Career Break Policy for Doctors in Training

Introduction

A Career Break is a means of enabling trainees to take a break from training and to provide a guaranteed return to that training, at a later date. It is seen by Peninsula Postgraduate Medical Education as an important factor in retaining skilled staff in the long term, by providing the opportunity of a lengthy break from training whilst ensuring that there is minimal negative impact on the individual’s future career development and training and that the return to work is made as easily and productively as possible.

A career break allows a trainee to take an agreed period of time away from their job to pursue other interests on the understanding that they will return when that period has expired.

Those trainees whose time-out-of-training plans are eligible for Out of Programme Experience (OOPE) should not apply for a career break. Please refer to the Peninsula Postgraduate Medical Education OOP policy.

The policy has been produced in line with national terms and conditions of service for doctors in training and the Guide to Specialty Training “Gold Guide”.

This policy does not apply to Foundation Trainees. Please refer to Time out of Foundation Programme policy.

Terms of the Scheme

In order to be eligible to apply for a career break, the trainee must have completed one year of the training programme at the time of application and have one year’s NHS service.

The minimum length of a career break is three months and the maximum, due to education and training considerations, is two years, but may be longer in exceptional circumstances, which must be agreed with the Postgraduate Dean.

In line with the “Gold Guide”, trainees wishing to take longer will, under normal circumstances, are expected to relinquish their NTN / DRN and re-apply in open competition for re-entry into the same specialty or a new specialty.

All applications will be considered on their merits, with service and training needs being an important determining factor

An application for a career break should be made by completing Form A. Incomplete forms will be returned and may delay the request.

A minimum of three months notice of a request for a career break up to one year and six months notice for requests over one year; however the applicant should give as much notice as possible.

An educational lead (Training Programme Director, Foundation Programme Director or Associate GP Dean depending on your grade and specialty) must sign to support your application. It is recommended that the applicant commence discussions with the educational lead at the start of the application process to help indentify learning objectives where appropriate.

When agreeing the duration of a career break a balance should be maintained between the needs of the applicant, the impact on the training programme as a whole and those of the service.

Limiting factors will include:

  • The ability of the programme to fill the resulting gap in the interests of patient care;
  • The capacity of the programme to accommodate the trainee’s return at the end of the planned break;
  • Evidence of the trainee’s on-going commitment to and suitability for training in the specialty.

A replacement NTN to fill the gap in a programme left by a trainee undertaking a career break may be made available but the Postgraduate Dean will need to ensure that the programme can accommodate any newly appointed trainees, as well as the subsequent return of the trainee who has undertaken the career break.

A period of refreshment of skills and updating may be necessary before the trainee returns formally to the programme. This will be at the discretion of the Postgraduate Dean, following consultation with the training programme director. Arrangements for how this will be achieved will be subject to local agreement and may not count towards training.

If all requests for a career break within a programme cannot be accommodated, priority will be given to trainees with any of the following:

  • Those with health issues;
  • Those who have caring responsibilities for dealing with serious illness in family members that cannot be accommodated through flexible training;
  • Those who have childcare responsibilities that cannot be accommodated through flexible training options;
  • At the discretion of the Postgraduate Dean, those with a clearly identified life goal which cannot be deferred.

Only one career break will be granted during any one training programme.

Possibilities might include:

  • Voluntary work or travelling abroad where the applicant is not in receipt of a paid salary;
  • Study outside of medicine;
  • Childcare beyond statutory entitlement;
  • Pursuit of a hobby or interest;
  • Caring for a dependant beyond statutory entitlement

Trainees must agree a return date prior to their departure and should be aware that it may not be possible to facilitate a return to work any earlier once this has been agreed.

Trainees who wish to extend their career break whilst they are on it may do so by arrangement with the Postgraduate Dean and up to a maximum of two years in total. The same terms apply when granting an extension.

Career breaks are breaks without pay and time out of medicine will not be recognised in increments to salary. If an applicant wishes to do paid voluntary work or paid work overseas then applicants will need to refer to the Out of Programme Experience (OOPE) policy and follow that process.

The period of the career break will not be counted towards training and on return the trainee will be issued with a new CCT date taking into account any refresher training required.

A period of a career break will be treated as continuous employment for statutory purposes only. All other provisions depending upon length of service, i.e. pensions, contractual redundancy payments, leave entitlements etc will be suspended for the period of the break.

It is the joint responsibility of the trainee and the appropriate educational lead to make certain that during the period of the career break the trainee stays up to date with organisational, training and service developments. This is to ensure the easiest integration back in to their role when it ends.

Peninsula Postgraduate Medical Education reserves the right to refuse a Career Break to an eligible trainee where it can be demonstrated that their absence will create significant problems either on service provision, the training programme as a whole or the trainees own training/career development.

