{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T19:59:44Z","timestamp":1781207984645,"version":"3.54.1"},"reference-count":44,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T00:00:00Z","timestamp":1739836800000},"content-version":"unspecified","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100018270","name":"Health Service Executive","doi-asserted-by":"publisher","award":["ICGP202"],"award-info":[{"award-number":["ICGP202"]}],"id":[{"id":"10.13039\/100018270","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,1,23]]},"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Irish healthcare has struggled with attrition and emigration. Reasons include long working hours and work\u2013life 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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Primary outcome measures<\/jats:title>\n                  <jats:p>Primary outcome measures include awareness of LTFT training in Ireland, satisfaction with it and its effectiveness in supporting career, service provision and training requirements.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Awareness of LTFT training was poor. Training structures were seen as inflexible. Trainees preferred higher whole-time-equivalent (WTE) hours, such as 70%\u201380% 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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-093744","type":"journal-article","created":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T20:20:52Z","timestamp":1739910052000},"page":"e093744","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Exploring experiences of less-than-full-time postgraduate medical training in Ireland and options for future improvement: a qualitative study"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-7597-9908","authenticated-orcid":false,"given":"Ciara","family":"Matthews","sequence":"first","affiliation":[{"name":"Irish College of General Practitioners, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5195-6617","authenticated-orcid":false,"given":"Gabriel Blankson","family":"Beecham","sequence":"additional","affiliation":[{"name":"College of Anaesthesiologists, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8413-3872","authenticated-orcid":false,"given":"Majid","family":"Khan","sequence":"additional","affiliation":[{"name":"Irish College of General Practitioners, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gillian","family":"Judge","sequence":"additional","affiliation":[{"name":"Royal College of Surgeons, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"Afrasinei","sequence":"additional","affiliation":[{"name":"College of Anaesthesiologists, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"McCormack","sequence":"additional","affiliation":[{"name":"College of Anaesthesiologists, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karena","family":"Hanley","sequence":"additional","affiliation":[{"name":"Irish College of General Practitioners, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,2,18]]},"reference":[{"key":"2025101812394744000_15.2.e093744.1","unstructured":"National Doctors Training and Planning . Working as a Doctor in Ireland - NCHD guide. 2024. Available: www.hse.ie\/eng\/staff\/leadership-education-development\/met\/working-in-ireland-as-a-doctor-nchd-guide-digital-2024.pdf"},{"key":"2025101812394744000_15.2.e093744.2","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2022-064518","article-title":"Less than full-time training (LTFT), is this the new norm? A cross-sectional study using a UK-wide online survey to evaluate trainees\u2019 views and intentions for LTFT","volume":"12","author":"Cathcart","year":"2022","journal-title":"BMJ Open"},{"key":"2025101812394744000_15.2.e093744.3","unstructured":"Macqueen R-A , Crowe S , O\u2019Heney J . RCOG LTFT training report 2019. London Royal College of Obstetricians and Gynaecologists; 2019."},{"key":"2025101812394744000_15.2.e093744.4","doi-asserted-by":"crossref","first-page":"866","DOI":"10.1111\/j.1445-2197.2012.06300.x","article-title":"Flexible surgical training: it is time for change","volume":"82","author":"Tomlinson","year":"2012","journal-title":"ANZ J Surg"},{"key":"2025101812394744000_15.2.e093744.5","doi-asserted-by":"publisher","DOI":"10.1370\/afm.1713"},{"key":"2025101812394744000_15.2.e093744.6","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1308\/147363506X91276","article-title":"Flexible training for a modern surgical workforce","volume":"88","author":"Walls","year":"2006","journal-title":"Bulletin"},{"key":"2025101812394744000_15.2.e093744.7","unstructured":"Webb K , Health Education England, RSM UK Consulting . Less than full time training category 3 initiative: year 1 evaluation report. 2021."