Flexible training in psychiatry

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.