Currently I’m an ST6 subspecialising in cardiac imaging - CMR and complex echo - in the West Midlands deanery. I applied for LTFT training for health reasons - I have end stage chronic kidney disease and became dialysis dependent in 2006. I need to dialyse 4x weekly at 4 hours per session which I do at home as this allows greater flexibility with work commitments.

When I came into the training number at ST3 level, I was working full-time, and dialysing, which was tough but doable. I didn’t know about the possibility of LTFT training until a consultant geriatrician friend suggested it. Applying was relatively simple and quick. Having the equivalent of an extra day off a week (I work 80%) is kinder to myself and something I don’t regret.

The deanery have been pretty supportive of my circumstances and have placed me at hospitals relatively nearby to limit commuting time.

My timetable sessions are as follows: 3 of CMR, 1 TOE, 1 stress echo, 1 clinic, 1 complex echo, and 1 admin. Despite being 80% LTFT, I still partake in 100% on-call rota (1 in 10).

Because I don’t want to miss any important sessions, I end up having two half days instead of one day off during the week. In my experience, taking half days off isn’t ideal, as if you’re anything like me, I never leave on time - sometimes at 1500, much to the horror of my wife and colleagues.

What do I do on my half days? I pick my son up from school and take him for his swimming lessons. On the other day, I try to get onto dialysis early so that I can have some family time in the evening.

What are the good bits? Having extra time during the week to do spend with my son is fantastic, and being able to get on dialysis at leisure as opposed to rushing home from work in the evening to try to fit it in before bed.

What are the bad bits? Workload still feels the same. I have an endless number of CMR/echo reports to do, but never have the time, so that usually means coming in early/staying late, or logging in via VPN at home (during dialysis). All this extra time isn’t recognised and training is still longer with LTFT.

Would I recommend it? Definitely, whatever your circumstances. I know a number of colleagues gone through their medical career and regretted missing out on family/children growing up/non-medical aspects of life. For me, it has been mainly health reasons that I chose LTFT, but being able to spend it with my son and family has been invaluable. Most of my placements have been completely supportive of LTFT training. Of course there has been opposition amongst some, but I can say this was definitely in the minority.