This may sound obvious, but thinking about your goals and where you want to be, both now and in the future will help you get perspective.  Considering what is important to you and what your goals are will make it easier to plan, and to gain satisfaction both at work and at home.

A vital part of working part-time is being able to plan ahead.  Planning, both for the short-term and the long-term can ensure that your slot-shares or rotas work to your advantage, and that you have professional goals to work towards.

Be prepared to negotiate for what you want, whether it be a change in rota, meeting time or training session. It is important to be flexible too, but if you don’t ask, you don’t get! See our guide on negotiating.

Use your contacts to share information and to keep in touch with what is going on.  It may help you feel more ‘in the loop’ and could even highlight opportunities you otherwise wouldn’t have known about.

Get involved and apply for things.  Initiate meetings that are suitable for you and manage them, be confident in your abilities and ensure that you maintain your profile to the same level as your full-time colleagues.

As well as doing this on a day to day basis through communication with your colleagues and maintaining your professional development, why not go a step further and enter for a prize (there are many awarded by the Royal Colleges), or offer to present at a departmental meeting or a regional (or even national) event?

Finally, sharing your experiences with other LTFT colleagues can be very valuable.  The role of mentors is important, so find a mentor or offer to be one!

We asked a trainee to talk about their experience training on a less then full time contract. Read the case-study below to see their thoughts:

I came to medicine late; after a number of years working in the pharmaceutical industry, project managing clinical trials, I decided I wanted to do something which offered a greater intellectual challenge and more personal fulfilment. After some soul-searching (and watching a TV programme about graduate entry medicine) I decided psychiatry fitted the bill. 

As a consequence of my delayed start, it became apparent that the concept of the ‘perfect time’ to have a child in combination with a medical career was a misnomer, so I went on to have my first child during the penultimate year of my medical degree. Number two came along during my F1 year, and because of this I have always worked part-time. I am currently working three days a week as a foundation trainee in General Surgery. The team consists of 5 consultants, 4 registrars and 5 other F1 doctors. Prior to this, I undertook rotations in Acute Medicine, Sleep Medicine and Gastroenterology.

Organising the approvals for less-than-full-time training was a relatively straightforward (although bureaucratic) process. I applied for foundation training in the usual way and subsequently applied for less-than-full-time approval and funding. Eligibility is dependent upon meeting one of a number of criteria; one of which is being the main carer for young children. I have found both the deanery and foundation school to be helpful.

As with anything, there are benefits and downsides to the arrangement. For the most part, being a flexible trainee works well.  Despite being supernumerary (an additional member of the team), I have always been accepted and incorporated into the team and had more than enough work to keep me busy.   However, being supernumerary means that payment for out-of-hours training is Trust-dependent so this can limit weekend and evening exposure, which is clearly vital to foundation training. It has also meant that I have had to work harder to get opportunities to clerk patients “on-take”.  It is possible to gain this experience; it just takes more organising than for the full-time trainees.

From a logistical perspective, the most difficult aspect is juggling work and childcare; most nurseries do not accommodate the hours required to do a surgical rotation and there is little flexibility in most childcare options. This means I have to leave work on time to collect my children, which can be frustrating (particularly when trying to get an urgent CT scan or review of a patient). I have learnt to work efficiently, getting through jobs as quickly and as early as possible and to keep my patient list up-to-date so as to ensure effective handovers at the end of the day. As with all working mothers, there is the inevitable stress of dealing with the seemingly endless stream of fevers, colds and episodes of diarrhoea that my children develop; leaving work in the middle of the day because my son has been sent home from school is irritating for both me and my colleagues who have to cover me, particularly so when my son invariably starts bouncing round the house an hour later.

At a personal level, the hardest part of flexible training is the length of time it takes. Each foundation year takes me a total of 20 months to complete. I have watched my peer group from medical school climb the career ladder and go onto specialty training whilst I languish as a house officer. However, this is markedly outweighed by being able to achieve a good work-life balance.  I get to spend plenty of time with my children; I (mostly) am able to bathe them and put them to bed, take them swimming and to the park and most importantly see them grow-up, without resenting the intrusion of my job.

