“ ... I completed most of my urology training as a full-time SpR, which helped to get up my learning curve but, in turn, also helped with having a break for maternity leave and being part-time.
In terms of maternity leave, it is good to plan to take a year out because you do not know how everything will be and how you will recover; it's easier to plan a year out and come back early than to try and extend an existing 6-month period. You can opt to spread your maternity pay over 12 months which is much easier for planning mortgage payments and bills; the default position is tto get full pay for eight weeks, half pay for seven months then nothing for the final three months. If you return early, you are back paid the remaining amounts.
“Keep in touch” days are advocated, where you plan to go in to work for a particular session to keep your skills up. People worry they will de-skill over 12 months and you will definitely feel a little rusty with some of your operative skills. However, in my experience, your clinical judgment and decision-making remains largely unchanged. If you take more than two years out, that gets more challenging, but it does not take long to get up to speed; you just need to re-set your expectations.
I have been less than full time (LTFT) starting from ST6. I was lucky to get supernumerary funding for 12 months, because there was no-one to share a job with when I applied for LTFT training. The process was relatively simple: discuss it with your Training Programme Director (TPD), complete the appropriate deanery forms get signed off by your TPD and mentor. I was allocated an excellent mentor in urology to aid with the process and I believe this is a requirement for all deaneries.
Out of three full days, my job plan includes on call 8-8, MDT, Admin, Study/Audit, two half-day theatre sessions and a clinic.
Some people choose to work full-time as a parent; it is definitely down to personal choice and defining what works in your particular situation. Personally, I found full-time work with young children very unsatisfying, I felt guilty and I only saw my children at weekends when I was not on call. Since working a 60% contract, I have a much better balance and it is easier to enjoy work and family time.
The key element is having support you can rely on, whether that is paid or from within your family, depending on locality. Having a nanny or relative that can come to your house for early morning starts is so helpful. Nurseries usually open at 07:00hr and close at 18:00hr, so you will still need extra help at either end of the day. An au pair is cheaper but would, of course, be expected to live in your home, so, again, that depends on your circumstances.
Working less than full-time means being more organised with your time, making sure you are ahead preparing your theatre lists and reviewing results, and keeping abreast of your administration. It also means being very clear about what you need for CCT and where your gaps are. It is not that easy just to come in on your usual day off, because child care needs pre-arranging and is costly, so job plans need to be carefully aligned with your specific training needs right from the start. Full days are much better than half-days; it can be difficult to leave a half-day on time.
When you have extra human beings to look after, your evenings are the main time available for you to deal with exam revision, write papers etc. Evenings, therefore, become your windows of opportunity.
I have found huge benefit in splitting my days, so that I do two days in a row, followed by a day with the children, then another day on. This has meant that, for me personally, everyone has got the best out of me. When the children are ill and sleep is minimal, I can manage with this pattern and have never had to take time off as a result. There is an argument for doing your days in a row for more continuity. If you communicate well with your colleagues it is possible for this to not be an issue at all, because clear handovers and follow-up form an important part of your training.
There will never be a “good time” in surgical training to have a family, so you should put aside any concerns over when to plan. The right time is the time that is right for you as a couple - then you will make it work ... "