The trainee must maintain any relevant professional registration including any training courses required for updating. Evidence of renewal of professional registration must be sent with a completed copy of Form B to the Postgraduate Dean who will keep a record on file. Trainees who are required to take responsibility for their own continuous professional learning and development will retain this responsibility during their career break.

Trainees must complete Form R and the relevant section of the OOP on an annual basis and submit this to the annual assessment outcome panel in order to continue to register their interest in staying in the programme. This should include an update of the date of their intention to return to the programme to facilitate the planning process.

Trainees will also have to consider the effect of a career break on their ability to maintain their licence to practise with the GMC.

Implementation

Trainees

 Trainees who meet the eligibility criteria for a career break may apply for one at any time by completing Form A and ensuring the appropriate signatories are completed.

Any trainee requesting a career break should ensure they read thoroughly the terms outlined in this policy.

In the interests of ensuring that backfill can be arranged for a trainee who is going on a career break all requests must be completed and made at least three months in advance of the planned career break. However a trainee should provide as much notice as possible when considering a career break.

On receipt of an application for a career break from a trainee, the Postgraduate Dean or nominated deputy will acknowledge receipt of the request within five working days. The Postgraduate Dean or nominated deputy must discuss the request with the appropriate educational lead.

Having spoken with the educational lead, the Postgraduate Dean or nominated deputy should evaluate the likely impact on the training programme, the training of the applicant and the service delivery of granting a career break.

If it is decided that a career break should be granted then the Postgraduate Dean or nominated deputy will complete the approval section of Form A and confirm in writing to the applicant that the career break has been granted accompanied by a copy of the completed Form A within 10 working days of the receipt of the initial application. A copy of this documentation should also be sent to the educational lead and the relevant manager in Peninsula Postgraduate Medical Education.

No career break can be finally authorised without the signatories of the appropriate educational lead and the Postgraduate Dean or nominated deputy.

If the Postgraduate Dean or nominated deputy does not consider it possible to approve a career break, they must respond to the applicant in writing within 10 working days of the receipt of the initial application, returning Form A accompanied by a letter setting out the reasons for not being able to approve it.

Any decision deemed to be unfair by the trainee may be appealed. .

Contractual Obigation

During the period of the career break, the following conditions will apply:

  • During the period of the career break, the trainee would be required to sign a new contract reflecting their status. This would take the form of an agreement between the trainees current employer and the trainee;
  • During the career break, the employee will maintain continuity of service from the point of view of the organisation for statutory purposes only;
  • Other provisions such as pensions, incremental service, contractual redundancy payments or leave entitlements are suspended for the duration of the break. This will be reflected in the revised contract;
  • Where there is a change of circumstance in the reason for the career break this must be notified by completing Form C and returning it to Peninsula Postgraduate Medical Education as soon as the circumstances change;
  • If the reasons for the career break no longer exist or the change in circumstances would lead to a withdrawal of approval of the career break the career break will be ended and where possible a return to the training programme will be facilitated. Where this is not possible the trainee will remain on the career break until such time they can either return to the training programme or the career break comes to a natural end;
  • During their career break trainees must not enter into full time paid employment within their training specialty, either in the UK or overseas. Such applicants will need to refer to the Out of Programme Experience (OOPE) policy and follow that process. Trainees who intend to undertake agency / locum employment during their career break must have sought, and obtained, approval from for this prior to commencing their career break;
  • The trainee and the educational lead have joint responsibility to remain in contact during the period of the career break. It is suggested that this should not be less than one occasion in any six month period;
  • On completion of the career break, the trainee will be reemployed by one of the Trusts on the rotation. This may not be the Trust that employed the trainee prior to the career break due to the rotational nature of the training programme.

The trainee will return to the same grade of post they vacated at the beginning of the career break. It will depend on whether the trainee has vacated a specialty specific rotation i.e. ophthalmology or whether they have vacated a rotation with a number of different specialties it i.e. core medical training as to which post and which Trust they will return to. It is unlikely that the trainee will return to the same rotation that they vacated on their return and they may find that they will return to a different Trust.

Trainees may return earlier than expected or request an extension to their career break whilst away from the training programme up to the maximum allowance.

A request for an extension should be made by completing Form D and returning it to Peninsula Postgraduate Medical Education at least three months in advance of the end date of the current approved career break. No extension may exceed the maximum career break entitlement of two year’s. The trainee will be notified of the outcome within 10 working days of receipt of Form D.

Trainees wishing to return to work early must complete Form E and return it to Peninsula Postgraduate Medical Education giving two months’ notice of the intended return date. An early return date may not be possible to facilitate and the trainee will be notified of the outcome of their request within 5 working days of the receipt of Form E.

Appeals

Trainees who have their request for a career break refused have the right of appeal against this decision.

