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Tebbutt JE, Spencer RJ, Balmer R. Flexibility and access to dental postgraduate speciality training. Br Dent J 2023; 235:211-214. [PMID: 37563400 DOI: 10.1038/s41415-023-6079-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/09/2023] [Accepted: 03/24/2023] [Indexed: 08/12/2023]
Abstract
Increasingly, there is a clear emphasis on the need for improved access to flexible training. This reflects changing societal attitudes and expectations towards work-life balance and increasing demand for flexible working. The recently published Advancing dental care review: final report (2021) reflects these same demands within dental postgraduate training. Increasing flexible training options has the potential for far-reaching beneficial effects for dental speciality training. There are barriers to accessing speciality training for specific applicant groups and this risks potentially excluding excellent-quality candidates from pursuing speciality training. There is opportunity in utilising and developing flexible training options to support widening access to dental speciality training. Recruitment and working pattern arrangements should reflect these aspirations, ensuring that the best trainees are successful irrespective of their personal circumstances.
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Affiliation(s)
- Jessie E Tebbutt
- Academic Clinical Fellow in Special Care Dentistry, University of Sheffield, UK.
| | | | - Richard Balmer
- Associate Professor and Honorary Consultant in Paediatric Dentistry, Leeds Dental Institute, UK; Associate Postgraduate Dental Dean for Speciality Training, HEE Yorkshire and the Humber, UK
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Alexander SM, Byerley JS, Page CP, Holmes AV, Beck Dallaghan GL. Reflections on part-time residency training, 15-25 years later: a qualitative study on wellness and career impact. TEACHING AND LEARNING IN MEDICINE 2022:1-8. [PMID: 35435100 DOI: 10.1080/10401334.2022.2050241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 02/18/2022] [Indexed: 06/14/2023]
Abstract
Phenomenon: While part-time clinical work options are popular for physicians, part-time residency training is uncommon. Some residency training programs have offered trainees the option to complete their training on a modified schedule in the past. These part-time tracks often involved extending training in order to complete equivalent hours on a part-time basis. Having experience with trainees in such programs, we sought to explore the impact of completing residency training part-time on the professional and private lives of physicians. Approach: Between 2019 and 2020, we conducted interviews with physicians who completed portions of their residency training part-time between 1995 and 2005 in our institution's pediatrics, combined medicine-pediatrics, and family medicine programs. Findings: Seven female physicians who completed at least some portion of residency part-time were interviewed. To better characterize their experiences, we chose phenomenology as our analytic framework. Members of the research team independently coded each interview and met to resolve conflicts. Codes were then combined and discussed to determine four overarching themes as reasons and benefits of part-time training: The pursuit of extended-time training, logistics, effects on career trajectory, and wellness. These themes highlighted the utility of part-time training and the need for programmatic support to ensure their success. Insights: Based on our findings, adaptability for training and a sense of agency from their part-time experiences persisted throughout interviewees' careers. Each felt empowered to make career choices that fit their personal and professional needs. These findings suggest further investigation into the benefits of offering time-variable training in residency programs.
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Affiliation(s)
- Seth M Alexander
- University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Julie S Byerley
- University of North Carolina School of Dentistry, Chapel Hill, North Carolina, USA
| | - Cristen P Page
- Family Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Alison V Holmes
- Department of Pediatrics, Geisel School of Medicine at Dartmouth University, Hanover, NH, USA
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Creo AL, Anderson HN, Homme JH. Productive Pumping: A Pilot Study to Help Postpartum Residents Increase Clinical Time. J Grad Med Educ 2018; 10:223-225. [PMID: 29686765 PMCID: PMC5901805 DOI: 10.4300/jgme-d-17-00501.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Revised: 10/15/2017] [Accepted: 10/30/2017] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Many female residents choose to start families during training, and they want to breastfeed their infants. Continuing lactation while balancing service and education demands can be challenging. OBJECTIVE We hypothesized that the presence of a dedicated and fully equipped lactation room with a hospital-grade pump (HGP) would increase ease and efficiency of lactation during residency. METHODS A quiet HGP was purchased for resident use, and it was stored in a designated room with a computer, telephone, and dictation system. Lactating residents provided information about pumping time and production using their own portable double electric pump (PP) versus the HGP based on the first pump of the morning (for consistency), averaged over the first month back from maternity leave. RESULTS Among 6 residents, lactation time with PP averaged 24 minutes (range, 15-40 minutes) versus 15.5 minutes with HGP (range, 10-32 minutes). Use of the HGP reduced total pumping time by 8.5 minutes (95% confidence interval 3.8-12.2, P = .045). Production volume increased from 6 ounces (range, 3.5-8.5 ounces) with PP to 8.8 ounces (range, 8-11 ounces) with HGP, for a mean increase of 2.8 ounces (95% confidence interval 1.2-4.3, P = .06) despite decreased lactation time. CONCLUSIONS In our pilot, an HGP significantly decreased lactation time, while increasing expressed milk volume. Residents completed clinical and educational tasks while pumping. Providing an HGP and equipped lactation space helped residents continue breastfeeding and decreased the burden of lactation on patient care and educational tasks.