},{"key":"2025101812394744000_15.2.e093744.8","doi-asserted-by":"crossref","DOI":"10.1186\/s12960-016-0162-3","article-title":"Factors associated with less-than-full-time working in medical practice: results of surveys of five cohorts of UK doctors, 10 years after graduation","volume":"14","author":"Lachish","year":"2016","journal-title":"Hum Resour Health"},{"key":"2025101812394744000_15.2.e093744.9","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1111\/anae.13096","article-title":"\u201cMainstreaming\u201d of less than full-time training","volume":"70","author":"Jones","year":"2015","journal-title":"Anaesthesia"},{"key":"2025101812394744000_15.2.e093744.10","doi-asserted-by":"crossref","first-page":"460","DOI":"10.5694\/j.1326-5377.2011.tb03061.x","article-title":"Adding flexibility to physician training","volume":"194","author":"Mahady","year":"2011","journal-title":"Med J Aust"},{"key":"2025101812394744000_15.2.e093744.11","doi-asserted-by":"crossref","first-page":"S10","DOI":"10.1016\/j.ijsu.2015.09.016","article-title":"Less Than Full-time Training in surgical specialities: Consensus recommendations for flexible training by the Association of Surgeons in Training","volume":"23 Suppl 1","author":"Harries","year":"2015","journal-title":"Int J Surg"},{"key":"2025101812394744000_15.2.e093744.12","doi-asserted-by":"crossref","first-page":"307","DOI":"10.7861\/clinmedicine.9-4-307","article-title":"Women and medicine: the future","volume":"9","author":"Dacre","year":"2009","journal-title":"Clin Med (Lond)"},{"key":"2025101812394744000_15.2.e093744.13","unstructured":"General Medical Council . National trainee survey 2014; key findings. London, 2014."},{"key":"2025101812394744000_15.2.e093744.14","unstructured":"Royal College of Physicians of London RCoPoE, Royal College of Physicians and Surgeons of Glasgow . Focus on physicians: 2017\u201318 census (UK consultants and higher specialty trainees). 2018."},{"key":"2025101812394744000_15.2.e093744.15","doi-asserted-by":"publisher","DOI":"10.1177\/1077558715589705"},{"key":"2025101812394744000_15.2.e093744.16","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2015-010136","article-title":"Less than full-time training in surgery: a cross-sectional study evaluating the accessibility and experiences of flexible training in the surgical trainee workforce","volume":"6","author":"Harries","year":"2016","journal-title":"BMJ Open"},{"key":"2025101812394744000_15.2.e093744.17","doi-asserted-by":"publisher","DOI":"10.1186\/1756-0500-5-230"},{"key":"2025101812394744000_15.2.e093744.18","doi-asserted-by":"publisher","DOI":"10.1097\/00001888-200405000-00015"},{"key":"2025101812394744000_15.2.e093744.19","doi-asserted-by":"crossref","first-page":"1931","DOI":"10.1016\/j.bjps.2021.03.127","article-title":"The state of plastic surgical training: Results of the PLASTA 2020 national training survey","volume":"74","author":"Hendrickson","year":"2021","journal-title":"J Plast Reconstr Aesthet Surg"},{"key":"2025101812394744000_15.2.e093744.20","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz545"},{"key":"2025101812394744000_15.2.e093744.21","unstructured":"Wiskow C , Albreht T , Pietro C . How to create an attractive and supportive working environment for health professionals. World Health Organization, Regional Office for Europe; 2010."},{"key":"2025101812394744000_15.2.e093744.22","unstructured":"Health Service Executive National Doctors Training and Planning . HSE national supernumerary flexible training scheme 2025 [Health Service Executive]. 2024. Available: https:\/\/www.hse.ie\/eng\/staff\/leadership-education-development\/met\/ed\/flex\/flexible-training-policy-2025-docx.pdf [Accessed 12 Dec 2024]."},{"key":"2025101812394744000_15.2.e093744.23","unstructured":"Health Service Executive National Doctors Training and Planning . Flexible training: health service executive. Available: https:\/\/www.hse.ie\/eng\/staff\/leadership-education-development\/met\/ed\/flex\/ [Accessed 12 Dec 2024]."},{"key":"2025101812394744000_15.2.e093744.24","unstructured":"Health Education England . Delivering greater flexibility. 2022. Available: https:\/\/www.hee.nhs.uk\/our-work\/doctors-training\/delivering-greater-flexibility2024"},{"key":"2025101812394744000_15.2.e093744.25","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2923.2000.00620.x"},{"key":"2025101812394744000_15.2.e093744.26","unstructured":"Illsley A , Olsson-Brown A , Sutherland R . Less than full time training: the trainee perspective (survey results). Edinburgh Royal College of Physicians of Edinburgh; 2019."