Part-time Training Research Articles

Job-sharing in paediatric training in Australia: availability and trainee perceptions.

To examine the current availability of job-sharing in paediatric training hospitals in Australia and to evaluate job-sharing from the trainees' perspective. National survey with structured telephone interviews and postal questionnai res. The eight major paediatric training hospitals in Australia. Directors of Paediatric Physician Training (DPPTs) at each hospital (or a staff member nominated by them) provided information by phone interview regarding job-sharing. All paediatric trainees who job-shared in 1998 (n=34) were sent written questionnaires, of which 25 were returned. Hospitals differed in terms of whether a trainee was required to give a reason for wishing to job-share, and what reasons were acceptable. One hospital stated that two specialty units (Intensive Care and Neonatal Intensive Care) were excluded from job-sharing, and another stated that certain units were unlikely to be allocated job-sharers. The remaining six hospitals said that all units were available for job-sharing, but the majority of their trainees disagreed. Only one hospital had a cap on the number of job-share positions available yearly. Trainees perceived benefits of job-sharing to include decreased tiredness, increased enthusiasm for work, and the ability to strike a balance between training and other aspects of life. Trainees believed job-sharing did not adversely affect the quality of service provided to patients, and that part-time training was not of lower quality than full-time training. Job-sharing in Australian paediatric training hospitals varies in terms of the number of positions available, eligibility criteria, and which units are available for job-sharing. In our survey, trainees' experience of job-sharing was overwhelmingly positive.

Obtaining a part-time consultant post

Sir: Caswell & Lowe ( Psychiatric Bulletin , February 2000, 24 , 64-65) discussed whether part-time training will lead to a part-time consultant post. They concluded that there is little current availability of such posts in their surveyed area which resulted in fully trained psychiatrists

A survey of postgraduate (specialist) orthodontic education in 23 European countries.

This paper reports on a survey of the duration, funding, and assessment of postgraduate specialist orthodontic training, the requirement for postgraduate training prior to entering specialist orthodontic training and registration of specialist orthodontists in Europe. A questionnaire and explanatory letter were mailed to all members of the EURO-QUAL BIOMED II project. Answers were validated during a meeting of project participants and by fax, when necessary. Completed questionnaires which were subsequently validated, were returned by orthodontists from 23 countries. The results indicated that a period of postgraduate training, prior to entering specialist orthodontic training was required in 12 of the responding countries. Specialist orthodontic training was reported as lasting 2 years in three countries, 3 years in 17, and for 4 years in three. Part-time training was reported as a possibility in four countries. In 21 of the 23 countries specialist training was reported to take place in full or part within universities, with some training taking place in government clinics in four countries. In five countries some or all training was reported to take place in specialist practices. Training was said to be funded solely or partially by governments in 15 of the 23 countries, to be solely self-funded in five countries, and partly or solely funded by universities in six countries. A final examination at the end of specialist training was reported to be held in 21 of the 23 countries. The nature of this examination varied widely and there was no such examination in two countries. Twelve of the 23 countries reported that they had a specialist register for orthodontics; 11 that they had no register. In none of the countries surveyed was there a requirement for those on a register to undergo periodic reassessment of competence once they are on the register. It was concluded that there was wide diversity in all aspects of specialist orthodontic training and registration within the countries surveyed.

Part-time training: will it lead to part-time consultant?

Aims and MethodTo determine the preference of flexible trainees in psychiatry for consultant posts. A questionnaire survey was conducted among all flexible trainees in psychiatry in the West Midlands Region.ResultsThe overall response rate was 19 out of 21 (90%). The majority 15 out of 19 (68%) hoped to gain such a post at the end of their training. Of those wanting a consultant post, 15 of the 19 (79%) would only consider working part-time. If such a parttime consultant post was not available, 12 of the15 (80%) said they would considera non-career grade post.Clinical ImplicationsIn the West Midlands Region there has been an exponential growth in the number of flexible trainees. Approximately a third are within psychiatry alone and most wish to continue flexible working patterns as consultants. This has major workforce planning implications for the future.