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Harries RL, Gokani VJ, Smitham P, Fitzgerald JEF. Less than full-time training in surgery: a cross-sectional study evaluating the accessibility and experiences of flexible training in the surgical trainee workforce. BMJ Open 2016; 6:e010136. [PMID: 27091819 PMCID: PMC4838701 DOI: 10.1136/bmjopen-2015-010136] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Generational changes in lifestyle expectations, working environments and the feminisation of the medical workforce have seen an increased demand in postgraduate less than full-time training (LTFT). Despite this, concerns remain regarding access to, and information about, flexible training for surgeons. This study aimed to assess the opinions and experiences of LTFT for surgical trainees. DESIGN Prospective, questionnaire-based cross-sectional study. SETTING/PARTICIPANTS An electronic, self-administered questionnaire was distributed in the UK and Republic of Ireland through mailing lists via the Association of Surgeons in Training and British Orthopedic Trainee Association. RESULTS Overall, 876 completed responses were received, representing all grades of trainee across all 10 surgical specialties. Median age was 33 years and 63.4% were female. Of those who had undertaken LTFT, 92.5% (148/160) were female. Most worked 60% of a full-time post (86/160, 53.8%). The reasons for either choosing or considering LTFT were childrearing (82.7%), caring for a dependent (12.6%) and sporting commitments (6.8%). Males were less likely to list childrearing than females (64.9% vs 87.6%; p<0.0001). Only 38% (60/160) found the application process easy and 53.8% (86/160) experienced undermining behaviour from workplace staff as a result of undertaking LTFT. Of all respondents, an additional 53.7% (385/716) would consider LTFT in future; 27.5% of which were male (106/385). Overall, only 9.9% of all respondents rated current LTFT information as adequate. Common sources of information were other trainees (47.3%), educational supervisors (20.6%) and local postgraduate school website (19.5%). CONCLUSIONS Over half of surgical trainees working LTFT have experienced undermining behaviour as a result of their LTFT. Despite a reported need for LTFT in both genders, this remains difficult to organise, access to useful information is poor and negative attitudes among staff remain. Recommendations are made to provide improved support and information for those wishing to pursue LTFT.
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Affiliation(s)
- Rhiannon L Harries
- Association of Surgeons in Training Council, Association of Surgeons in Training, London, UK
| | - Vimal J Gokani
- Association of Surgeons in Training Council, Association of Surgeons in Training, London, UK
| | - Peter Smitham
- The British Orthopaedic Trainees Association, British Orthopaedic Association Offices, London, UK
| | - J Edward F Fitzgerald
- Association of Surgeons in Training Council, Association of Surgeons in Training, London, UK
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Harries RL, McGoldrick C, Mohan H, Fitzgerald JEF, Gokani VJ. Less Than Full-time Training in surgical specialities: Consensus recommendations for flexible training by the Association of Surgeons in Training. Int J Surg 2015; 23 Suppl 1:S10-4. [DOI: 10.1016/j.ijsu.2015.09.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Gordon MB, Sectish TC, Elliott MN, Klein D, Landrigan CP, Bogart LM, Amrock S, Burke A, Chiang VW, Schuster MA. Pediatric residents' perspectives on reducing work hours and lengthening residency: a national survey. Pediatrics 2012; 130:99-107. [PMID: 22665414 DOI: 10.1542/peds.2011-3498] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE In 2011, the Accreditation Council on Graduate Medical Education increased restrictions on resident duty-hours. Additional changes have been considered, including greater work-hours restrictions and lengthening residency. Program directors tend to oppose further restrictions; however, residents' views are unclear. We sought to determine whether residents support these proposals, and if so why. METHODS We surveyed US pediatric residents from a probability sample of 58 residency programs. We used multivariate logistic regression to determine predictors of support for (1) a 56-hour workweek and (2) the addition of 1 year to residency to achieve a 56-hour week. RESULTS Fifty-seven percent of sampled residents participated (n = 1469). Forty-one percent of respondents supported a 56-hour week, with 28% neutral and 31% opposed. Twenty-three percent of all residents would be willing to lengthen training to reduce hours. The primary predictors of support for a 56-hour week were beliefs that it would improve education (odds ratio [OR] 8.6, P < .001) and quality of life (OR 8.7, P < .001); those who believed patient care would suffer were less likely to support it (OR 0.10, P < .001). Believing in benefits to education without decrement to patient care also predicted support for a 56-hour-week/4-year program. CONCLUSIONS Pediatric residents who support further reductions in work-hours believe reductions have positive effects on patient care, education, and quality of life. Most would not lengthen training to reduce hours, but a minority prefers this schedule. If evidence mounts showing that reducing work-hours benefits education and patient care, pediatric residents' support for the additional year may grow.
