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Equity in study leave

BMJ 1999; 318 doi: (Published 06 March 1999) Cite this as: BMJ 1999;318:S2-7184

All doctors in training are equal but some are more equal than others. Yorkshire postgraduate dean Rosemary Macdonald reports from a working party that addressed the issue

  1. Rosemary Macdonald, postgraduate dean (Yorkshire)
  1. Department for NHS Postgraduate Medical and Dental Education, University of Leeds, Leeds LS2 9JT

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    Is it fair that orthopaedic trainees should have their study leave funded at the expense of trainees in palliative care? Should plastic surgical specialist registrars attend courses in preference to paediatric specialist registrars? Before 1996 in the Yorkshire deanery the average annual cost of study leave for orthopaedic trainees was £835 per trainee and for palliative care trainees £235 per trainee. One orthopaedic trainee received £2,000 of funded leave in one year and is now a consultant with an entirely different subspecialty interest. That same year, a trainee in learning disability had £25 of funded study leave. Trainees in plastic surgery had been given a list of “essential” and “desirable” courses to attend. There was minimal guidance for paediatric trainees. Medical senior house officers seemed to attend innumerable MRCP courses such as PASTEST (costing £400-1,000), never received educational advice between attendances, and still failed the exam. Trainees attending the same course often submitted grossly different expenses. This was discovered only in the mid-1990s, when computerised records became the norm. The records reveal many anomalies.

    How could a hospital trust's clinical tutor adjudicate the educational requirements of trainees in different specialties? It was easy for college regional advisors and chairs of specialty training committees to recommend mandatory study leave for specialist registrars, knowing that the organisation and funding was someone else's problem. Why did trainees wish to attend so many courses in London, Edinburgh, and Davos? Surely not just because of academic excellence - perhaps also cultural and sporting activities.

    Strategic principles for study leave

    Study leave should:

    • Enhance clinical education and training

    • Be planned as far in advance as possible as an integral part of the educational process

    • Provide education and training not easily acquired in the clinical setting

    All trainees should be encouraged to develop coherent plans for study leave early in their senior …

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