Job sharing in medical training: an evaluation of a 3-year project.

Job sharing has been introduced on a major scale in one deanery to help accommodate increasing demand for flexible (part-time) training. We arranged 37 job shares for 74 trainees between 1996 and 1999. Job shares lasted from 6 months to 2 years. Trainees in job shares were as satisfied with their training as those in supernumerary posts or in full-time training.

Options for part-time training

As we approach the new millennium, more doctors are seeking part-time training, in all specialities and grades, with the demand outnumbering the opportunities (Goldberg, 1997; Clay, 1998).

Evaluation of Flexible (Part-Time) Training in Anaesthesia

One hundred and six former or current flexible trainees in anaesthesia responded to a questionnaire evaluating their part-time training (a response rate of 71%). They were compared with a group of 32 flexible trainees in obstetrics and gynaecology. Anaesthetists were more satisfied than obstetricians and gynaecologists with their training (96% compared with 84%); opportunities to publish (75% and 63%); research training (63% and 48%); and monitoring of their progress (78% and 67%). Without flexible training, 20% of the anaesthetists would have ceased to train, compared with 9% of the obstetrics and gynaecology group. Nearly all those who had finished their training were working as consultants (54% of the whole group); 4% had either retired, become a clinical assistant or a locum consultant. The remainder (42%) were senior registrars.

Part-time residency training in internal medicine: analysis of a ten-year experience.

To evaluate a ten-year experience (1983-1993) with a part-time residency curriculum. In 1994, the authors analyzed the curriculum through interviews with graduates of a part-time residency track, surveys of faculty and graduates of a full-time residency program, and a quantitative comparison of faculty evaluations of those part-time and full-time residents. Both participants and full-time residents supported the part-time track and reported no adverse effect on the residency program as a whole. Analysis of faculty evaluations found that part-time residents scored significantly higher with respect to clinical skills (p = .0005) and humanistic skills (p = .0001), while there was no difference between the groups in leadership or teaching skills. This part-time residency curriculum provided a highly useful program track for a group of internal medicine residents with concomitant obligations, allowing them to complete their training in an uninterrupted fashion. The part-time structure did not adversely affect clinical competence and may have fostered humanistic attributes. The authors believe that this form of curriculum deserves wider consideration in residency training.

Counsellor training: An evaluation of the effectiveness of a residential outdoor pursuits activity weeked on the personal development of trainee counsellors

Trainee counsellors were taken on an outdoor development weekend training course, organised as a component of a two year part-time professional counsellor training course. The weekend was held during the final term of the second year of the course at an outdoor pursuits centre in the Lake District. The weekend's activities included canoeing, abseiling, onenteering, hill walking, rope work and climbing as well as other adventure exercises. Attendance at the weekend was compulsoy for all the 17 students on the course. This training weekend was an innovation in counsellor training and therefore a pilot study was designed to evaluate its effectiveness in making a contribution to the overall development of the trainees as counsellors. The study used a same subject experimental design and data was collected pre and post the weekend. The assessment procedure adopted for the purpose of this research included the use of repertoy grids and a series of questions with analogue scales for responses. There was some evidence to suggest that as a result of the weekend the participants experienced an increase in their self esteem, changes in their level of self confidence, felt more co-operative towards their fellow students, felt more helped by and helpful towards others and had an increased awareness of their competitiveness and stamina. It was concluded that the weekend made some contribution to the personal development of counsellors in training, particularly with regard to team building, co-operation and group cohesion.

Evaluation of flexible (part-time) training in anaesthesia

One hundred and six former or current flexible trainees in anaesthesia responded to a questionnaire evaluating their part-time training (a response rate of 71%). They were compared with a group of 32 flexible trainees in obstetrics and gynaecology. Anaesthetists were more satisfied than obstetricians and gynaecologists with their training (96% compared with 84%); opportunities to publish (75% and 63%); research training (63% and 48%); and monitoring of their progress (78% and 67%). Without flexible training, 20% of the anaesthetists would have ceased to train, compared with 9% of the obstetrics and gynaecology group. Nearly all those who had finished their training were working as consultants (54% of the whole group); 4% had either retired, become a clinical assistant or a locum consultant. The remainder (42%) were senior registrars.

