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Trainees: Getting the best out of less than full time training (LTFTT)

Updated on: 04 Apr 2020   First published on 13 Dec 2019

Getting the best out of less than full time training (LTFTT)

LTFTT presents an enormous opportunity for trainees in gastroenterology.  Whatever your reason for considering LTFTT there are some key aspects to consider.  Follow the 10 key insights I have learnt during my experience of LTFTT over a decade, to help you navigate and guide you in getting the best from LTFTT.  Various working patterns are available for LTFTTs although HEE do strongly encourage job shares with other LTFTTs.  When this is not possible LTFTTs are likely to work within a full time slot due to rota shortages.  Consult The Gold Guide [1] and contact your individual deanery.

Personal values and family considerations

First decide what your primary goal of LTFTT is, before you start the application process.  Ensure you keep a record of this to remind yourself why you embarked on LTFTT when the going gets tough.  Consult widely with immediate and extended family/ friends regarding your decision.  Detail a plan A, B and C that you and your family would be happy with.  Take into consideration geography, working patterns (including shifts), clinical experience and rotations.  Re-evaluate the primary goal for LTFTT on a yearly basis (ideally with a mentor) to ensure that LTFTT continues to meet your personal goals.

Build a LTFTT network

Ensure you’ve done ample research before you start discussing your plans with your training programme director (TPD).  Consult as many people who have been LTFTTs as possible, including trainees outside of your speciality and consultants who have been LTFTTs previously.  Collate other trainee’s timetables and discuss with them successful training experiences and barriers encountered.  Many deaneries will have LTFTT support groups, return to training support and social media groups and annual events – become part of this network.

You are the expert

Accept you will have to know more about LTFTT than anyone else you work with (within gastroenterology and possibly beyond) well before you have your first day as a LTFTT!  Build a strong relationship with your TPD and educational supervisor.  Meet them early including whilst on parental leave (or other) and keep in regular email contact.  Face to face is always best – using your keeping in touch (KIT) days for these meetings is very valuable.  Prepare well for meetings having all the necessary policies and dates in written and electronic form at meetings.  Ensure your educational objectives are agreed in advance and reviewed regularly to protect your training within LTFTT slots.    Ensure you know your rights around study leave, lieu days and annual leave (including bank holidays) [2].


Accept early on that there is no one size fits all professional map and becoming a LTFTT challenges you to accept this earlier than you might expect.  Undertaking LTFTT means without a doubt you will feel different (and be perceived as different) to your peers.  Avoid comparing your progress and achievements with your peers.  Set your own goals and follow your passions.

Opportunity scanner

Take new opportunities; this is your time to follow your passions, expand interests or subspecialise.  Consider how best to maintain skills; think outside the box.  Adversity can spark new ideas and opportunities, every cloud has silver lining.  Remember that you are allowed to pursue other interests including non-work related and that this in the long run will improve your wellbeing [3].

Nurture the Team

Create a surrogate family at a work, and make yourself a family member in that service.  You will spend fewer hours at work per week than your peers, but over many years of LTFTT you can build meaningful and lasting relationships with members of many teams and services.  This will be invaluable if you obtain a consultant post in your training region.

Transferable leadership skills

At nearly every juncture in your LTFTT you will have walk a new training path that has not been travelled before.  Regular experience at negotiating this process will develop your negotiating and advocacy.  Personal growth as a LTFTT is significant and the skills required to do it successfully are a perfect springboard for your next career goals.

Transition to Consultancy

You are a healthcare leader of the future.  Job planning for yourself as a LTFTT requires a similar set of skills to the skills needed for consultant job planning, you will have obtained a lot of practice over the years – use it!

Get a mentor/coach

Seek out professional development opportunities such as mentoring, coaching and become part of local, regional and national networks.

Fulfil your dreams

Ensure you enjoy what you are doing as much as possible.  Don’t procrastinate, avoid guilt, be yourself and remember that you can do it!  Cultural and personal barriers do exist for LTFTT, but not only are conquerable they may well be the making of you.


LTFT presents many opportunities, but requires careful navigation to ensure success.  Practical enablement is key to this as are personal and professional relationships.  LTFTTs will develop ample leadership skills in order to make a successful transition to consultancy.  Be yourself as a LTFTT, don’t compare yourself to others and enjoy your individual training path.

“No one ever made a difference by being like everyone else.” – P.T. Barnum, The Greatest Showman


Dr Alenka J Brooks: graduated from Sheffield University in 2001 and is Consultant Gastroenterologist at Sheffield Teaching Hospitals NHS Foundation Trust (STHFT).  Alenka is a specialist in Inflammatory Bowel Disease, and is lead for adolescent and young people (AYP) with IBD at STHFT.   Alenka is completing her PhD in AYP with IBD, having recently published the national British Society of Gastroenterology (BSG) Transition Guidelines for AYP with gastrointestinal disease.

Alenka is a former chair of the Trainees Section of the BSG and in recognition of contributions to the Society she was awarded the BSG President’s Medal in 2014 and in 2015 was named BSG Emerging Leader, Young Gastroenterologist of the Year.  Alenka has received national awards for work championing gender equality in healthcare regionally and nationally, receiving Personal, Fair & Diverse Champion Individual Award by NHS Employers in 2015.


  1. A Reference Guide for Postgraduate Speciality Training in the UK; The Gold Guide 7th Edition 2018. https://www.copmed.org.uk/gold-guide-7th-edition/the-gold-guide-7th-edition
  2. Less than full time guidance; The BMA. www.bma.org.uk/advice/career/applying-for-training/flexible-training-and-ltft
  3. Schumann A.  Inflexibility in specialty training is at the heart of the NHS specialty recruitment crisis.  BMJ 2019: bmj.com/bmj/2019/05/24/

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