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Thank you again for taking the time today. Thank, there are some resident doctors who are doing the needful and I will rejoin them. I promise. And why are we not sharing? There we go. That one. Great. Hopefully, you can all see that and now can you all see that? Hopefully? Yeah. Floor is yours? Great. So, um yeah, my name is Chris Slos and I'm a consultant uh up in Scotland in Tayside in Dundee um at the moment, but I undertook most of my less uh my higher surgical training as a lesson, full time trainee. And um I've been asked to just kind of talk to you a bit about that uh today. So we're gonna talk about what it is and why you might choose to do less than full time training and then talk a bit about the practicalities how to apply and, and, and when and where and who with. Um and I'll, I'll talk a bit about some of the benefits, some of the challenges, but also kind of with my story and some of the pitfalls that I fell into and problems that arose uh during my lesson, full time training and then point you guys in the direction of as many resources as possible to get you that help. So first thing is what is less than full time training. Well, it's also known as flexible working or flexible training. And this is any training that's undertaken at less than 100% of the normal contractual working hours. And that obviously depends where you're working and what speciality and what devolved nation. Um And it's generally 50 to 80% of less than full time, you can let work less than 50% but that requires sort of additional um postgraduate dey approvals that can be quite tricky to get. And all of this is in line with the Employment Pa Act of 2002 that says that regardless of where you work, if any in the NHS or as a trainee, oops, sorry. Um You are entitled to apply for flexible working or sort of family friendly working. Um So my route into lesson and full time training was fairly traditional one. I became a, a mum and that's why I chose to become a lesson fulltime trainee. Um And that for a long time was kind of thought to be the only reason that you would do less and full time training. But nowadays, there's lots of different reasons. Um it might be that you have other caring responsibilities, not just for Children, but for um anyone within your family or friends or people that you have uh kind of caring responsibilities for. It may be that you want to pursue sort of additional um professional kind of opportunities both within medicine. So it might be, you know, kind of leadership roles in assets or within surgical training. Um or it may be rules out with whether that's with charities or religious bodies or leadership programs and things like that. So that's another reason that some people choose to do that or even research is another reason you may wish to go less and full time. It may be that you want to acquire additional skills. So you might like here become want to become a yoga instructor. It may be that you're a professional athlete or a semi professional athlete and want to take some time to concentrate and focus on that. And again, that can uh lessen full time training can really support that. Oh, I know a lot of my slides today. Um health care problems, whether it's physical health or mental health, um may mean that less than full time training means that you can continue working, continue training um um a kind of relatively normal pace um albeit with a slightly flexible approach to it. So again, it's been a common one that people have used. I also know people that have taken less than full time training to go through things like IVF. And that's also another valid reason, but mostly it's about giving you the space and the kind of headspace or physical space and time to really develop you as a person um to progress through your career in a way that you want to. Um and it's about giving you that balance. So whether that's work life balance or balancing two different rules. Um It's, it, this is what lesson, full time training is about. So when can you work as a lesson, full time trainee where you can do it at any stage of your training, whether that's some foundation program, core training or beyond. And there are even some consultants who are not trainees, but who choose to work less than full time. Um Obviously, it's slightly different processes depending on what stage you do it. So you're making contact with your foundation program director as opposed to your training, program director if you're doing it early in your career. Um but you have a right to apply for it at any point during your career. So what are the eligibility? Well, all doctors in training with a well founded individual reason can become a lesson or apply for less and full time training. And that's broadened out from kind of the traditional categories that we used to be given. So you may have heard of kind of category one, less and full time trainees who are doing it for caring childcare or health reasons. Category two was for the people who wanted to kind of go down other professional development opportunities or maybe um opportunities out with the NHS again, professional or semi professional athletes did that a lot. And then a few years back, we had category three, the trial of category three less and full time training, which was being able to train less than full time for any reason. You didn't really need to give a reason, you just had to say that you wanted to do it. Um And they abolished these categories recently. Um So now all trainees um can apply and just give a reason whether that's for, you know, physical reason, physical health care reasons or maybe mental wellbeing um or career progression. But the important thing to remember is that we have a right to request less and full time training and flexible working, but we do not have a right to have that request granted and that's the same for any employee in the UK. Unfortunately, that being said, your employer, in this case, your generate do have to give a good reason as to why they cannot um allow your request. Um And if it's anything to do with the predicted characteristic, then they are very unlikely