Intended for healthcare professionals

Rapid response to:


How can we make changing rotations easier?

BMJ 2023; 381 doi: (Published 30 May 2023) Cite this as: BMJ 2023;381:p1093

Rapid Response:

Rotational Training poses unique challenges to LTFT trainees

Dear Editor,

The challenges faced by trainees in rotational programmes will resonate with many readers. Much work needs to be done to improve the experience of training programmes if the NHS hopes to train and retain the much-needed skilled workforce of the future.

Most less-than-full-time trainees have extended rotation lengths, meaning we rotate out of sync with the rest of the training cohort. This leads to a number of unique challenges.

The absence of group induction sessions mean less-than-full-time trainees miss out on opportunities to meet fellow trainees and establish relationships early in the training programme. These sessions provide an opportunity for trainees to come together, share experiences, and receive important information about new rotations. As a result, the sense of camaraderie that develops among trainees starting their jobs simultaneously is often missed by less-than-full-time trainees. This can lead to feelings of isolation and a perceived lack of support, making it more challenging to navigate the new environment and integrate into the team effectively. Without group inductions, we often rely on the goodwill of individual consultants or fellow trainees to provide us with the necessary guidance and orientation, which may not always be readily available or comprehensive.

Teaching sessions or programmes are often arranged to cater to the typical rotational calendar. Crash courses and key training sessions are delivered early on. When changing hospitals, we are indirectly excluded from the first induction sessions, which include essential IT training and introductions to the Guardian of Safe Working. Additionally, we miss out on teaching scheduled on our non-working days, and may receive or be due to receive the same teaching twice if the timetable repeats every rotation. However, these sessions do not contribute to our portfolio learning hours or our development as trainees. There is a need for more flexible teaching arrangements that take into account the diverse needs and schedules of all trainees, regardless of their working hours or rotation start dates.

Finally, less-than-full-time trainees frequently find themselves justifying their decision to work reduced hours on their first day, as the normal rotation day is well known amongst staff. The pressure to explain personal circumstances can be intrusive and adds an additional layer of stress and discomfort to an already challenging situation.

There is much work that can be done to improve the experience of rotational training for all staff. Suggestions made by Morris, Bhayankaram, and Ivan are welcome, and more attention should be paid to suggestions from trainees and trainers to improve our experiences of rotational training.

Competing interests: No competing interests

08 July 2023
Daniel J Chivers
Junior Doctor
Barnsley Hospital
Barnsley Hospital