Exploring experiences of less-than-full-time postgraduate medical training in Ireland and options for future improvement: a qualitative study.

OBJECTIVES

Irish healthcare has struggled with attrition and emigration. Reasons include long working hours and work-life balance. Worldwide interest in less-than-full-time (LTFT) postgraduate medical training is increasing. Potential benefits include cost savings, reduced burn-out and improved patient safety; potential difficulties include maintaining service provision and negative perceptions from colleagues. This study aimed to examine experiences, awareness and attitudes towards LTFT training in Ireland, to identify potential improvements.

DESIGN

This prospective qualitative study used semistructured interviews. Interview participants were selected by volunteering in response to advertisements and by purposeful sampling. Data were coded and compiled into key themes, with the sample size determined by code saturation.

SETTING

This study took place across a number of rural and urban centres in Ireland, including secondary and tertiary hospitals, administrative departments and postgraduate training offices.

PARTICIPANTS

29 participants were interviewed. Recruitment targeted doctors of varying levels and specialties (both in training and non-training posts), medical educators and other individuals involved in postgraduate medical training, such as training administrators and medical manpower managers.

PRIMARY OUTCOME MEASURES: Primary outcome measures include awareness of LTFT training in Ireland, satisfaction with it and its effectiveness in supporting career, service provision and training requirements.

RESULTS

Awareness of LTFT training was poor. Training structures were seen as inflexible. Trainees preferred higher whole-time-equivalent (WTE) hours, such as 70%-80% WTE, which may present administrative challenges. Participants felt LTFT training would have little impact on service provision. Some feared that LTFT training might affect career progression and competency, but participants with experience of LTFT training disagreed. Many felt that making LTFT training mainstream would foster positive attitudes.

CONCLUSIONS

Potential improvements to LTFT training include increasing administrative and medical staff support, accommodating higher WTE percentages and providing liaison officers. Focused improvement of LTFT training could contribute to the welfare of doctors in postgraduate training.