Less than Full-Time Training (LTFT)
Increasingly, doctors are seeking to train and work flexibly at varying stages in their careers. Training and working on a less than full time (LTFT) basis can help to achieve a better work life balance.
The Medical Women's Federation is very aware of its responsibility to support and involve doctors who choose to work flexibly and as a result we have developed this webpage. We hope that the information will be of help to those wishing to train less than full time.
Further information links:
- What is Less than Full Time training?
- Who can train less than full time?
- How to apply for LTFT Training
- Is there a difference between Slot Share and Job Share?
- Recommended reading & useful documents
- Frequently asked questions
LTFT training is defined by European Law (EC directive 93/16/EEC) as being part-time training that involves a limitation in participation in medical activities but trainees must work at least half the time of a full-time trainee. It can be undertaken at any stage during training.
All trainees, both men and women, are eligible to apply for LTFT training. Those wishing to do so must show that they would be unable to train on a full-time basis for well-founded individual reasons (EC Directive 93/16/EEC). In most deaneries there is an associate dean who manages less than full time training and determines whether a trainee's request to train LTFT is well founded. If a trainee does not meet the eligibility criteria, the deanery may be able to offer careers advice or discuss alternative career pathways.
The only formal requirement to be permitted to train LTFT is a well-founded individual reason. Reasons for needing to train on a less than full time basis are put into two main categories by COPMeD, and these categories are used by the deaneries to assess eligibility.
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 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.
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 which 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.
Other well-founded reasons may be considered but it would be dependent on the particular situation and the needs of the specialty in which the individual was training.
The responsibility for Less than Full Time (LTFT) training lies with the Deaneries. Therefore,the first step is to contact the Deanery in the region where you will be working and speak to the Associate Dean with responsibility for LTFT training (or Postgraduate Dean) to discuss your reasons for wishing to train flexibly and to ascertain whether funding will be available. For contact details see below and see also the Deanery tab on this web-site.
The Associate Dean (or Postgraduate Dean) will confirm your eligibility to work LTFT and initiate the paperwork needed. The Training Programme Director (TDP) for your specialty will then work out the logistics of the proposed post. There may be some delay because the TPD will have to fit you into the rotation and he/she may need to find someone of the same seniority of training to fill a slot share with you. It is therefore important to seek advice early. Trainees may also experience difficulties with obtaining LTFT placements because of financial constraints in the Trusts and Deaneries may not be able to insist on placements. Again this might take some time to sort out, so the earlier you initiate arrangements with the deanery, the better. However, approval to train less than full Time will only be given to trainees who have specified a preferred start date within six months. Trainees with start dates beyond six months will automatically be kept on the waiting list.
Once your LTFT training place has been organised you send your job-plan to the LTFT Advisor at your Royal College so that he/she can check that the proposed programme allows you both to access enough educational opportunities to reach your targets and that the full-time trainees in the Trust are not disadvantaged.
There can be confusion around the terms "slot share" and "job share" so this section attempts to make things clear, with thanks to Dr Melanie Jones Associate Dean, Careers and LTFT Wales and past President of MWF.
The term "slot share" applies to less than full time (LTFT) TRAINING posts. The term was introduced in 2005 as part of the UK agreement on flexible training between the Deaneries, the BMA and the 4 Departments of Health. When a trainee is assessed as eligible for LTFT they may be placed in a slot share by the training programme director or deanery.
There are many varieties of slot shares where 2 or more trainees are allocated to a training department instead of full time trainees
Slot share examples:
- 2 LTFT at 50% slot share instead of 1 full time trainee
- 2 LTFT at 60% slotshare in a fulltime slot.
- 3 LTFT at 65% share 2 full time slots
- 3 LTFTs in 2 fulltime slots, 2 working at 60% and 1 working at 80%
Each trainee is paid on the Band F pay scale. They do not share the salary of the full time slot. If 1 slot sharer leaves or moves on, the training programme will look for another LTFT to share the slot or the remaining trainee may work part time in a fulltime slot. Slotsharers are not required to cover each others annual or maternity leave.
