information above then RCOG can allow this.
It is possible to revert or move to full-time training, but you may have to wait until the next full-time training slot becomes available. You should discuss this with your LETB and Training Programme Director as far in advance as possible.
The time allowed is not pro-rata as stated in the Gold Guide which addresses this. As for all trainees, LTFT trainees may apply for a period of acting up as a consultant, up to a maximum of three months. This is on a fixed-term basis and not pro rata. Trainees may be able to take time out of programme to act up as a consultant and may be able to credit this time towards a CCT or CESR (CP). If this kind of post is formally included in the approved specialty curriculum, additional prospective approval is not required from the GMC. Trainees acting up as consultants will need to have appropriate supervision in place, and approval will only be considered if the acting up placement is relevant to gaining the competences, knowledge, skills and behaviours required by the curriculum. In these circumstances, OOPT will normally be for a fixed-term period of three months for both full-time and LTFT trainees.
The arrangements for extension of training after award of a CCT (the ‘period of grace’) are the same for LTFT and full-time trainees with no pro-rata extension for LTFT. The standard Period of Grace is 6 months after the CCT date.