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Affiliation(s)
- Mary Beth Gordon
- aDivision of General Pediatrics, Children’s Hospital Boston, Boston, Massachusetts 02115, USA.
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Rushton JL, Djuricich AM. The intersection of flexibility and outcomes in pediatric education. Acad Pediatr 2012; 12:17-9. [PMID: 22243707 DOI: 10.1016/j.acap.2011.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2011] [Accepted: 11/08/2011] [Indexed: 11/16/2022]
Affiliation(s)
- Jerry L Rushton
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, USA
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Abbett SK, Hevelone ND, Breen EM, Lipsitz SR, Peyre SE, Ashley SW, Smink DS. Interest in and perceived barriers to flexible-track residencies in general surgery: a national survey of residents and program directors. JOURNAL OF SURGICAL EDUCATION 2011; 68:365-371. [PMID: 21821214 DOI: 10.1016/j.jsurg.2011.04.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2010] [Revised: 03/30/2011] [Accepted: 04/27/2011] [Indexed: 05/31/2023]
Abstract
OBJECTIVE The American Board of Surgery now permits general surgery residents to complete their clinical training over a 6-year period. Despite this new policy, the level of interest in flexible scheduling remains undefined. We sought to determine why residents and program directors (PDs) are interested in flexible tracks and to understand implementation barriers. DESIGN National survey. SETTING All United States general surgery residency programs that participate in the Association of Program Directors in Surgery listserv. PARTICIPANTS PDs and categorical general surgery residents in the United States. MAIN OUTCOME MEASURES Attitudes about flexible tracks in surgery training. A flexible track was defined as a schedule that allows residents to pursue nonclinical time during residency with resulting delay in residency completion. RESULTS Of the 748 residents and 81 PDs who responded, 505 residents and 45 PDs were supportive of flexible tracks (68% vs 56%, p = 0.03). Residents and PDs both were interested in flexible tracks to pursue research (86% vs 82%, p = 0.47) and child bearing (69% vs 58%, p = 0.13), but residents were more interested in pursuing international work (74% vs 53%, p = 0.004) and child rearing (63% vs 44%, p = 0.02). Although 71% of residents believe that flexible-track residents would not be respected as the equal of other residents, only 17% of PDs indicated they would not respect flexible-track residents (p < 0.001). CONCLUSION Most residents and PDs support flexible tracks, although they differ in their motivation and perceived barriers. This finding lends support to the new policy of the American Board of Surgery.
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Affiliation(s)
- Sarah K Abbett
- Department of Surgery, Brigham and Women's Hospital, Boston, MA 02115, USA
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Affiliation(s)
- Bonita Stanton
- Department of Pediatrics, Wayne State University, Children's Hospital of Michigan, Detroit, MI 48201, USA.
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Berkowitz CD, Frintner MP, Cull WL. Pediatric resident perceptions of family-friendly benefits. Acad Pediatr 2010; 10:360-6. [PMID: 20692217 DOI: 10.1016/j.acap.2010.06.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2010] [Revised: 06/18/2010] [Accepted: 06/22/2010] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to examine the importance of family-friendly features in residency program selection, benefits offered to and used by residents, and importance of benefits in future job selection. METHODS A survey of a random, national sample of 1000 graduating pediatric residents in 2008 was mailed and e-mailed. RESULTS Survey response rate for graduating resident respondents was 59%. Among the respondents, 76% were women. Thirty-seven percent of men and 32% of women were parents. Residents with children were more likely than residents without children to rate family-friendly characteristics as very important in their residency selection (P < .05). Many residents reported that their programs offered maternity leave (88%), paternity leave (59%), individual flexibility with schedule (63%), and lactation rooms (55%), but fewer reported on-site child care (24%), care for ill children (19%), and part-time residency positions (12%). Among residents reporting availability, 77% of women with children used maternity leave and lactation rooms. Few held part-time residency positions (2%), but many expressed interest (23% of women with children). The majority of residents with and without children reported that flexibility with schedule was important in their future job selection. Most women with children (71%) and many women without children (52%) considered part-time work to be very important in their job selection. CONCLUSIONS Family-friendly benefits are important to residents, particularly those with children. The data provides a benchmark for the availability and use of family-friendly features at pediatric training programs. The data also shows that many residents are unaware if benefits are offered, which suggests a need to make available benefits more transparent to residents.
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Affiliation(s)
- Carol D Berkowitz
- Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, Calif, USA
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