to refuse your er request. So how do you apply? Well, the, the process takes a few months. And so therefore, as soon as you start thinking about it, it's worth making those early uh kind of contact with particularly your program director. Um But like I say, the process in itself takes about three months from start to finish. It is slightly deary dependent and program dependent. But the first port tool is to get in touch with your training program or founding foundation program director and tell them that you're considering it, then there's some forms to fill in and they go both to your program director, but also the post graduate dean who is responsible for less than full time training and they'll review it and um and essentially review your reasons and either grant it or not or grant it with kind of alternative arrangements. And then you need to make contact with the individual poster rotation that you're going to be applying to um nice and early so that we can manage the rota around it. Now, once you are less a full time trainee apologies, um you have a yearly review um and this takes the form of just a bit of paper to be honest with you that asks you if you're happy with your um current working ratio um if you want to increase to full time or reduce your percentages. Um and, and it's like I say, it takes a few minutes to apply uh to, to fill in and then you just submit it usually through your foundation program or training program director. So what are the benefits? Well, better work life balance is definitely the main reason. And like I say, that might be because your life has other things going on in it or that you want to have more than one work role. Um It really gives you the opportunity to, to do that and get that balance right for you. Um There are some amazing opportunities for career, personal development, whether that's because you want to go into a kind of leadership role within one of our kind of um organizations such as asset or Royal Colleges and learn a bit about kind of the wider surgical training world. Um There's leadership opportunities, research opportunities, medical education, things like that. So you can have sort of things that will help build your CV or it might be that you want to develop, sorry, you want to develop kind of personal things. And I know from my point of view that my lesson, full time training really did help me grow as a kind of person and that actually had a positive impact upon my work. The major benefit of of less and full time training is is increasing the diversity of surgical trainees. So it means that we are still able to attract the best and brightest to surgical training, who maybe some of whom maybe previously would have not wanted to do surgical training because of the working hours or the pressure to be there at all hours of the day. So it means that you can get that flexibility and allowing more people to apply for the rules. Actually, as a little side effect, you often end up getting more training. So less than full time trainees often tend to be more focused on our training when they're at work. And therefore they can squeeze sometimes five days of work into four days. It's always quite remarkable and often it's been shown that less than full time trainees, log books are proportionately better, have more cases, have more experience on them by the time they see ct than those who trained full time alongside them. And I want to say a little bit about consultant pay as this is where I've ended up. Um It would be wrong for me to say that you get improved consultant pay for being a less than full time trainee, you actually get equal consultant pay. So if you have trained at any point, um as a less than full time trainee, when you become a consultant, that time served is taken into account and you're moved up the consultant pay scale pro rata. So for my, in my case, I got to move up the consultant pay scale by about six months um for my training as a lesson, full time trainee and that really hopefully change. Uh It closes the gap and makes um less in full time training more appealing because you're not really gonna be penalized for it at the end of the day with pensions and things like that. So some of the challenges will you end up out of sync, you might end up having to have a CPS at all sorts of weird times of years, particularly for your key progression points in core training and higher surgical training. So I remember having one in kind of November to get into my phase three training. And that can be a bit awkward when you're going to consultants and asking them to sign things off, particularly with the new M CRS at the wrong time of year from everyone else. Um But it does just take a bit of planning a bit of forward thinking and it probably only needs to be focused upon at a few key points in your training. Unfortunately, there is no guarantee of your desired working patterns. So you may choose to be an 80% less than full time trainee and want every Friday off. But actually, the post that you're sent to or you're allocated isn't able to give you every Friday off for kind of departmental reasons. Um It also doesn't mean that you'll get every Friday off when you're on call. Um Often you find when you train at 80% or less that it just means that you're on call is reduced by a set number maybe one week per every six months of on call. As opposed to having that fixed day off. That being said in the English 2016 Junior doctor contract, there was some more safeguards over getting that fixed day off. Um That's not the same in devolved governments. You will just have to check. Uh pay problems are ubiquitous for less than full time trainees. Um The pay structure is not quite as simple as saying, well, I work 80%. Therefore, I get 80% of my colleagues salaries. Um So you really need to be cleared up on that. And there's a lot of information on the BMA website to support you with uh navigating the pay problems and your pay will be wrong. So keep an eye on it, really get to know your pay slip very well. Um Rota problems also happen thankfully, there are more or less than full time trainees and so rota masters are getting used to it again. A