Whilst medicine can be a very fulfilling career, there are lots of reasons why medics may now choose to work less-than-full-time (LTFT). For many, stepping down their clinical work allows them to curate a beautiful portfolio career by complementing their training with other areas within medicine. This blog should act as a guide to help you decide if LTFT training is for you.

🤔Why Consider Less-than-Full-Time?

Working LTFT is all about creating a sustainable work-life balance. Here are a few common reasons why doctors choose this path:

  1. Well-being and Burnout Prevention: Medicine is rewarding but demanding. LTFT allows you to prioritise mental and physical health and avoid burnout.
  2. Family Commitments: Parenting, caring for relatives, or other family responsibilities may necessitate reduced hours.
  3. Academic Pursuits: Whether it’s a Master’s degree, research, or medical education, working LTFT frees up time to focus on additional qualifications.
  4. Personal Development: From starting a side business to pursuing creative interests, LTFT can support broader ambitions.

💼Building a Portfolio Career as an LTFT Doctor

One of the most exciting aspects of working LTFT is the opportunity to explore and build a portfolio career. LTFT working creates time to:

  • Pursue Medical Education: Many LTFT doctors take on roles as educators, enhancing their teaching portfolios.
  • Engage in Research: Use your additional time to contribute to research projects, publish papers, or present at conferences.
  • Develop Non-Medical Skills: Explore opportunities in leadership, management, or creative industries to diversify your expertise.
  • Launch a Side Business or Project: Whether it’s writing, consulting, or entrepreneurship, LTFT working provides the flexibility to grow beyond the traditional boundaries of medicine.

⏰How Long Does It Take to Complete Foundation Years as an LTFT Doctor?

The time it takes to complete your Foundation Years depends on the percentage of full-time hours you work. Here’s a breakdown:

LTFT PercentageApproximate Duration to Complete Foundation Programme
50%4 years
60%3 years and 4 months
70%2 years and 10 months
80%2 years and 6 months

You can move between LTFT percentages at any time and can even return to full-time work if you feel you want to. Your specific timeline may vary slightly depending on how your deanery structures rotations and placements, but the general rule is that the lower your percentage, the longer the programme duration.

🫵Who Can Apply for LTFT?

In the UK, applications are considered for those who fall under one of two categories:

Category 1: Caring Commitments or Health Reasons

  • Parenting or primary caring responsibilities.
  • Health issues that make full-time work challenging.

Category 2: Personal and Professional Development

  • Pursuing academic research or qualifications.
  • Engaging in non-medical professional development.

✍️How to Apply for LTFT

Applying for LTFT involves a series of steps. Here’s what you need to do:

1. Indicate that You Might Consider LTFT on Your Oriel Application

Oriel is the portal used when applying to Foundation jobs, you can indicate that you may be interested in LTFT training when filling out your application. This isn’t essential as you can choose to go LTFT at any point during your application and after you start working, it also doesn’t tie you to committing to LTFT work, however, it does help facilitate LTFT working, and allows your Foundation School to point you in the right direction.

2. Understand Your Deanery’s Policy

Each Foundation School or Deanery may have slight variations in how they handle LTFT applications. Check your specific guidelines and deadlines.

3. Discuss with Your Educational Supervisor

Your educational supervisor or Foundation Programme Director will need to support your application. Discuss your reasons and how working LTFT fits within your training requirements.

4. Complete the Application

Submit an LTFT application form, detailing your reasons and providing any necessary supporting documents (e.g., medical evidence or proof of caring responsibilities).

5. Agree on a Work Schedule

If approved, work with your rota coordinator to create a feasible schedule. Common options include:

  • 60% or 80% contracts are most common, however a discussion about what works best for you allows you to make an individualised decision.
  • Discuss how you want to use your hours, would it be better for you to have an extra day off a week, or reduce your working hours so you work for shorter bursts each day?
  • There is also an option for two LTFT trainees to share one full-time rota, speak to your foundation school about this option to see if it could work for you.

Please Note:

Adjusting Percentages: Doctors can often choose to work between 50% and 80% of full-time hours, and can change this percentage as you go along, depending on their needs and the deanery’s capacity. e.g. you might work 60% on one rotation but feel that you can work 80% on the next.