Professional Training in the Practice of Hypnosis-the Australian Experience

Increasingly around the world as clinicians and researchers alike become more sophisticated in their understanding of the hypnotic process, there is developing a conviction that the hypnotic state or process itself poses no inherent dangers for patients but that its inexpert use may. The solution to prevent potential patient harm is to ensure that all clinicians of whatever discipline have adequate and appropriate clinical training prior to being allowed to practice. Since 1985, in all the Australian states, the appropriate disciplines, already licensed to practice their profession, have completed 2 years part-time academic and clinical training in the nature and nuances of hypnosis (30 hours), practical experience of direct and indirect approaches, and supervised clinical case management (50 hours). At the end of the training they complete a 3 part examination of competence (clinical cases reports, written examination, and oral examination) in order to be accepted as members of the Australian Society of Hypnosis. Only by completing this training and peer reviewed assessment are clinicians able to receive the backing of the Society and recommendation to patients of their competence as clinicians using hypnosis. Recently in the states of Victoria and South Australia (and soon in the state of Queensland), the training program of the Australian Society of Hypnosis has been incorporated into a university diploma course, giving formal academic recognition to the approach to training. The University of Melbourne diploma course will be discussed with a view to illustrating these recent developments.

Shiatsu.

Shiatsu is a deep and effective hands-on treatment for many conditions as well as being very relaxing and providing support for general health and well-being. Through the balancing of the body's energy, better physiological and psychological functioning can occur. Recommendations for diet and lifestyle based on traditional Chinese medicine theory can also be offered, according to individual need. The 3-year part-time training in shiatsu is demanding but enables the nurse using shiatsu to offer a particularly beneficial complementary therapy.

Conjoint job-share: conjugal bliss

By describing a conjoint job-share in a single registrar post on an acute adult psychiatric ward in Wellington, New Zealand, this paper contributes to the growing literature on the subject of part-time training. We shared, on the one hand a registrar post and, on the other hand, our domestic life and the raising of our first child. We supplement our subjective impressions with information gathered from the multidisciplinary team, using a short

Reflections on part-time training in psychiatry

We have seen many interesting accounts of people's training experiences on the part-time scheme published in this journal, and one or two interesting articles looking at broader related issues, for example looking at attitudes and awareness of part-time training among colleagues and the impact of these factors on recruitment to part-time training.

The retainer scheme and psychiatry in primary care

Publications in the Psychiatric Bulletin have highlighted trainees' interest in part-time training and described different kinds of part-time training, but the feasibility of working as little as four hours a week has not been addressed. I have made unusual use of a Retainer Scheme for Doctors with Domestic Commitments to support part-time psychiatry in a general practice setting. This has proved a useful short-term option for bridging a career gap.

Attitudes to and awareness of flexible training in psychiatry in Birmingham

Part-time training has been available for over 25 years. However, women remain under represented in the higher grades. Following the report of the Joint Working Party on Flexible Training, April 1993, we aimed to investigate awareness and attitudes towards flexible training in Birmingham among psychiatric trainees and their consultants. The results suggest that while most had heard of flexible training, many had little knowledge of the recent registrar flexible training scheme locally. A substantial minority of doctors agreed with pejorative statements about part-time training and more of these were Juniors. Senior psychiatrists did not perceive part-time training adversely and many would consider part-time work in the future.