bit of flexibility. A bit of kind of saying to the roto master, look, I can work this out for you, but often you will sit down with your rotor, count up the shifts and something's not quite right and you have to decide if that's ok for you for it to not be quite right. Maybe you're working an additional weekend but one less week or if you want to be a stickler for it, but it should be fair. You should be working the same number of shifts reduced by percentage as everyone else, the same number of weekends, the same number of weekday night shifts, et cetera. And I think stigma is still an issue there when I was first less and full time trainee, I would hear sort of comments about my day off and trust me being at home with young twins was far from a day off and it was just a less well paid job. Um But I think that stigma is disappearing more or less than full time trainings exist. More people are doing it for diverse reasons. And it's a reason that I really push people to do less than full time training because um it's great to have uh flexible workers around me. So I think, yeah, we're realizing that the stigma um is wrong and that actually lesson full time trainees really do um diversify our workforce. So some of the pitfalls where you have a right to request, as I said, but not necessarily to be granted um what you want. It might be that the dry come back and say they can't grant you your less and full time quest at that point in time. So this really does mean that you need to be applying early so that you can get it in place for when you want. They may say that they can't grant you the particular ratio that you want. So maybe you want 60% and they say they can only offer you 80% or vice versa. And it may be that you have your heart set on going to one place. And because there's maybe a certain number of trainees or less than full time trainees there that your TPD says, well, if you want to be less than full time training at this time, you may have to go to a different unit. I think communication is key um really being aware of what you can and can ask for talking to your program directors, early talking to your colleagues and explaining to them what you can and can't do so why you can work certain shifts, but you can't work this day of the week because of say um, meetings or responsibilities and, and your training units, like I say, most of them are very, very supportive of it. It's so common now. Um But like I say, make sure you understand your rights. Um, a lot of the reasons for going less than full time training are may maybe protected characteristics. And so therefore you do have rights. Um, and you should be supported through all of this. I think another pitfall is that coming to A R cps. Um, we often have a situation where they'd be asking you for the same number of work based place assessments as your full time contemporaries and sort of having to explain to them that. Well, no, you don't need to do this many because you've only trained at 80%. Um And like I said, I did have to explain that a few times and there was sort of some kind of slightly disgruntled faces. Um, but the fact is you shouldn't be having to do more work just because you've chosen to take less than full time training. Um, but again, that is getting better, particularly with the curriculum change to competency based progression and there's less kind of, er, pressure to get ticky boxy numbers um, than before, but they are still there. So I just want to share with you my story. I um qualified in 2008 and I worked full time through Foundation Corps and then as AAA registrar before getting my ST three number um in 2013. Um and then in 2016, my twins arrived rather slightly unexpectedly. And um when I returned to work a year later, as an ST six, I chose to train as a lesson, fulltime trainee. Now, we had something in our January at that time, which I don't think is available as commonly now, but we called it 90% less than full time training. And that was for the 80% of the elective duty. So I had one fixed day off a week on my elective weeks, but I did the full compliment of on call because I knew that I could get cover for my on calls from my fixed nonworking day. I was lucky enough that we, we had flexible childcare and I didn't want to, you know, lose out on that day off and then get reduced number of on calls in a year. And actually, this meant that my emergency general surgical logbook was particularly good at the end of my training because I'd done that extra bit of on call throughout my training. It also meant that my pay was a little bit higher because I was doing slightly more hours overall and slightly more of them in an antisocial way. Um When I first applied for less than full time training, though, I got immediately hauled in by the associate postgraduate dean because he was convinced that my, um, TPD and my training unit had insisted that I worked at 90% or 80%. Um And I sort of explained to him that the only conversation I'd had with uh my training unit was with one of them at the till. And Asta and I didn't really think that counted. And so he was reassured that I wasn't being pushed into that percentage and it was right for me and my family. Um But at that time, I was the only less in full time training on the ROTA. And I definitely heard those comments about um it being a day off, um or the moans from my colleagues about having to cover my duties on my day off. Um But thankfully that seemed to get better as they realized some of the benefits of me being less in full time training. Then I went out of program in 2018 to 2020 to do some research. And I returned to work in 2020 to program and I actually went back full time and the reason I went back full time was because later that year, um I had my third child, so my daughter landed and the benefit of being full time at that stage meant that my maternity pay was calculated on a full time salary. So it was slightly better than, um a less than full time salary. So that's why I did it just for a few months and it was very manageable for a few months And my twins were a bit older, so it was, it was doable and then returned to training again at the