Less Than Full-Time Training
Postgraduate medical training on a less than full-time (LTFT) basis is well established. LTFT training is fully supported in ICM and offers many advantages and opportunities.
Indications for LTFT training are included in the current edition of the Gold Guide for Postgraduate Foundation and Speciality Training in the UK.
Reasons for working LTFT
Doctors can work on a less than full-time basis for a variety of reasons. There are few barriers to part-time working and the majority of trainees say that they are well supported and find their work extremely fulfilling.
ICM doctors in training can apply for LTFT training for category 1 and 2 indications, as per the recommendations of the current edition of the Gold Guide for Postgraduate Foundation and Speciality Training in the UK. Clinical components of LTFT training may also be a part of academic training programmes, or military service. From August 2022, HEE has agreed to support category 3 indications for ICM trainees in England, at the discretion of the local Postgraduate Dean.
Disability, ill health, carer responsibilities
Unique opportunities, Religious commitment, Non-medical development
Personal choice (short-term)
*From Aug 2022 for ICM, England only
StRs wishing to train LTFT, will need to make a formal application to their deanery, after they are successfully appointed to an ICM training programme.
An individual trainee should be neither advantaged nor disadvantaged by training LTFT. The LTFT trainee will be reviewed on an annual basis (ARCP) and move between posts on the rotation to ensure they receive a programme that is educationally comparable with that undertaken by full-time trainees.
Rotations for LTFT doctors are usually scheduled pro-rata, e.g the Stage 2, three-month specialty modules, would ordinarily be scheduled over four calendar months, for a LTFT Doctor working at 80%. However, this is not prescriptive, as the 2021 ICM curriculum is outcomes-based, and progression is assessed on capabilities achieved, rather than time spent, in training.
In some circumstances, doctors in training may be able to complete certain attachments, in a shorter time-period, if local training programme leads are satisfied that the requirements of a particular HiLLO have been met and the doctor feels ready to progress (N.B. this also applies to full-time doctors in training). This is at the discretion, of the deanery ARCP panel and bespoke plans should be made, for each doctor.
LTFT in emergencies
Emergency/immediate LTFT arrangements can be implemented for all doctors in training, in all UK deaneries, at a time of crisis.
How to apply
- Confirm your eligibility for LTFT training (as per the current edition of the Gold Guide)
- For all regions, the process should begin with an initial informal discussion with your TPD, ideally well in advance of the date on which, you wish to commence LTFT training. This meeting should include a discussion of why you wish to undertake LTFT training, and when. LTFT working patterns, including arrangements for the percentage of clinical commitments compared to a full-time doctor in training, are determined at a deanery level, in conjunction with the TPD and will take into account local service needs.
- Submit your application. Your TPD will be able to explain the relevant application process for your region. In most regions a period of 3 months from the point of LTFT authorisation, to commencement, is required. Early discussion with rota coordinators, is recommended. Summary information and relevant links for each of the 4 Home Nations, are included below:
Apply online via your regional HEE website.
Click here for further information regarding LTFT training in England.
Complete Form A and ask your TPD to sign this. Applications should be made at least 3 months prior to the date at which, you wish to commence LTFT. A meeting with the ICM Associate Postgraduate Dean will follow.
Click here for further information regarding the process on the NES website.
Complete LTFT Application/Renewal Form and submit form to TPD and HEIW. Applications should be made at least 3 months prior to start of rotation (in certain circumstances, 6 months may be required to enable planning) and new applications, should be submitted earlier.
Click here for further information, including the application stage flow chart, on the HEIW website.
Complete NIMDTA LTFT training application form and meet with your TPD. Applications for August must be submitted by 31 March.
Click here for further information, including the application stage flow chart, on the NIMDTA website.
Perspectives on LTFT from StRS, Trainers and Clinical Managers
"Choosing to work less than full time changed everything for me. I was struggling with a small baby at home, a long commute and full time working in ICU. A consultant colleague suggested that I considered going down to 60% to allow me a better work life balance. Having never wanted to work LTFT before this was a big change in my mindset. My department, TPD and deanery were not only supportive of this, but they encouraged me to change, and I honestly haven’t looked back. My training will take more years, and I see some of my juniors over taking me but the benefits, in my eyes, far outweigh the downsides. I enjoy work, I am more relaxed, I have time to develop my CV whilst raising my children and sometimes, I even make it to a school assembly!
