Less than full time training in plastic surgery: A qualitative survey-based study and practical suggestions for improvement.

The General Medical Council (GMC) has voiced its support of less-than-full-time (LTFT) training, which has been shown to have a positive impact on workforce well-being, burnout and attrition and patient safety. However, barriers to LTFT exist within plastic surgery. This study aims to understand plastic surgery trainees' perceptions of LTFT and provide practical suggestions for improvement. Two surveys were disseminated by the UK Plastic Surgery Trainees' Association (PLASTA). Survey 1 formed part of the PLASTA National Training Survey (NTS) 2021, and all plastic surgery trainees with a National Training Number (NTN) were eligible. Survey 2 looked specifically at the lived experience of LTFT trainees in plastic surgery. A total of 177 trainees responded to the NTS. Seven per cent of respondents currently work LTFT, and 50% would consider it in future. Reported barriers to applying for LTFT included concerns about reduction in pay, extension of training time, and concerns about trainers' negative perceptions of LTFT. Twenty LTFT NTN trainees responded to the LTFT-specific survey. The majority of respondents reported an overall positive impact on their training and personal lives, although many still encountered negative attitudes from trainers and peers. Based on the results of this study, we provide practical suggestions to make LTFT more accessible to and acceptable for all trainees regardless of reason for applying or gender. Promoting the uptake of LTFT and improving the experience of LTFT in plastic surgery will support a healthy work-life balance in our workforce, prevent attrition and support gender equality.