Disability - Employment Issues

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Less Than Full-Time (LTFT) training

LTFT is supposed to be accessible to doctors in training who have a well-founded reason for being unable to work full-time. Eligible are doctors who have physical or mental health problems, who would like to continue their training but are unable to do so full-time.  

There are three options for LTFT training:

• “Slot sharing” is the most common with 2 trainees sharing 1 slot.
• LTFT in a full time slot is becoming more common with the increasing numbers of unfilled training posts.
• Supernumerary post. If neither of the other 2 options is possible then your Deanery/Local Education and Training Board may consider placing you in a supernumerary post.  This is funded from a different ‘pot’ which is limited so this opportunity is often closely guarded.  

It is possible to work less than full time from any point from the start of your foundation programme on-wards throughout the rest of your training and career.  

The General Medical Council currently requires that trainees undertake no less than 50% WTE (“whole-time equivalent”). In very exceptional circumstances, your Local Education and Training Board (LETB) may agree to an absolute minimum of 20% WTE for a specified period.

Sick leave

Being off work because you’re disabled is not the same as time off for ‘being ill’.  Sick leave is defined as time taken off work due to ill health. 

If someone has time off because of sickness that is not related to their disability, this should be recorded as sick leave in the usual way.

It can also be helpful for disabled doctors to explain to colleagues that, sometimes, sick leave can be predicted.  In such cases, advanced warning with some notice might be possible.

Disability leave

Disability leave is different from sick leave. Disability leave can cover a range of disability-related absences, including from attending clinic appointments to taking time off to come to terms with a new diagnosis or cope with treatment side effects - what is required will vary from person to person. 

If your employer does not know that you’re disabled, then they will treat you as just being ‘ill’. This means that their usual sick leave policy will apply to you. Most policies do not allow time off for medical appointments. 

It is worth noting that whilst on a training programme, whilst disability leave may be an additional allowance to sick leave in terms of pay arrangements, if the total maximum allowance of days off per year is exceeded, the time may still be required to be ‘paid back’ prior to achieving Certificate of Completion of Training (CCT).  

Issues when moving posts regularly:

• You are likely to be moving post every four - six months in the foundation years and in some specialty training programmes.  This can prove challenging when you require adjustments in the workplace, for any reason.
• For Foundation trainees, liaising with your Foundation school lead and educational supervisor to ensure all clinical supervisors of all posts are made aware of your condition and the implications of this, prior to you starting can be very helpful.  

Make sure that your clinical supervisors are allocated in plenty of time.  

Contacting your clinical supervisor around a month in advance of the post starting and arranging a face to face meeting with them if possible, to discuss adjustments needed is a very good idea.  For example, walking around your new working environment with them to assess any access challenges, etc that you may face so that these can be addressed prior to your first shift.  

Trying to have a named contact in the human resources department, to discuss your job plan/rota commitments with is also advisable. 

Updated, October 2024.

To find out more, contact us to obtain our full disability factsheets.