An Exploratory Evaluation of Barriers to Study Leave Application Amongst Psychiatric Trainees in the West Midlands

Abstract

Aims

Between 2018–2021 there was a downward trend in study leave applications and the total spending on trainee study leave activities. There was concern that trainees may not be maximising educational opportunities. The authors were aware of anecdotal evidence indicating barriers to applying for study leave and therefore sought to objectively explore this. We aimed to evaluate qualitative and quantitative responses amongst psychiatric trainees within the West Midlands deanery regarding study leave applications. We also endeavoured to identify positive aspects and barriers, to improve knowledge and confidence in the process and identify areas for improvement in making the system more accessible.

Methods

The authors met with Health Education West Midlands to clarify current processes and gather objective data regarding study leave applications between 2018 and 2021. A survey was distributed to all Psychiatric trainees in the West Midlands in December 2021. The survey was open for three weeks and contained closed and open questions. Data were analysed and a thematic analysis was completed independently by the authors to allow for triangulation.

Results

There were 62 responses (response rate of 27%) from trainees ranging from CT1-ST7+. 55% were unclear about the study leave application process, and of these, 79% said this had prevented them from applying. Only 37% of trainees found the process ‘very’ or ‘moderately easy’, with 23% finding it ‘very difficult’. When exploring barriers, worryingly 69% of trainees did not know where to find the list of approved courses. Other themes included too many signatures being required, long delays in forms being returned and money being reimbursed.

Conclusion

The majority of respondents were unclear about the study leave process or found it difficult. This acts as a barrier to application in the majority of cases and may have a knock-on effect on the overall quality of training. By identifying these barriers, we are now able to address these more directly.

The results were presented at a deanery wide level leading to a better understanding of the reduction in spending of study leave funding. Phase two of the project will see the introduction of an electronic application system, aiming for an easier and shorter process, in addition to creating consistency across trusts. There may have been some confounding factors, such as COVID-19 that may have contributed to the decline in study budget being utilised.