Matthews Ciara, Beecham Gabriel Blankson, Khan Majid, Judge Gillian, Afrasinei Manuela, McCormack Martin, Hanley Karena
Irish College of General Practitioners, Dublin, Ireland
College of Anaesthesiologists, Dublin, Ireland.
BMJ Open. 2025 Feb 18;15(2):e093744. doi: 10.1136/bmjopen-2024-093744.
Irish healthcare has struggled with attrition and emigration. Reasons include long working hours and work-life balance. Worldwide interest in less-than-full-time (LTFT) postgraduate medical training is increasing. Potential benefits include cost savings, reduced burn-out and improved patient safety; potential difficulties include maintaining service provision and negative perceptions from colleagues. This study aimed to examine experiences, awareness and attitudes towards LTFT training in Ireland, to identify potential improvements.
This prospective qualitative study used semistructured interviews. Interview participants were selected by volunteering in response to advertisements and by purposeful sampling. Data were coded and compiled into key themes, with the sample size determined by code saturation.
This study took place across a number of rural and urban centres in Ireland, including secondary and tertiary hospitals, administrative departments and postgraduate training offices.
29 participants were interviewed. Recruitment targeted doctors of varying levels and specialties (both in training and non-training posts), medical educators and other individuals involved in postgraduate medical training, such as training administrators and medical manpower managers.
Primary outcome measures include awareness of LTFT training in Ireland, satisfaction with it and its effectiveness in supporting career, service provision and training requirements.
Awareness of LTFT training was poor. Training structures were seen as inflexible. Trainees preferred higher whole-time-equivalent (WTE) hours, such as 70%-80% WTE, which may present administrative challenges. Participants felt LTFT training would have little impact on service provision. Some feared that LTFT training might affect career progression and competency, but participants with experience of LTFT training disagreed. Many felt that making LTFT training mainstream would foster positive attitudes.
Potential improvements to LTFT training include increasing administrative and medical staff support, accommodating higher WTE percentages and providing liaison officers. Focused improvement of LTFT training could contribute to the welfare of doctors in postgraduate training.
爱尔兰医疗保健行业一直面临人员流失和人才外流的问题。原因包括工作时间长以及工作与生活的平衡。全球范围内，对非全日制研究生医学培训的兴趣与日俱增。潜在益处包括成本节约、减少职业倦怠以及提高患者安全；潜在困难包括维持服务提供以及同事的负面看法。本研究旨在调查爱尔兰对非全日制培训的经历、认知及态度，以确定潜在的改进之处。
这项前瞻性定性研究采用半结构化访谈。访谈参与者通过回应广告自愿报名以及有目的抽样选取。数据进行编码并归纳为关键主题，样本量由编码饱和度确定。
本研究在爱尔兰的多个城乡中心开展，包括二级和三级医院以及行政部门和研究生培训办公室。
29名参与者接受了访谈。招募对象包括不同级别和专业的医生（包括培训中和非培训岗位的）、医学教育工作者以及其他参与研究生医学培训的人员，如培训管理人员和医疗人力经理。
主要结局指标包括对爱尔兰非全日制培训的认知、对其满意度以及在支持职业发展、服务提供和培训要求方面的有效性。
对非全日制培训的认知较差。培训结构被认为缺乏灵活性。学员更喜欢较高的全职等效工时，如70%-80%的全职等效工时，这可能带来管理挑战。参与者认为非全日制培训对服务提供影响不大。一些人担心非全日制培训可能会影响职业发展和能力，但有非全日制培训经验的参与者不同意这种看法。许多人认为将非全日制培训主流化会培养积极态度。
非全日制培训的潜在改进措施包括增加行政和医务人员支持、适应更高的全职等效百分比以及提供联络官。针对性地改进非全日制培训有助于研究生培训医生的福利。
