Less Than Full Time Training in Foundation

In Scotland we are committed and keen to encourage Less-Than-Full-Time (LTFT) training in the Scottish Foundation School and adhere to the relevant regulations as set out in the Gold Guide V9 (August 2022).

The operational arrangements to allow LTFT training in Foundation are potentially complex and are detailed below. There is no guarantee that a doctor can be placed in any specific programme. All placements are the result of discussion with all parties. 

General principles

All Applications for LTFT  will require confirmation of eligibility by the Associate Postgraduate Dean with responsibility for LTFT training (APGD - LTFT) in the first instance. This can be sought by completing a contact form for the Trainee Development and Wellbeing Service.  This information will then be passed to the Foundation Lead (usually Associate Postgraduate Dean - Foundation) who will meet with the trainee to discuss what options are available including location of programmes and availability of slot shares. This will include close liaison with the relevant Local Education Provider (LEP).

It is important to note that even if eligibility is confirmed, trainees need to be aware that:

• LTFT training is encouraged and supported but cannot be guaranteed.
• Availability of LTFT training will depend upon availability of suitable posts.
• All LTFT trainees need to complete the GMC's requirement for the equivalent of one full year at F1 (Whole-Time Equivalent - WTE) and one full year at F2 (WTE).
• Once committed to LTFT training trainees are bound, within reason, to maintain that status for at least one calendar year (August - July). This is due to the complex nature of Foundation rotations which cannot be easily amended.
• LTFT can only be accommodated where there is sufficient training and service capacity. This means that the service may be unable to accommodate an LTFT trainee as to do so would compromise the safety of colleagues or patients.
• Geographical proximity cannot be guaranteed in the allocation of LTFT training posts.
• If a trainee moves from a full-time established post, there is no guarantee that they will be able to stay in their individual programme and may need to accept another programme. 
• LTFT training can be any proportion of the full-time programme depending upon individual circumstances, the needs of service and availably of funding. Most LTFT trainees train between 50-80% of full-time.  Only in exceptional circumstances will alternative proportional allocations be possible. Working less than 50% would require specific Occupational Health certification supporting the case and is unlikely to be approved, other than for short, focused periods. Early completion of foundation competencies is not sufficient reason alone for alternative arrangements.
• Specific rotations able to accommodate LTFT training may have been identified and selected by the Deanery for this purpose.
• Close liaison is required between LEP and the Deanery in the management of all LTFT requests.
• Returning from Parental or Sick Leave:
• You will be guaranteed a 2-year foundation programme. It is important to note that even after being matched to and starting an individual programme within the 2-year foundation programme, you may have to change from the indicative allocated individual programme or have placements within your individual allocated programme altered at short notice. This could be for a number of reasons, including your training needs, working time regulations, national directives and service redesign.
• In addition, we believe that the work pattern in some programmes will change each year. The principal reasons are:
  • the need for all Foundation posts to be rota compliant and educationally appropriate.
  • local organisational circumstances - for example new hospital developments.

Additional operational issues apply to the following:

F1:

LTFT training is based on the assumption that a complete year at LTFT will be required. In exceptional circumstances, completion of alternative time blocks will be considered but always based on complete WTE 4-month blocks. This will usually only occur when an individual is returning from maternity leave part way through a year. It may only be possible to return to work at the beginning of a 4-month rotation due to the requirement to fill a slot.

If a trainee has completed less than one block WTE in F1 before moving to LTFT training, then they will always be required to complete a full 12 months WTE before moving to F2.

Wherever possible, LTFT training will be maintained at the same LEP unit (as dictated by the current WTE programme) throughout the required time to completion. Occasionally this may not be possible and the Associate Postgraduate Dean (Foundation) in conjunction with the relevant Director of Medical Education (DME) and Associate Postgraduate Dean (LTFT) will agree an alternative programme.

LTFT training during F1 cannot be linked to a specific F2 programme therefore posts during F2 for the continuation of LTFT training are subject to both suitability (see below) and availability. Trainee preferences cannot always be met either for the specialties involved or the geographical situation of the posts.

Trainees will be expected to rotate at the same time as standard trainees to ensure they receive appropriate induction. This may require moving every 4 or 8 months. We  are unable to support out-of-sync rotations.

F2:

The expectation, as for F1, will be for completion of 1 year WTE and the amount worked will be agreed with the Associate Postgraduate Dean (Foundation) and your LEP. Trainees will be expected to rotate at the same time as standard trainees to ensure they receive appropriate induction. This may require moving every 4 or 8 months. We are unable to support out-of-sync rotations.

It is anticipated that a programme will be identified that is suitable for LTFT training.

Assessments

All Foundation Doctors who are working LTFT will be required to complete assessments and requirements for completion for each year on a pro rata basis. The minimum requirements will be the same as for full-time doctors on a pro rata basis. However, there will be a requirement for an end of placement review form completed by the Educational Supervisor for each placement. This will probably mean that they will have more End of Placement Reviews than full-time doctors. All Foundation doctors will receive an ARCP every calendar year. The outcome will be based upon the progress they have made in relation to the training time.

All foundation doctors working flexibly will be reviewed at the end of the Foundation Programme year to ascertain progress and review of LTFT working circumstances. At this review, discussion will also take place on working pattern and locations for the next year.

This page was last updated on: 11.10.2023 at 11.33