},{"key":"2025101812394744000_15.2.e093744.27","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2018-028631","article-title":"Why do trainees leave hospital-based specialty training? A nationwide survey study investigating factors involved in attrition and subsequent career choices in the Netherlands","volume":"9","author":"Bustraan","year":"2019","journal-title":"BMJ Open"},{"key":"2025101812394744000_15.2.e093744.28","doi-asserted-by":"publisher","DOI":"10.1503\/cjs.004616"},{"key":"2025101812394744000_15.2.e093744.29","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1016\/j.jsurg.2015.11.008","article-title":"Thoughts of Quitting General Surgery Residency: Factors in Canada","volume":"73","author":"Ginther","year":"2016","journal-title":"J Surg Educ"},{"key":"2025101812394744000_15.2.e093744.30","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1001\/jamasurg.2016.4086","article-title":"Prevalence and Causes of Attrition Among Surgical Residents: A Systematic Review and Meta-analysis","volume":"152","author":"Khoushhal","year":"2017","journal-title":"JAMA Surg"},{"key":"2025101812394744000_15.2.e093744.31","unstructured":"RSM UK Consulting LLP . Health education England less than full time training category 3 initiative year 1 evaluation report. 2021."},{"key":"2025101812394744000_15.2.e093744.32","article-title":"Trainee Knowledge and Perceptions of Less Than Full Time Training","volume":"114","author":"Howard","year":"2022","journal-title":"Ir Med J"},{"key":"2025101812394744000_15.2.e093744.33","doi-asserted-by":"crossref","DOI":"10.1186\/s12874-018-0594-7","article-title":"Characterising and justifying sample size sufficiency in interview-based studies: systematic analysis of qualitative health research over a 15-year period","volume":"18","author":"Vasileiou","year":"2018","journal-title":"BMC Med Res Methodol"},{"key":"2025101812394744000_15.2.e093744.34","doi-asserted-by":"crossref","unstructured":"Vaismoradi M , Jones J , Turunen H , et al . Theme development in qualitative content analysis and thematic analysis. JNEP 2016;6. doi:10.5430\/jnep.v6n5p100","DOI":"10.5430\/jnep.v6n5p100"},{"key":"2025101812394744000_15.2.e093744.35","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"2025101812394744000_15.2.e093744.36","doi-asserted-by":"crossref","DOI":"10.1186\/s12960-015-0022-6","article-title":"\u201cEmigration is a matter of self-preservation. The working conditions\u2026 are killing us slowly\u201d: qualitative insights into health professional emigration from Ireland","volume":"13","author":"Humphries","year":"2015","journal-title":"Hum Resour Health"},{"key":"2025101812394744000_15.2.e093744.37","doi-asserted-by":"crossref","DOI":"10.1186\/s12960-019-0424-y","article-title":"\u201cEverything was just getting worse and worse\u201d: deteriorating job quality as a driver of doctor emigration from Ireland","volume":"17","author":"Humphries","year":"2019","journal-title":"Hum Resour Health"},{"key":"2025101812394744000_15.2.e093744.38","doi-asserted-by":"crossref","DOI":"10.1186\/s12960-021-00573-4","article-title":"COVID-19 and doctor emigration: the case of Ireland","volume":"19","author":"Humphries","year":"2021","journal-title":"Hum Resour Health"},{"key":"2025101812394744000_15.2.e093744.39","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2018-025433","article-title":"Doctors don\u2019t Do-little: a national cross-sectional study of workplace well-being of hospital doctors in Ireland","volume":"9","author":"Hayes","year":"2019","journal-title":"BMJ Open"},{"key":"2025101812394744000_15.2.e093744.40","doi-asserted-by":"crossref","first-page":"1768","DOI":"10.1111\/imj.15403","article-title":"Design and implementation of flexible advanced training in rheumatology: report of a pilot programme","volume":"52","author":"Anandacoomarasamy","year":"2022","journal-title":"Intern Med J"},{"key":"2025101812394744000_15.2.e093744.41","unstructured":"Irish Clinical Academic Training (ICAT) programme - about. Available: https:\/\/icatprogramme.org\/about\/ [Accessed 26 Nov 2024]."},{"key":"2025101812394744000_15.2.e093744.42","unstructured":"Wellcome Trust . SFI-HRB-wellcome research partnership. Available: https:\/\/wellcome.org\/grant-funding\/sfi-hrb-wellcome-research-partnership [Accessed 26 Nov 2024]."},{"key":"2025101812394744000_15.2.e093744.43","unstructured":"Health Service Executive Medical Education and Training . Implementation of the reform of the Intern Year: second Interim report on the implementation of recommendations of the National Committee report on the Intern Year. Phase 2: July 2010 \u2013 July 2011. Dublin. 2012."},{"key":"2025101812394744000_15.2.e093744.44","article-title":"A Study of Consultant Attitudes to NCHD Less-Than-Full-Time (LTFT) Training","volume":"114","author":"Pereira","year":"2021","journal-title":"Ir Med J"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2024-093744","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T19:39:58Z","timestamp":1760816398000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2024-093744"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2]]},"references-count":44,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,2,18]]},"published-print":{"date-parts":[[2025,2]]}},"alternative-id":["10.1136\/bmjopen-2024-093744"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2024-093744","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2]]}}}