An Appeal is an opportunity to question a decision, or complain about treatment which a trainee considers to be unfair. An Appeal will allow all parties to have the case heard before an independent panel, and a decision to be reached on the facts that have been presented.

The process can be used to appeal the refusal of access to the career break policy.

It should not be used for:

  • Issues with the employing Trust, or equivalent body, relating to terms and conditions and contract of employment

Before beginning the full appeals process Trainees and Deans (or nominated deputy) must first jointly attempt to resolve the issues of concern informally, if you wish, your union representative in these discussions. If, after due consideration, the matter can be resolved without recourse to the appeals procedure, then this agreement should be confirmed in writing. If agreement cannot be reached you will then have recourse to the formal appeals process.

Registering an Appeal

Submit your appeal, in writing, using a copy of the Notification of Appeal Form F. It is the trainees’ responsibility to ensure the completed form is submitted to Peninsula Postgraduate Medical Education; therefore it is advisable that proof of postage is obtained at the time of sending.

Send it to the Postgraduate Dean, within 20 working days of the decision about which you wish to appeal being made.

Process Following An Appeal Being Registered

You will be invited to attend an appeal hearing, which will be held within 15 working days of the submission of the appeal. You will need to provide a written “Statement of Case” at least 10 working days in advance of this appeal hearing to the Postgraduate Dean for it to proceed.

You will be given a minimum of five working days notice of the appeal hearing date, which will be confirmed, to you in writing. This will allow you at least five working days to prepare your statement of case.

The representative(s) from Peninsula Postgraduate Medical Education, who made the initial decision regarding your application will also be required to provide a Statement of Case, to be submitted to the Postgraduate Dean at least 10 working days before the hearing

The Postgraduate Dean will ensure that panel members receive the papers as soon as possible, and in any case at least five working days before the hearing.

Both parties will be given copies of the other’s Statement of Case at least five working days before the hearing.

A Statement of Case should include:

  • The grounds/reason for the appeal
  • A simple list of events, in date order.
  • Copies of all relevant correspondence and written evidence
  • Details of any witnesses to be used.

The Appeal Panel

An independent appeals panel will hear your Appeal.

The appeals panel will comprise five members as follows:

  • One representative from Peninsula Postgraduate Medical Education (normally the Dean) who will normally chair the Appeal.
  • Human resources professional (either an independent practitioner or from within a healthcare organisation within Devon and Cornwall).
  • One doctor in training nominated by the BMA
  • One independent external assessor nominated by the Health Education South West or equivalent. This could be a Medical Staffing Manager at a Trust where the trainee is not currently working;
  • A Consultant in an educational role (i.e. Head of School or Royal College Adviser)

A person other than a panel member will keep an accurate record of the proceedings.

You will have the right to be represented by a representative of your professional organisation or trade union. Your representative may also be a work colleague, friend or any other person, other than someone acting in the capacity of a legally qualified practitioner.

The panel will listen to both sides of the argument and then reach a balanced decision based upon the evidence that has been presented.

The panel members will not have been involved in the original decision that gave rise to the appeal.

The panel will have the discretion to co-opt external advisors in appropriate circumstances.

How the Appeal is carried out

The Appeal will be a meeting between the panel, a representative from Peninsula Postgraduate Medical Education who made the initial decision and the appellant. Any witnesses, representatives or companion may also be invited to the meeting with prior consent from the Chair of the panel.

At the meeting the appellant, or their representative, will be given the opportunity to put forward the reason for the Appeal. Any evidence additional to that included in the statement of case may be presented at this time, subject to sufficient time being allowed for both sides and the panel to consider it fully.

The representative from Peninsula Postgraduate Medical Education who made the initial decision will be given the opportunity to explain why the decision was made. They may also submit any further evidence not included in the Statement of Case, as long as both sides and the panel are allowed sufficient time to consider it fully.

Each side will have the opportunity to question the other on issues of fact.

At any time during the appeal a request can be made by either party for an opportunity to meet privately with their representatives to consider any matter which may help in clarifying or resolving the Appeal.

Decision of the Appeal

The decision of the panel, and the reasons for making that decision, will normally be announced at the end of the Appeal; this decision will be confirmed in writing within ten working days.

The decision of the panel is final.

You may seek the advice of your union representative at any stage during this procedure.

Intended Outcomes

The intended outcomes of this policy are:

  • All managers, staff, trainees and those in educational roles have an understanding of the arrangements regarding a career break application;
  • All trainees on the career break scheme will have kept in contact with Peninsula Postgraduate Medical Education through their educational lead;
  • All trainees who have been refused a career break will have received a written letter explaining the reason for this.

An impact assessment for this policy has been completed. .An impact assessment for this policy will be completed every three years.

This policy has been developed in consultation with the British Medical Association (BMA).