All things considered, I would recommend part-time working to anyone in a similar position. Most of my colleagues and seniors have been supportive of my training (with a couple of notable exceptions). There are also some issues around parity of training between part-time doctors and their full-time counterparts. However, I feel fortunate to be able to work on a less-than-full-time basis as it affords me the opportunity to achieve other things outside of work whilst also having a varied and rewarding job. I benefit from having a satisfying career and my children benefit from having a more contented mum.

SE, Foundation year one LTFT trainee

Please note the content and opinions expressed in all case studies are those of the writer and do not necessarily reflect the views of NHS Medical Careers.

We asked a trainee to talk about their experience training on a less then full time contract. Read the case-study below to see their thoughts:

At only 5 months into my F1 year I found myself unexpectedly pregnant and, whilst delighted to be starting a family, I was incredibly anxious about the effect that it might have on my new career.  I had never expected to have to grapple with the motherhood vs. work debate so early on in my life as a doctor.

Initially, I was adamant that having a baby would have no slow-down effect on my training. I had come to medicine as a graduate and, as I was already a year or two older than most F1s, was anxious to progress as quickly as possible.  I would have a few months off after having the baby and then return full-time to complete my F2 year, I said confidently to anyone who asked.  

To this end I booked an appointment to meet the head of the foundation school to discuss the interruption to my training.   It was only as she questioned me in detail about my plans, and forced me to think about the childcare that I would need, and the amount of time that my baby would spend in the care of others, that I began to feel how unrealistic my initial plans had been. 

My husband is a lawyer and works long hours in the City.  On a good day he leaves the house at 7am and returns at 8pm.  Although my parents only live 40 minutes from us they both work full-time, and there isn’t any obvious family member who could help with childcare.  As a result, we would be dependent on paid childminders or one sort.

Most childminders and nurseries will have children from 8am to 6pm or thereabouts, but unfortunately the shifts that junior doctors work can make fitting to these hours extremely challenging.  Even with my limited experience of hospital work I knew that on a busy firm with very sick patients, there would be evenings when I could not leave until 7 or 8pm at the earliest, and I couldn’t imagine being able to consistently leave in time to pick up a baby for a 6 o clock deadline.  I also wondered how we would cope when I were on weeks of nights.  I wouldn’t get home in the morning until 9am, but my husband would have to leave for work well before the nursery was open, so what would happen to the baby in the intervening hours?  It seemed that the only childcare option that would actually allow me to return to work full-time was a live-in nanny, and we couldn’t stomach either the expense or the constant presence in our small flat of a third person.

Less than full time training appeared, then, as the perfect way for me to continue my training, and retain my skills, whilst working childcare-friendly hours and still spending some time at home with my baby.  By the time I started my maternity leave I had completed my F1 year and 2 months of my F2 year.  After discussions with the LTFT co-ordinator at the deanery I worked out that if I were to take 5 months off work, I could then return to work 3 days a week working 9-5 in order to complete F2 by the following August, in line with the standard trainees and one year later than I would have originally finished.

My son Thomas was born in October and I am currently in discussions with my local trust to return to work in March on 60% of a normal rota.  The discussions with the trust have not been straight-forward, largely as finding somebody to take ownership of managing my programme has been very difficult.  It is most likely that I will be a supernumerary F2, and I hope to complete rotations in GP, A&E and Cardiology.  My son will be looked after by a childminder 3 days a week, and I will spend the remaining 2 days at home with him.

I hope that this will be the perfect balance, and I am so grateful to have the chance to spend some quality time with Tom whilst he is still so young.  However, I will not know until I start my post how my colleagues will respond to my part-time status and whether I will complete F2 as confident in my skills and experience as my full-time colleagues.  Although I do not know how LTFT training will suit me in practice, I am very glad that the choice was available for me to make. 

TIPS for Arranging LTFT Training

• Start early; it takes quite a while to get eligibility approval and then to negotiate the minutiae of the post
• Don’t assume you necessarily have to return to the trust you worked for.  The deanery were happy for me to consider moving to a hospital closer to my home address.
• In a supernumerary role there is considerable flexibility about which rotations you can do.  Whilst there is, for foundation training, a requirement for the posts to be educationally balanced, and to include an ‘acute medicine’ job, it can be an opportunity to look into specialities that particularly interest you.

