Specialty Training Rotation Structure

From recruitment August 2018 onwards

For the last few years the Specialist Training Committee of the Yorkshire and the Humber School of Anaesthesia has made changes to the Speciality training rotations. The reasons for these changes are to try and ensure more even trainee distribution whilst also broadening access to regional training opportunities and sharing teaching and training best practice. This has meant that trainees will now have rotations that feature a period of time out of their “hub”, though the majority of their training will still be within a limited geographic area.

We have seen real benefits to this process in terms of standardisation in approach to paperwork and ARCP, better staffing in areas, and positive feedback about the broader range of training received. However, we are aware that there are down sides to change too. After each change, the School has attempted to assess the impact on the trainee body and the School as a whole, with the intention of making additional improvements. For example, trainee feedback indicated that having a planned rotation which gave the location of placements at the start of the programme would allow forward planning of training, geography, housing and modern life. Consequently, the School has been publishing 4 year rotations at the recruitment stage so that trainees will know their planned rotation location even before they start.

With the Aug 2020 recruitment round we have made further changes in direct response to trainee feedback.

We have acted on feedback from trainees who stated they would prefer their more distant training to occur later in their rotation. There is now a choice between rotations where the more distant training occurs early, and those where it occurs later.
Trainee and TPD feedback has suggested that non-Tertiary training opportunities should also be shared, therefore some of the new rotations feature exposure to smaller hospitals too.
Trainees and TPDs have suggested that 12 months continuously in more distant locations can be difficult, therefore we have tried to spread out the opportunities as two six month bocks, between placements in closer locations
Trainees have suggested specific mixes of hospitals in rotations that we had previously not considered. We have tried to write these rotations too, e.g. featuring DRI and Hull.

We are mindful of the new RCoA Curriculum just around the corner, hence we have tried not to make large, sweeping changes that may be counter to the new Curriculum. Equally, we have only been able to issue 3-year rotations on this occasion as the effect the new Curriculum will have beyond 2022 is still not clear.

The School, and HEE as a whole, recognise the impact of long distance travel and lengthy commutes on trainee wellbeing, and tries very hard to minimise this. Some of the changes mentioned above are directly related to this. In addition, we have pushed for the improvements in rest facilities and mileage claims, as well as more transparent advertising of these resources. We will continue to monitor and improve the situation.

Why has the ST training changed? Would it be better to stay in a smaller number of hospitals at Speciality level, to allow relationships to be built with potential future consultant colleagues?

Training environment is good throughout the school. The purpose of the redesign is to maintain equitable distribution of skilled medical workforce across the whole of Yorkshire. Given an even training quality then patient safety still remains a priority. However, within that context the Training Programme Directors have tried to ensure that training enviornment, quality of life and commute times have been considered in the rotations being offered

What happens if my circumstances change and I want to change my rotation?

Changes to one’s individual rotation may be requested in exceptional circumstances. These will be considered in the same way as InterDeanery Transfers (IDTs

Can I swap parts of my rotation with one of my friends who wants to do a reciprocal swap?

Unfortunately, this will not be possible as all of the rotations are balanced for training, for minimising trainee commute and to balance the gaps in each of the Trusts. Additionally, it will be impossible to assure that a proposed swap is actually in the best interests of both parties.

Will it be possible to “mix and match” travel expenses and accommodation to allow commuting some times and staying over for example on a weekend?

Unfortunately, travel and accomodation policies change frequently, and the current situation is that trainees can claim travel expenses OR accomodation for the entirety of their placement but CANNOT mix and match . At the request of trainee forums there is a National policy coming that covers travel and accomodation to try and iron out regional variation, but this is not yet in place.

During your "out of hub" placement you can claim back travel expenses (subject to your Trust's normal policy). If you wish to claim accomodation instead then you can do so, up to the value of the travel expenses (again, subject to your Trust's policy). You cannot claim both.

This arrangement is separate to your new contract post-on-call rest requirements.

Will there be any guarantee that the structure of our training won’t be altered part way through to accommodate the training needs of other individuals?

There is a commitment to honour the rotation that you are offered. However, it is possible to think of situations where trainee movement might be required. For example, changes to the Royal College of Anaesthetists (RCoA) Curriculum are anticipated within the next few years and individual Trusts may reconfigure the services they provide (e.g. centralisation of Vascular Surgery).

In addition, some trusts only have a few higher posts. If maternity or illness occurs in one or more of your colleagues they will not be alble to rotate. In these rare occasions it could mean that we would need to move you elsewhere, In this event we will contact you and discuss where the alternative placements are and give you the choice.

What happens if I take time out of training (e.g. OOP, Parental leave, Sick leave)?

With any time out of training the intention will be to honour the rotation that you applied for. However, the time spent in each Trust and the order which you rotate through them may change. Any alterations to your rotation will be made through discussion between you and your Training Programme Director (TPD).

I want to Dual train in ICM. Will my rotation stay the same?

If you are successful in applying to Dual ICM training, a new, bespoke rotation will be written with you.