Trainee
Returning to trauma and orthopaedic training with SuppoRTT Iris Kwok, Zoe Little and Kash Akhtar The landscape of orthopaedic training is continually evolving, with an increasing number of trainees taking time out during their training. Fortunately, the current training pathway has a degree of flexibility to facilitate and nurture this diverse and well-rounded workforce.
T Iris Kwok is an ST8 trainee on the Royal London rotation. She has a specialist interest in foot and ankle surgery and trauma. As a departmental rota coordinator and registrar representative, she has helped trainees transition back to work following time out of training.
46 | JTO | Volume 09 | Issue 02 | June 2021 | boa.ac.uk
rainees can take time out of training for a variety of reasons – to undertake academic research, to pursue interests outside of medicine (for example, setting up a business or participate in competitive sport), taking parental leave or fulfilling family responsibilities, studying for an MBA or higher educational degree, or needing time out for personal sickness. This is thus an issue that impacts both male and female trainees alike, and can occur at all stages of training.
According to a study on return to work on Higher Surgical Trainees in 2018, the most common concerns trainees had surrounding returning to work following time out of programme were operative skills and skill fade, diminished confidence and the ability to manage worklife balance2. In recent years, increasing emphasis has been placed in ensuring safe and supported return to clinical practice after a period of time out. The Bawa-Garba case in 2015 that shook the medical profession brought the issue of patient safety to the forefront. This was formally addressed following the ACAS agreement in 2016, stemming from safety concerns of returning trainees raised in the Junior Doctors Contract. The SuppoRTT (Supported Return to Training Programme) programme was therefore established by HEE in 2017 to address these issues across all specialties and provide a structured process for trainees and trainers. 11 offices across England are responsible for establishing and implementing the programme within their local areas.
“An interruption in training can have an impact on ones’ clinical skills, knowledge and confidence on return to work, particularly in a craft-based speciality such as trauma and orthopaedics.”
An interruption in training can have an impact on ones’ clinical skills, knowledge and confidence on return to work, particularly in a craft-based speciality such as trauma and orthopaedics. Previously, trainees were expected to return to full clinical duties with on calls and emergency operating in full swing, often in a completely new trust. This has potentially serious implications for patient safety, trainee confidence and rate of return to training altogether. These issues have been well-described in other surgical specialties1.