The term "job share" applies when 2 or more individuals apply to share a post – they share the duties, the salary and the annual leave of that post. Job shares are used in career grade posts e.g. consultant or specialty doctor posts or in general practice. How a job share is managed requires careful negotiation and agreement when the arrangement is established. Sharers may agree to cover each other when on annual or maternity leave. They may agree to divide the working week or work 1 week on and 1 week off. There are many advantages for the employer as each of the job share partners will bring differing areas of expertise to the post i.e. 2 for the price of 1. If 1 of the sharers leaves then the other may be expected by the employer to work full time. Job shares are not used for doctors in training. There are many examples of consultants job sharing and the arrangement works well as long as there are clear arrangements for hand over, communication and continuity of care, as other staff members must know who to contact about their shared patients.
- RCPSG Report: A Flexible and Functional Workforce;
- RCPSG Suggested Action Plan;
- Doctors in flexible training: A guide to the new arrangements for flexible training (PDF Format);
- Doctors in flexible training: Principles underpinning the new arrangements for flexible training;
- Doctors in Training: Equitable Pay;
- "Women in Medicine: The Future" - Royal College of Physicians of London (Full Report);
- "Women in Medicine: The Future" - Royal College of Physicians of London (Executive Summary);
- PMETB Approval of Flexible Training.
- Partnership Information Network (PIN) - Family Friendly Policies
- Guideline for trained doctors working flexibly
- Flexible Retirement
- MWF document - Making Part-time Work (this document is available to MWF members from Central Office - see contact us)
- COPMED conduct bi-annual surveys into LTFT training.
How are less than full time trainees funded?
In most postgraduate deaneries the deanery pays all the basic salary but the out-of-hours supplement is the responsibility of the local Health Board or Trust. Many deaneries will only fund a 5 or 6 session post (50% or 60% of whole time) because of the demands of their budget.
Pay has two basic components - basic salary and supplement:
- Basic salary is determined by the actual hours worked by the less than full time trainee. This needs to be no more than the appropriate proportion of the actual hours worked by full-time trainees on the same rota.
- The supplement is determined on the basis of frequency and proportion of out-of -hours duties.
- The supplement is paid as a proportion of the basic salary determined by the actual hours worked.
Will I have to reapply for Less than Full Time training for each new post, or can I just extend?
You do not need to go through the full application procedure for every Less than Full Time training post. Once you have started training and have taken steps to secure your next post, you will need to contact the Deanery for a Less than Full Time Training Extension Pack. This includes a form, which asks for the reason for your continuing need to train Less than Full Time as well as a blank Less than Full Time Training Approval Form, which must be completed for each new post. You should allow at least three months to complete the extension process.
On what grounds could the Deanery reject my application for Less than Full Time training?
The Deanery may decide to reject your application if you do not fit the eligibility criteria under Category 1. Often Category 2 applications will not be considered by Deaneries
Does the Deanery fund Less than Full Time training for GPRs?
Yes. However, the GP Department handles these applications directly. GP trainees in the GP Registrar year should contact their Trainer/Course Organiser for advice.
Do I need to inform the Deanery if I go on maternity leave?
Yes. As well as informing you employer, you must notify the Deanery of your planned maternity leave dates as soon as possible. If there is a change to the initially approved end date of your current Less than Full Time training post, you will need to apply for a Less than Full Time training extension and complete a new Less than Full Time Training Approval Form stating the date of your anticipated return to work and new post end date.
Am I exempt from shiftwork or on call duties?
Am I able to take study leave whilst training Less than Full Time?
Less than Full Time trainees are entitled to periods of study leave with funding pro-rata to their sessional commitments. At the discretion of the local Clinical Tutor, funding in a year may be the same as that allowed for full-time trainees. This will enable Less than Full Time trainees to undertake a necessary course of study, which requires the entire annual funding allowance. However, Less than Full Time trainees should not expect to go on similar courses two years in succession and will not be granted extra 'time out' of sessional commitment.
How much annual leave am I entitled to?
Annual leave for Less than Full Time trainees is calculated on a pro-rata basis, so if you work 60%, your annual leave entitlement will be 60% of that of a full-time trainee.
Can I appeal against the Deanery's decision not to accept my application?
Yes, though it is recommended that you first attempt to resolve any issues informally in discussion with the Deanery. If agreement cannot be reached you will then have recourse to the formal appeals process.