Intended for healthcare professionals

Rapid response to:


Allowing more doctors to work less than full time could reduce burnout, says royal college

BMJ 2019; 366 doi: (Published 27 September 2019) Cite this as: BMJ 2019;366:l5778

Rapid Response:

Re: Allowing more doctors to work less than full time could reduce burnout, says royal college

The RCP helpfully highlighted that the current rules governing the availability of LTFT training are not suitable for the current medical workforce.

It is important to consider that many of the barriers to LTFT training can be found not in a trainee's local hospital or deanery, but in the royal colleges themselves.

The subscription rates of a number of royal colleges create an additional burden on LTFT trainees compared to their full time colleagues. Charging the same annual fee for LTFT trainees as for full time trainees results in a higher total cost of training, as LTFT training is spread over more years even though the total hours of training (over the whole programme) is the same.

I discovered recently that the Faculty of Intensive Care Medicine does not have an LTFT subscription rate, so that an LTFT trainee working 70% of a full time rota must pay over £400 more over the course of their training compared to a full time trainee. The additional cost is higher for LTFT trainees working 60% or 50% of a full time rota. It is not clear how a higher cost per training hour can be justified, nor why the higher cost per training hour should fall disproportionately on female trainees who are more likely to occupy LTFT training posts.

In contrast the Royal College of Surgeons and the Royal College of General Practitioners have both implemented a discounted rate for LTFT trainees, ensuring that LTFT trainees are treated equally with their full time colleagues.

Employers and deaneries have a clear responsibility to facilitate flexible working, however the royal colleges also have a duty to not disadvantage those working flexibly.

Competing interests: I am an LTFT trainee in ICM/Anaesthesia

15 October 2019
Aaron A D'Sa
Specialty Registrar (ICM)
Addenbrookes Hospital