HWS - Foundaton Year 2, LTFT trainee

Please note the content and opinions expressed in all case studies are those of the writer and do not necessarily reflect the views of NHS Medical Careers.

We asked a trainee to talk about their experience training on a less then full time contract. Read the case-study below to see their thoughts:

I decided to apply for flexible training for the last eight months of my FY2 year, because, while I wanted to continue my medical training, I also wished to spend as much time as possible with my baby girl. As neither my parents nor my parents-in-law live in the UK, I preferred the idea of looking after my baby myself to entrusting her to another person. In the department where I was working, there were three other young moms, including an FY2, an ST1 and a consultant, who were working three full days a week. The two former had taken a year of maternity leave, but the consultant six months. I, too, took six months maternity leave, thinking that this would be adequate, little knowing that at six months, the baby is still very young. In retrospect, I wish that I had taken longer leave.

The obvious advantage of flexible training was that I would be watching my daughter grow up. I also chose to work on Mondays, Tuesdays and Thursdays, hoping to go away for 3-day weekends, but that didn’t happen! If I was working full-time, like my husband, I would only see my daughter in the evenings. Instead, we organised activities during the day. I really treasure my time with her. We go on walks in the park, swimming in the local pool or to baby groups. Importantly, I speak to her in my language so that she can learn it alongside English and grow up bilingual.

I was looking forward to my first rotation (General Practice) because I would have no weekends and no on calls. I found a nursery near the surgery, hoping that I could visit my daughter during my long lunch breaks. Little did I know that the staff weren’t happy to allow this, because my daughter was upset to see me go at the end of my lunch break. We eventually removed her from the nursery because we wanted to find one-to-one care for her. Four out of the other five babies were at the nursery part-time, which shows that most mums, regardless of their profession, choose to work part-time, so I am glad that part-time work has been introduced in medicine.

I enjoyed my GP rotation, but I found that a longer period exposes one’s weaknesses. I was perceived by some GPs as less competent than other juniors, because of having taken a break from medicine. I definitely had to work hard to remember all the clinical medicine that I had forgotten. The hardest thing was getting my confidence back. As someone who had needed encouragement all along medical school, I found hard to accept that I had become even more out of sync with my peers. Whenever I discussed my cases with the supervisors, they would say that I was “coming along,” “getting there,” and when I wasn’t sure about something, they would ask me how long I had been away from medicine. When I replied “six months,” they acted surprised that I should have forgotten everything during this short time. Some went as far as asking me what was distracting me, and saying that it was obvious that I had only prepared an informal tutorial presentation the night before (rather than allowing a longer preparation). Because some GPs forgot that I was part-time, they had the same expectations of me at the end of the 4 months, as full-time juniors. Having a baby was, however, a bonus in paediatric consultations. When parents brought their child in, I often mentioned that I had a little one, and this made them feel more comfortable.

I found that others had variable attitudes towards my flexible training. The receptionists were keen to accommodate me as I was doing “my own thing;” they also re-arranged the weekly tutorial for my benefit, squeezing it in one of my working days, because it used to take place on one of the days that I didn’t work. My long attachment meant that the practice had an incentive to maximise its gains from me. I was shown how to re-authorise repeat prescriptions, conduct medication reviews, answer my correspondence and follow up patients (e.g. with mild depression) from start to finish.

As I begin my second flexible training rotation, I feel that I have accomplished what I set out to do. Family is more important to me than medicine. I have applied for General Practice and for Core medical training but, in any case, I would like to continue training flexibly.

KD - Foundation Year 2, LTFT trainee

Please note the content and opinions expressed in all case studies are those of the writer and do not necessarily reflect the views of NHS Medical Careers.

• We also have a section on LTFT working in our career options pages.
• There is general information on eligibility for less than full time training in points 6.47 - 6.57 of the Gold Guide (fourth edition June 2010).
• For practical advice about how to apply visit your Deanery website.
• Futher information can be found on the NHS Employers website.
• BMA members can access further information on LTFT.
• BMJ careers have published some case-studies.