Start earlier rather than later: As with all admin, things can take time, so if possible get the ball rolling ASAP! Speak to the rotas team about logistics and don’t be afraid to advocate for yourself and your needs.

6. Budget Accordingly

While working fewer hours has many benefits, it also means a proportional reduction in salary. Consider how this impacts your financial planning and look into support options like bursaries or grants.

♻️Changing Rotations as an LTFT Doctor

Working LTFT may affect how you rotate through specialties during your Foundation Programme. Some key considerations include:

  • Extended Training Timeline: LTFT doctors typically take longer to complete their Foundation Years. This can provide more time to consolidate learning and allow you to experience more specialty rotations than your peers.
  • Negotiating Rotations: You may have the option to request rotations that align with your personal needs, such as proximity to home or preferred specialties.

Speak to your Foundation Programme Director early to plan rotations that work for you.

🧑‍⚕️Locuming as an LTFT Doctor

One advantage of LTFT working is the flexibility to take on locum shifts during your non-working days. Locuming is particularly beneficial once you have completed your foundation training and are waiting to start specialty training. Locuming offers several benefits:

  • Supplementing Your Income: Locum shifts can help offset the reduction in salary from working LTFT.
  • Exploring Different Specialties: Locuming provides exposure to various specialties and work environments.
  • Building Experience: It’s an excellent opportunity to develop skills outside your usual rotation.

However, if you are working LTFT for health reasons, you may not be permitted to locum beyond your agreed percentage. This is to protect your well-being and ensure your health remains a priority. Always clarify with your employer what is allowed within your specific circumstances.

🫁Planning for Specialty Training as an LTFT Foundation Doctor

When working LTFT, it’s essential to consider how this might impact your transition to specialty training. Specialty applications in the UK typically have two application rounds (August and February). This structured timing may require you to:

  • Adjust Your Percentage: Increase your working percentage temporarily to align with the specialty application cycles and required competencies.
  • Extend Your Foundation Contract: If your LTFT schedule doesn’t align with specialty application deadlines, you may want to extend your Foundation Programme.
  • Consider Locuming: Use the interim period between Foundation and specialty training to locum and gain additional experience while supplementing your income.
  • Take a Break: Alternatively, you might choose to take a break to travel, rest, or explore other career opportunities before moving on to specialty training.

❤️NHS Support and Additional Benefits for LTFT Doctors

The NHS provides support to LTFT doctors to ensure their training and well-being are prioritised. This includes:

🙌Tips for Thriving as an LTFT Doctor

  1. Set Clear Boundaries: Protect your non-working days. Communicate your availability clearly to colleagues and rota managers.
  2. Stay Connected: Being LTFT can sometimes feel isolating. Maintain strong connections with your peers and participate in teaching sessions or social events.
  3. Maximise Your Time: Use your non-clinical days effectively, whether it’s for studying, relaxing, or pursuing other projects.

🦄Myth-busting

Myth 1: “You’ll Miss Out on Training Opportunities”

Reality: LTFT doctors are entitled to the same learning opportunities as full-time colleagues, just over a longer timeline. Additional rotations may improve your training opportunities and with proper planning, any LTFT doctor can meet all their training requirements.

Myth 2: “It’s Career-Limiting”

Reality: Many LTFT doctors go on to excel in competitive specialties, research roles, and leadership positions. Success depends on dedication, not hours worked.

Myth 3: “It’s Too Difficult to Arrange”

Reality: While there’s paperwork involved, the process is well-supported. The NHS is increasingly accommodating LTFT requests as awareness of burnout and work-life balance grows.

Myth 4: “You Won’t Be Taken Seriously”

Reality: Working LTFT doesn’t diminish your professionalism or commitment. Many colleagues and supervisors recognise the benefits of this approach and are supportive.

💭Final Thoughts

Choosing to work less-than-full-time as a Foundation Doctor is a personal decision that requires careful consideration. However, it’s a viable option that can transform your experience of medicine, helping you thrive both professionally and personally. By planning ahead, communicating openly, and seeking support, you can build a career that fits your life rather than the other way around.