Those doctors in training with:

• disability or ill health (this may include those on in vitro fertility programmes)
• responsibility for caring (men and women) for children
• responsibility for caring for an ill/disabled partner, relative or other dependant.

These result in the individual doctor or dentist being professionally disadvantaged by circumstances, and less able to fulfil their potential on a full-time rather than on a part-time basis

Those doctors in training with:

• unique opportunities for their own personal/professional development, for example training for national/international sporting events, or short-term extraordinary responsibility, for example a national committee
• religious commitment – involving training for a particular religious role with requires a specific amount of time commitment
• non-medical professional development such as management courses, law courses, fine arts courses or diploma in complementary therapies.

Sources: Doctors in flexible training – Principles underpinning the new arrangements for flexible training and the Gold Guide (page 95)

It should be noted that there are slight differences between policies for LTFTT of different deaneries. For example, in some deaneries you may be eligible if you are caring for children up to the age of 12, for other deaneries they may have a lower or higher age limit. It is recommended that you look on your individual deanery website for details.

Applying for LTFTT can be a lengthy process, but it should take no longer than 3 months.

The regulatory requirements that LTFTT had to be for at least 50% of the hours of a FT trainee has been removed (although the Gold Guide still refers to this). LTFTT can now be for any proportion of FT post, but of course the difficulty for deaneries is accommodating all requests at the same time ensuring training programmes remain fully populated and making sure that there are sufficient trainees overall.

• If you have children you will have the opportunity to spend more time with them and you will get to see more of them as they are growing up
• A better work/life balance
• You may appreciate your time at work more, as you will not be wishing that you are at home so much
• A greater ability to manage and prioritise workload
• A better control over rotations and you more flexibility in taking your annual leave if you are supernumerary (and so extra to the team). Although there are very few places now that are supernumery - see article in 'Case Studies', below.

• Your training will take longer to complete
• Less overall pay! – you are paid pro rata to full time trainees.
• It may take longer to become integrated with the team
• Contact with the consultants can be constrained
• Less access to out of hours experience
• Less continuity with patients/handover issues
• Limited slot-sharing opportunities
• Pro rata access to leave, including study leave
• Pro rata access to study leave funding
• If you are supernumerary you may feel a bit like an extra member that no one misses when you are not there.

There are advantages and disadvantages to working full days or deciding to work part-days (i.e. doing one session per day). If you are slot-sharing, it will be good to brush up on your negotiation skills, especially as you will want to try to negotiate a win/win situation with your slot-sharing colleague and your employer. You may not be in a position to choose when you work, but instead have to work to a rota.

Advantages to working full days:

• You will be able to concentrate on your work for a whole day
• If you are caring for your children then you will be able to spend a whole day with them
• You arrive and leave with the rest of the team
• You can attend lunch-time teaching sessions (and so they don’t cut into your half day
• You do not have worry if morning surgeries run late
• You will save in travelling time and costs

Advantages to working part days:

• It will not be as tiring as working full days, especially for those who have a particular health problem and who tire more easily
• If you work the morning session, then this will mean you get work done and out of the way so this leaves you with free time for the rest of the day
• If you work during the afternoon session, then if you are caring for children, you can be with them during the part of the day when you are not so tired
• If you are caring for children and your child is ill, then you will only miss one session (rather than two, if you are working for a whole day).

Read our three case-studies for LTFTTs here:

We also have pages on:

Medical Mums and Dads

Negotiation Skills for LTFTTS

• LTFTT is integrated into mainstream full-time training by either the use of slot-shares or supernumerary posts (where slot-share arrangements are not practical). From the deaneries’ perspective supernumerary posts cost more and as budgets are not guaranteed there is a general push to try to move more to slot-sharing where possible (especially as across the NHS there is a general tightening of budgets for the foreseeable future). It is best to check with your deanery first as to whether supernumerary posts are available, most deaneries are not able to offer supernumerary posts, except on very rare occasions.
• Slot-sharing sometimes has the advantage that you are likely to be able to spend at least some time with your slot-share partner if both of you work 60% of a normal working week. Therefore you will have the chance to share 1 day or 1 session, where you can carry out a proper handover. However, this may not be the case, as not all slot shares work in the same department. This is a financial arrangement and there may be, for example one slot share in dermatology, and another in neurology.

It is also advisable that you refer to your deanery for information regarding your options available for what proportion of a full-time post you can work. For example, the 60% slot share working is not common to all deaneries. It is also important to note that where there is a 60% slot share, sometimes the extra 10% is for handover and equal access to formal training, and the trainees are counted as training at 50%.

• The advantage of being supernumerary is that you will be an ‘extra’ pair of hands on your firm, so when your team is busy, then you will really be appreciated!
• It is now the case where slot-sharing is much more common than supernumerary posts, and this means there may be restrictions in the areas where trainees can work LTFT (as they will need to be paired up). The ‘Principles underpinning the new arrangement for flexible training’ document published by NHS Employers, however contains a section to say that a few supernumerary posts will be available for ‘those who need flexible training at short notice, for example those in ill-health, and those with dependents who suddenly need increased care’.