beginning of 2022 again at 90%. And this time, my paperwork went in without a hitch at all. The associate postgraduate dean signed it off immediately and was quite happy and I started off as one of one of two and then eventually, one of four, less than full time trainees on the ROTA and our department were really, really supportive of the four of us. And we actually went from an eight person rotor to a nine person rotor because they were saving, you know, the salary on the four of us. And so they could employ an extra person, which meant we were very rarely short staffed because of less than full time trainees. And I stayed less than full time until I was ct So even when my daughter went to nursery full time with her funding and was there five days a week, I stayed less than full time to allow me to have some additional time to revise for my exams. And then even after my exams to get on with life, to do the food shopping, to pick up additional roles within um asset and the Royal College and other training bodies. Um And then it meant that at weekends when my kids were not at nursing, at school, I could actually just be mum and I could be wife and I could do all my things that I wanted to do at the weekend, normal things. So it definitely helped having that day a week to get on with all the kind of additional bits and Bobs that I had to do and laterally in my training, um my mother became unwell and really having that day to attend appointments with her and to spend time with her and helping her around the house really made a huge difference. Um So yeah, so I kind of ended up cycling through all the different reasons, but I didn't have to reapply for lesson full time training once it's been accepted and you are happy at that percentage, you just stay there regardless of your reasons and all in all it added six months additional training time. So I moved my CCT date which would have been in August became uh late January uh CCT date. So really not a huge burden um in terms of time, but mostly less than full time training has meant that I am able to be uh a better mum and wife and friend. Um And when I'm not at work, but it's also meant that when I am at work, I am much more able to concentrate on my do job and really enjoy being at my work. Um and, and focusing on that. So I think it's benefited me both at home and professionally. So there's loads of resources out there um to get you support. The first place is to go for your Gold Guide. The Gold Guide has uh I think it's in section three, has everything about less and full time training, all the reasons you might consider it. Um and sort of lots of contacts and support there that you need to go through and talk to you through the process of, of how it's uh um applied for your dey website or your training kind of organization. So you're um for us in Scotland, it's NHS education for Scotland or your sort of devolved national training bodies will have a web page dedicated to lesson full time training and it's usually split over the different stages of training. So foundation core and then higher um your royal colleges, certainly the Edinburgh College has got a toolkit um on how to get the best out of parental and maternity leave. And that also include a bit about how to apply for less than full time training and the reasons you might do it. So again, the information is out there. And within your health board of trust, there should also be a less than full time or flexible working champion. And these guys are absolute experts and they may have a different name in different places. They may be associated with the diary, but they do exist. So find out who they are and and ask them as many questions as you want. Social media can be useful as well. There's some really great Facebook groups that are dedicated to less and full time training. And on there, there are some of these less and full time champions who know about all the policy and all the kind of ins and outs. But there's also people on there that have done it that have lived through it and are able to offer you advice when your pay is not right or when your rota doesn't look quite right. And they can even offer to review your Rotas as well if you don't want to go down the kind of formal BM route. But also your peers, I found my tribe. Um This photo shows you me and five other Edinburgh General Surgical mums, all of whom have undertaken bits or large percentages of our training um as less than full time trainees. And we shared our forms around. So we would sort of text and say, oh, I need to do this form. Oh yeah, I've got a copy of that. I can send you the link to it. So they were really, really useful. And again, also, who do I need to talk to at this unit about my rota? Again, we all knew and, and it was a really helpful informal network. So these people will exist whether it's a foundation core or higher level and they'll be able to give you advice and they may even be able to share with you their experiences and support you. So, thank you. And I would really encourage all of you to consider less and full time training for any or all of your training. Um It really, it, it brings so many benefits to the department. I'm loving that we've got a couple of trainees with us at the moment that are applying and have got less and full time training for really different reasons. Um And that it's not just because they're parents. Um So, and, and, and also seeing that it's all genders that are choosing to do it now as well. So, and certainly as a consultant, I think it's a great thing and as a trainee, it really gave me that balance that I needed. So, um but yeah, if you've got any questions, stick on the chat box and I'll try and answer as many as I can. Thank you very much for taking the time. Kirstie. I really appreciate it just for the sake of time. We've got one question from uh Melissa Matthews. Are you happy? To type out an answer to her. Just yeah, not a problem at all. I'll, I'll do that. Lovely chap. Perfect. Thank you again so much for your time. No worry, it's not a problem. I know you're working today. All good juniors is fine. No judgment for me. Don't worry, I'll see you later guys.