Psychiatric Bulletin (2000) 24: 353-354. doi: 10.1192/pb.24.9.353-b
© 2000 The Royal College of Psychiatrists
Psychiatric Bulletin (2000) 24: 353-354
© 2000 The Royal College of Psychiatrists
Flexible training in psychiatry
Alicia Etchegoyen, Consultant Child and Family Psychiatrist
Chelsea and Westminster Hospital, 869 Fulham Road, London SW10 9NH
Sir: I am writing on behalf of the Executive of the Woman in Psychiatry
Special Interest Group, where I hold the brief for flexible training. We were
very interested to read the recent articles on flexible training. As a general
comment, we think it is encouraging that more information is becoming
available on part-time training in psychiatry. Findings are overall
encouraging: the Dean et al (Psychiatric Bulletin, November
1999, 23, 613-615) study found that flexible trainees were satisfied
with the quality of their training in spite of some drawbacks mentioned,
including perceived lack of status, some inequality in training opportunities
and a lack of part-time consultant posts at the end of training. Herzberg
& Goldberg (Psychiatric Bulletin, November 1999, 23,
616-619) found that the quality of flexible trainees compares favourably with
that of full-time trainees.
There is general agreement that there is an increased demand for flexible
training and working which needs to be addressed. Job-sharing both at training
and consultant levels has been suggested as an alternative. In connection with
this, we would like to make two specific points arising from Garrard's
(Psychiatric Bulletin, November 1999, 23, 610-612) paper. The
first point relates to the author's own experience of setting up her own
job-share in an approved senior house officer post. Regarding the negotiation
of her contract she says "We agreed to share our on-call duties, study
and annual leave, pro rata and return to full-time training if the
other left". We believe this is not a good arrangement, as it does not
protect the trainee's basic requirement to work part-time. Further, we suggest
that study leave ideally should not be shared pro rata, as both
partners are expected to gain continuing professional development points on an
equal basis to full-time trainees.
We believe that protective arrangements should be negotiated for a
consultant job-share, to secure the part-time position if the job-share
partner leaves. In that case, it should be up to the employing trust to
advertise the vacant part-time position. In fact it may be better altogether
for separate part-time training contracts to be issued in all cases. If
flexible training and working is to be seen as a valid and solid option, it
has to be respected as such. Although job-shares may be convenient for
financial or managerial reasons, they should not be binding for the incumbents
to revert to full-time occupation.
The second point relates to the comment "Additional funding from the
postgraduate dean's budget was arranged by our medical staffing department for
us to overlap in one session per week". This is a welcome development.
We are pleased to report that the Flexible Training Office Thames Region has
taken the initiative to make this ‘overlapping’ session available
for all job-share schemes. It has been pointed out that there may be financial
implications, such as increased administrative costs, for trusts to employ two
people. We would argue that the possible additional cost should be balanced
against the possibility of recruiting and retaining well-trained doctors into
the speciality.
