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Flexible training in psychiatry

Nottingham Healthcare NHS Trust, Duncan Macmillan House, Porchester Road, Nottingham NG3 6AA

Sir: Three recent papers highlighted issues relating to flexible training (Psychiatric Bulletin, October 1999, 23, 610-612, 613-615, 616-618). The term ‘flexible training’ implies flexibility, which does not exist, although colleagues may assume it does. Timetables and posts are agreed with the College to ensure that training is equivalent to that undertaken by full-time trainees. Flexible trainees are comparable in calibre and undertake comparable training to full-time trainees (Psychiatric Bulletin, October 1999, 23, 616-618). They have considerable experience, both medical and non-medical, which they bring to their work. Despite this there is a perception that flexible trainees have lower status than full-time trainees.

Most flexible trainees are female and have domestic commitments. Those regarding flexible training as inadequate are mainly male. Is this perceived lower status simply a result of the gender difference? Another explanation may lie in "the machismo of medicine" (Dinniss, 1999). Within medicine, difficult working conditions, long hours and traumatic situations are expected and dealt with by machismo rather than other coping strategies. Doctors who work fewer hours are not subjecting themselves to the same quantity of this burden as their full-time colleagues and so are not regarded as equal to them.

Flexible training is in reality part-time training, that is less work for less money, taking longer to complete. This training is no more flexible than full-time training. A change in the terminology to part-time training would remove some of the myths that surround flexible training.

References

DINNISS, S. (1999) The machismo of medicine. British Medical Journal, 319, 929.[Free Full Text]

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