Less Than Full-Time (LTFT) Training in Medical Oncology

Dr Joni Howells (ST5 Medical Oncology Trainee -Wales, South west Wales Cancer Centre)

Training less than full time (LTFT) is an option available to all Medical Oncology trainees, provided there is a well-founded individual reason for doing so. This includes personal choice or considerations related to wellbeing, as outlined in the Gold Guide (10th Edition, August 2024).

Approximately 35% of current Medical Oncology trainees are LTFT. All LTFT trainees are expected to meet the same curriculum and progression requirements as their full-time counterparts in order to achieve Certificate of Completion of Training (CCT).

Our aim is to support LTFT trainees by offering practical advice and helpful resources.

Application Process for LTFT Training

  • The application process varies by region, so it is important to refer to local guidance.
  • It is advised that you discuss your intentions with your Training Programme Director (TPD) as early as possible.
  • Please note that processing LTFT applications can take up to three months.
  • Most Medical Oncology trainees opt for 80% whole time equivalent (WTE) and a smaller proportion 60%. The flexibility of WTE may depend on your region.

Planning Your Training and Rotations

  • Keep a record of rotations, including tumour site exposure and the duration of each placement.
  • Use the Medical Oncology curriculum to plan the tumour sites that you need to cover.
  • Employers may request flexibility in working days to accommodate service needs.
  • You may need to compromise on training opportunities to fit within your agreed working days.
  • Proportional adjustments should be made for varied WTE percentages, considering both working hours and clinical intensity.
  • A timetable planning document is available, including examples of timetables for 60% and 80% WTE working: Clinical Timetable Guidance for Medical Oncology Trainees. Clinical timetable guidance for medical oncology trainees.pdf
  • Consider:
    • The length of time on each tumour site.
    • Whether your clinic numbers are equivalent to full-time colleagues.
    • Involvement in audit and quality improvement projects.
  • Use a CCT calculator to estimate your expected completion date: Calculating completion dates | The Federation

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Curriculum Requirements and ARCP

  • All trainees, including those LTFT, are expected to undergo an Annual Review of Competence Progression (ARCP) at least every 12 months, and no less frequently than every 15 months.
  • Keep your e-portfolio updated regularly to reflect your progress.
  • Plan for your Specialty Certificate Examination (SCE), typically undertaken in ST5 or ST6.

Annual Leave and Study Leave

  • Annual and study leave entitlements are calculated on a pro-rata basis.
  • If you request study leave on a non-working day, you may be eligible to claim a day in lieu.

Accelerated Training for LTFT Trainees

The Joint Royal Colleges of Physicians Training Board (JRCPTB) has published supplementary guidance on accelerated training. In certain circumstances, CCT dates may be brought forward for trainees who are:

  • Demonstrating exceptional capability and commitment, or
  • Have undertaken substantial relevant experience prior to entering training.

These options are available to both full-time and LTFT trainees. However, LTFT training does not guarantee accelerated progression. Acceleration must be justified by capability or prior experience, and not solely by comparison to a previous full-time schedule. Accelerated%20CCT%20guidance%20updated%20August%202022.pdf

Benefits and Challenges of LTFT Training

Advantages

  • Encourages a healthy work-life balance and promotes wellbeing.
  • Supports personal and professional development.
  • Care needs
  • Extended time in training to develop or participate in longer projects with potentialy more opportunities
  • Longer preparation for the role as a consultant

Challenges

  • May result in an extended overall training duration (although progression is based on capability, not time).
  • Reduced income and pension contributions.
  • Potential impact on rotational placements and training exposure.
  • May miss out on regular teaching or training opportunities that do not fall on your working days
  • May be asked to change your working days to fit with clinical commitment

Top Tips for LTFT Trainees

  • 83% worked the same number of clinics as their full-time colleagues at some point in their training, of which 39% do the same number of clinics on all rotations.
  • Many LTFT take work home with them and 69% of LTFT trainees reported that they often or frequently need to do work related activities on non-working days, beyond their contracted hours to complete essential clinical duties.
    • Try to set boundaries by not working on weekends unless on-call commitments
    • Try not to have work emails on your phone or avoid responding to work emails or engaging in clinical duties on yournon-working days.
  • Keep a record of time spent on each tumour sites and have an awareness of tumour sites that you need to rotate to
  • Be proactive in seeking and creating learning opportunities.
  • Maintain good communication with your educational supervisor and TPD.
  • Make full use of your portfolio to demonstrate progression.

Consultant Applications and Acting Up

  • LTFT trainees may apply and interview for consultant posts up to six months prior to their anticipated CCT date. This timeline is fixed, not adjusted for WTE.
  • LTFT trainees may also undertake a period of “acting up” as a consultant in their final year. This is typically for three months, but can be extended proportionally to match the LTFT percentage.

Useful Resources and Links

For any further queries or support, please consult your TPD or Educational Supervisor, and refer to the guidance documents linked above