Less than full-time training in surgery: a cross-sectional study evaluating the accessibility and experiences of flexible training in the surgical trainee workforce.
OBJECTIVE
Generational changes in lifestyle expectations, working environments and the feminisation of the medical workforce have seen an increased demand in postgraduate less than full-time training (LTFT). Despite this, concerns remain regarding access to, and information about, flexible training for surgeons. This study aimed to assess the opinions and experiences of LTFT for surgical trainees.


METHODS
Prospective, questionnaire-based cross-sectional study.


METHODS
An electronic, self-administered questionnaire was distributed in the UK and Republic of Ireland through mailing lists via the Association of Surgeons in Training and British Orthopedic Trainee Association.


RESULTS
Overall, 876 completed responses were received, representing all grades of trainee across all 10 surgical specialties. Median age was 33 years and 63.4% were female. Of those who had undertaken LTFT, 92.5% (148/160) were female. Most worked 60% of a full-time post (86/160, 53.8%). The reasons for either choosing or considering LTFT were childrearing (82.7%), caring for a dependent (12.6%) and sporting commitments (6.8%). Males were less likely to list childrearing than females (64.9% vs 87.6%; p<0.0001). Only 38% (60/160) found the application process easy and 53.8% (86/160) experienced undermining behaviour from workplace staff as a result of undertaking LTFT. Of all respondents, an additional 53.7% (385/716) would consider LTFT in future; 27.5% of which were male (106/385). Overall, only 9.9% of all respondents rated current LTFT information as adequate. Common sources of information were other trainees (47.3%), educational supervisors (20.6%) and local postgraduate school website (19.5%).


CONCLUSIONS
Over half of surgical trainees working LTFT have experienced undermining behaviour as a result of their LTFT. Despite a reported need for LTFT in both genders, this remains difficult to organise, access to useful information is poor and negative attitudes among staff remain. Recommendations are made to provide improved support and information for those wishing to pursue LTFT.
Association of Surgeons in Training Council, Association of Surgeons in Training, London, UK.
Rhiannon L
RL
Harries
Association of Surgeons in Training Council, Association of Surgeons in Training, London, UK.
Vimal J
VJ
Gokani
The British Orthopaedic Trainees Association, British Orthopaedic Association Offices, London, UK.
Peter
P
Smitham
Association of Surgeons in Training Council, Association of Surgeons in Training, London, UK.
J Edward F
JE
Fitzgerald
D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D004503:Education, Medical, Graduate / Q000458:organization & administration*; D005260:Female; D006801:Humans; D007494:Ireland; D008297:Male; D008875:Middle Aged; D010561:Personnel Staffing and Scheduling; D011446:Prospective Studies; D013043:Specialties, Surgical / Q000193:education*; D006113:United Kingdom; D017132:Workplace / Q000523:psychology
Education; Flexible working; Less than full-time training; SURGERY; Surgical training