Flexible training

Read our overview of less than full time training for doctors and some of the things to consider when you are making your decision.

Location: England
Audience: Junior doctors
Updated: Tuesday 8 February 2022
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What is LTFT (less than full time training)?

LTFT covers any arrangement with reduced working hours for doctors, as arranged with an employer. All doctors that are training can apply for less than full time training.

Access to LTFT could rely on a number of individual circumstances, such as:

  • domestic commitments
  • disability
  • ill health
  • any activities undertaken outside of medicine.

It could also be reliant on the number of spaces available in your training location.

Deaneries or LETBs (local education and training boards) are advised to review applications based on ‘well founded individual reasons’ which are divided into two categories.

Category one

  • Disability or ill health
  • Responsibility for caring children
  • Responsibility for caring for ill or disabled partner, relative or dependent.

Category two

  • Unique opportunities for personal professional development, for example, training for national or international sporting events, or short-term extraordinary responsibility
  • Religious commitment
  • Non-medical professional development, such as management courses, law courses, fine art courses or diploma in complementary therapies.



Deaneries usually only approve applications that are based on need. Once the deanery or LETB assesses eligibility, the employer determines whether they have capacity to employ someone less than full time.

You will be informed by the deanery or LETB if you do not meet the criteria, with the reasons in writing. If you feel you do meet eligibility criteria, then you do have the right to appeal.


How to apply

The application process and can take up to three months.

The process for each deanery or LETB is different so read the guidelines on their website carefully. At an interview, the best candidates, whether full time or less than full time, will be offered training placements.

Depending on the situation you are when you apply to LTFT, we have offered an overview of what you should consider.

FY1 (Foundation Year 1)
  • Contact the LTFT department in the foundation school you are applying to, to discuss eligibility and to seek their approval.
  • Use the special circumstances procedure to get pre-allocated to the foundation school that you need to be at. It is not guaranteed that you will in the exact location you want but you should be pre-allocated to a specific(identified) foundation school.
FY2 (Foundation Year 2)

Apply to the UKFPO if you wish you to be considered for less than full time training post and you are in a full time FY1 post.

Specialty training

If you are not already working within the specialty grade that you wish to train less than full time in you should apply through competitive entry to a full time post.

If you are already in a full-time training post and wish to train less than full time within that same post, you will not have to reapply for training.

Training to be a GP

If you are on the GP training scheme, you will be employed on a new deal contract throughout your time in hospital training.

Once you leave the hospital part of your training you will be employed on a different contract and under terms and conditions as set out in the GP Registrar 'Directions'.

Once your application has been submitted to your deanery or LETB, there are three principal stages to completion:

  1. Agree training with deanery or LETB.
  2. Approval training programme will be obtained by regional specialty education committee or training programme director.
  3. Approval of postgraduate deanery or LETB for funding for post and employing board or equivalent.

Once you have the approval of your deanery or LETB (which often includes approval from your employer), you should approach your employer to ensure they have been notified that you will be working less than full time.

Training and assessments

Your post will normally be longer than the full time equivalent, so your overall training programme will be extended. 

You should speak with your deanery or LETB to discuss how long your training will be extended for.

The length of your training will depend on the successful completion of competency based annual reviews. Your expected CCT (certificate of completion) date will be reviewed as you progress through your programme.

The joint royal colleges of physicians training board provides a tool to work out your CCT date if you train LTFT. 


Extension to category three LTFT pilot

An agreement to extend flexible-working arrangements to junior doctors was reached in March 2020, following negotiations between the BMA and NHS.

Trainees in England will no longer need to meet specific criteria such as caring responsibilities, health reasons or religious grounds to qualify for the right to work LTFT, following the success of a three-year pilot scheme.

The agreement reached between the BMA, HEE (Health Education England) and NHS Employers as part of the Enhancing Junior Doctors Working Lives group, will ultimately see a third category of LTFT working introduced to all specialties.

Under the terms of the existing pilot scheme junior doctors working in England in specialities such as emergency medicine, obs and gynae and paediatrics are able to work at 50%, 60% or 80% of a full time post.

COVID-19 and category three

HEE has informed the BMA that due to COVID-19 pressures and concerns, they are not currently accepting applications from trainees in any specialty for LTFT category three.

The BMA has lobbied HEE to encourage this to open, however a change in decision has not yet been possible on this to date. The BMA is hoping that applications will be opened up later in 2020 to allow trainees to use LTFT category three in due course.

Next steps

The success of the pilot saw it extended by 12 months on two occasions, with the most recent extension running until August 2020.

It is understood that category three will be introduced incrementally across all specialties and will be extended to all junior doctors in England by the end of 2022.


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