So, yes the journey is longer, but I am a better mum, better wife and a better and more rounded intensivist for it.”
“With the upturning of our lives after the arrival of our first child, both of us going less than full time has been really beneficial. It has given each of us a day off in the week to spend time with our son and also do a little bit of life admin. It has meant that I feel less guilty about carving out a little bit of time on the weekend for me, usually to go out on my bike and has, generally, taken pressure off the weekend in terms of trying to catch up on household things (which have felt never-ending since the little one arrived) that did not get done in the week.
So far, the trusts I have worked for have been very accommodating and I have not run into any issues requesting a specific day off each week. The benefits at work are subtler, but the disruption that goes along with nights, evenings and weekends feels much more manageable and I do enjoy my work more.”
“An increasing number of ICM doctors in training, have taken the decision to train LTFT. This enables doctors to undertake ICM training, who might otherwise have been unable to do so, expanding the diversity of our future ICM consultant workforce. It also: allows trainees to complete valuable projects that will enhance their training, increases the number of career and personal development opportunities available to ICM trainees and improves the quality of ICM training programmes.”
"As a Clinical Director for my critical care unit, staff wellbeing and work life balance are a key area for me, because if the workforce is looked after then patient safety increases, clinical errors decrease, sickness levels are lower and the work area is a more healthy place to be.
I have worked LTFT myself and have seen many excellent LTFT trainees. It is clear to me that, our LTFT doctors in training, bring extra skills to the team and are a valuable asset. Intensive Care Medicine benefits from having diversity in our team, and people who work LTFT always add to that diversity."
Managing a successful transfer to LTFT
Consider contacting another LTFT
Someone who has been through the process can provide advice; there may be one based in your department. Your Faculty Tutor should be able to give you the name of the local LTFT advisors at the LETB and School should you require any further information. Some School websites have local information on LTFT training in their area.
This is is an essential component of a seamless transfer to LTFT. Start by ensuring your Training Programme Director and Regional Advisor are aware of your request to change to LTFT. Don’t ever assume someone else will have told them!
Complete the application form
These will be available from your Local Education Training Board (LETB), Health Education “X” (LETB or Deanery equivalent in some regions), NHS Scotland or Deanery.
Confirmation of eligibility for LTFT
This will come from your LETB. As you are applying from a substantive post, no interview is required. Once you have confirmation of eligibility, contact your TPD who will identify a potential space – and agree a date with you for transfer to LTFT.
If you are going to a new hospital LEP, consider contacting the Faculty Tutor and administrative lead in that department to ensure they are aware of your LTFT status This is also an opportunity to discuss and/or confirm which days you will be working and how the OOH is to be managed.
For slot sharing positions it is valuable to meet with your slot share ‘partner’ in advance of starting LTFT to discuss working arrangements, including maximising training opportunities. To ensure correct payment at the end of the month, HR will need a timetable of your working week to confirm your hours and LTFT banding supplement.
Please don’t forget to inform the Training Department at the Faculty of the exact date you changed to LTFT along with the percentage of full-time work you are doing.
LTFT in Anaesthesia and Intensive Care Medicine: An A-Z Guide
The purpose of this guide is to collate information from a variety of sources (e.g. Association of Anaesthetists, Royal College of Anaesthetists (RCoA), British Medical Association (BMA) and
National Health Service Employers (NHSE) to make it easier for anaesthetic and intensive care medicine (ICM) trainees to access information regarding LTFT training as well as offer suggestions on how to maintain a successful LTFT training programme.
This is a generic document adapted from a deanery specific guide originally intended for LTFT trainees in the Northern Deanery. It is hoped it will be of use to current or prospective anaesthetic LTFT trainees nationally; however, many local education and training boards (LETBs) or employers will already have excellent information resources locally for LTFT trainees. Policies relating to LTFT training will vary from employer to employer. It is important that you contact your local Human Resources officer, LTFT Training Advisor, Training Programme Director or Head of School to make sure you follow the correct local process. The information contained in this document was correct as of April 2021.
Interested in training?
Read more about Out of Programme options.