Personal reflection of LTFT

Dr Emily Ramsay, MBBCh BSc (Hons) MRCPsych PgCertClinEd FHEA

ST6 Forensic Psychiatry

After training in Cardiff, and completing a BSc in Medical History at UCL, I graduated in 2007.  Unsure of what career path to follow I took the opportunity to work in New Zealand after F2, which finally converted me to psychiatry and I have not looked back!  I completed my Core Training with Severn Deanery (2010 – 2015) and am now a Senior Trainee in Forensic Psychiatry in Peninsula (2015 – present).  I have trained less than full time since starting a family in 2013, working different combinations of 60%, 80% and full time over the years as my circumstances have changed.  I intend to continue to work flexibly as a Consultant. 

Overall, my experience of LTFT has been very positive, particularly as an ST.  I have received excellent support from my supervisors and have never encountered any issues with the application process.  LTFT has allowed me to gain experience across a greater number of teams and subspecialties than my full time colleagues, opening up clinical and educational opportunities I could not otherwise have imagined.  The day to day practicalities have forced me to advocate for myself as a junior doctor, prioritise my interests and honed my organisational skills.  It gives me time to be present for my family and (occasionally!) the opportunity to pursue my own hobbies separate from both.

That is not to say that combining raising a young and growing family with psychiatric training is easy.  Prejudice against medical parents is insidious and persistent within the profession (1), the government’s own equality analysis of the junior doctor contract imposed in 2016 found that it ‘disadvantages women working part time’ (2) and the gender pay gap in medicine stubbornly remains (3).  Yet for every awkward encounter in which I have been excluded from a clinical or educational opportunity due to not working full time or taking breaks in my training, I have had many more to which I have been welcomed. 

I am constantly motivated and inspired by the clinicians around me (of all grades and levels of experience) who balance flexible working with the many other demands on their time and energies.  Whilst negative attitudes to part time doctors may persist in sections of the press and public imagination (4), within the profession it is recognised that flexible working is crucial to the maintenance of the NHS’s workforce going forward and similar views are increasingly rare.  In our interconnected world cultural change happens faster than ever, I am proud to be a part of it.     

  1. Dr Kate Lovett, Hitting the ‘maternal wall’ in medicine, BMJ 2018;363.
  2. Dr Margaret McCartney, A sexist contract for junior doctors, BMJ 2016;353.
  3. Abi Rimmer, Review of £10,000 gender pay gap in medicine launched, BMJ 2018;361.
  4. Time Neward, Part time doctors are stretching NHS to breaking point, Daily Express 18 August 2018