Osteoid osteoma of the os calcis — computed tomography-guided diagnosis and excision

A 34-year-old male manual worker and part-time physical training instructor presented to the orthopaedic department with pain on the outer aspect of his left ankle following a twisting injury. This had been present for about 9-10 months. On examination, there were no visible abnormalities of the foot and ankle. There was pain on forced inversion. Radiographs of the foot and ankle were normal. A diagnosis of sinus tarsi syndrome (STS) was made and the subtalar joint/sinus tarsi were injected with steroid. This had no effect on his symptoms. A magnetic resonance scan was therefore performed. This showed an area of high signal in the OS calcis just below the subtalar joint. Since the diagnosis was still unclear, a computed tomography (CT) scan was requested. This clearly showed a well-defined lesion, 1.5cms below the subtalar joint, with a nidus typical of osteoid osteoma (Fig. 1). Because of the vicinity of the subtalar joint, it was felt that open excision should be avoided as it would lead to subtalar osteoarthrosis in a fit, physically active young man. A CT scan assisted excision and was therefore performed.

Make an application for flexible (part time) training.

Part time training posts are advertised in the BMJ each year in August or September in an advertisement placed by the Department of Health. Although the advertisement is placed by the department and manpower approvals are allocated centrally, each region runs its own scheme, and the first person to approach is the regional postgraduate dean (most regions have an assistant dean responsible for flexible training). If an application is successful then part time trainees are interviewed by the same appointments committee as full time applicants and they are judged by the same criteria. Manpower approval is granted to applicants who reach the same standard as full time applicants, but there may be a waiting list if there are more suitable applicants than training places available. The next stage is to gain educational approval from the relevant higher training committee for the proposed training programme, followed by funding from the region.

Evaluation of flexible senior registrar training in obstetrics and gynaecology.

To evaluate part-time senior registrar training in obstetrics and gynaecology from the perspective of the trainees. Postal questionnaire. Past and present senior registrar trainees on the PM(79)3 scheme. Thirty-two questionnaires were returned (86% response rate) from 20 current trainees (100% response) and 12 (71% response) past trainees. Family commitments were the main reason for training part-time. Of these, 84% were satisfied with their training and most (81%) thought the quality as good or better than full time training. Personalised timetables were seen to be of particular benefit. Negative attitudes towards part-time training and discrimination in favour of full time trainees were seen as some of the biggest difficulties associated with part-time training. Other problems included administrative delays in organising part-time posts, time restriction, and the length of training. Part-time senior registrar training is effective in retaining trainees with domestic commitments within the speciality. It is regarded as being of high quality but with attendant problems, particularly those related to the negative attitudes of others. Recommendations for improvements have been made.

Junior doctors' fears for the future BMA proposes alternative models for the NHS GPs should consider a list of preferred drugs Defence medical services to be halved MPs question whether performance bill will work

# Junior doctors' fears for the future {#article-title-2} Failling morale among doctors featured widely in the debates at the recent meeting of the BMA's Junior Members Forum. The NHS seems to be attracting more doctors from other European Union states while recruitment in Britain is dropping. One doctor told the forum that 25-30% of the students who graduated with her had gone to Australia, and there were reports of general practitioner vocational training courses being unfilled. The lack of flexible and part time training does not help, particularly for women graduates, who now account for over 50% in most medical schools. To try to discover future doctors' intentions the BMA is to ask a cohort of final year students what their plans are and to follow them for 10 years. But it is the lack of progress on the Calman report on specialist medical training that is causing major frustrations, and the meeting condemned the lack of consultant expansion and called on the government for more central funding. “Failure to abide by this commitment must result in the whole profession supporting the juniors in their refusal to continue formal negotiations on the terms and conditions of the unified training grade.” The forum also resolved that because the overall employment position of doctors in the NHS had deteriorated to such an extent the BMA's health policy unit should investigate alternative ways of employing doctors. “This motion arises out of despair,” one of the Junior Doctors Committee's deputy chairmen, Dr Paul Miller, told the meeting. The meeting defeated a proposition that charging patients for general practice consultations would encourage a more responsible use of services. According to Dr Jonathan Reggler, who practises in the Oxford region, patients now saw demands and needs as rights, as the government encouraged them to go to their doctor. “We should be bold and think …