Emma Toman: Don’t underestimate the value of “non-training” junior doctor posts

Non training posts for junior doctors provide great benefits both for the junior doctors that choose them and the NHS, says Emma Toman

An increasing number of junior doctors are taking the colloquially named “F3” year following the completion of the Foundation Programme. [1] Having recently entered a specialty training post, cutting short my “F8” year, this is an opportune time to reflect on the frequently overlooked benefits that come with non-training , both for junior doctors and for the NHS institutions in which they work.

Perhaps the most obvious benefit as a non-trainee is that one may choose a geographical location in which one wants to work. Many junior doctors are in relationships with other junior doctors, an unsurprising phenomenon that is complicated by the postcode lottery of national training number allocations. Many are forced to make difficult decisions about moving away from their loved ones. Starting a family is often a logistical, and emotional, minefield. Non-training jobs provide a level security for a family that cannot be replicated within rotating national training number posts.

Remaining in the same location for periods of time extending beyond the traditional six months allows non-training doctors to identify clinical mentors and develop strong relationships with them. Mentorship plays a vital role in the career development of junior doctors and being able to spend extended amounts of time working with a colleague who inspires and supports you is invaluable. This also means that non-trainees are in a unique position to execute and develop local projects, which are comparable to national training number posts frequently migrating round departments.

Being free from a rigidly structured training programme, non-training doctors also have the freedom to pursue their own interests outside of immediate clinical training and ultimately design their own career pathway. Examples of these interests include research, non-medical higher degrees, or teaching. This requires a great deal of organisation to maintain a coherent CV, equivalent portfolio evidence and annual appraisal, but it is entirely achievable with the consistent support of clinical mentors.

Having recently experienced the process of national selection I believe that entry into national training number posts is inherently biased towards UK medical graduates. We are trained throughout our time in UK medical schools on how to “score points” on application forms and at interview. I fear this approach to national training number post allocation leads to a rather narrow spectrum of personalities, experiences and ideas that are being recruited to specialty training. Having worked with many other non-trainees over the past five years I have relished working among a group of clinicians that provides so much variety of experience, ideas and character. Such diversity should be embraced lest we become a workforce of carbon copies. 

I have been fortunate to work in departments where non-trainees are treated relatively equally compared to their national training number equivalents in terms of clinical responsibility and training opportunities. Other non training doctors, however, have described a discrepancy in workload allocation. 

It is commonplace for non-trainees to be used primarily for service provision. Non-trainees provide continuity among the junior doctor workforce in most departments so equal training opportunity is imperative in order to retain staff and advance skills, which benefits the whole department. For this to happen a synergistic relationship must develop between trainees and non-trainees. As junior doctors we feel so much pressure to complete training and secure a consultant post. Ultimately, we will be working well into our sixth decade, so what is the rush? Adding a couple of years at the dawn of our careers to gain greater experience outside of our eventual specialty should be encouraged. 

My experience as a non-trainee has enabled me to secure a job in a location with my family and in a specialty I love. The experience I gained in non-training posts has given me greater clarity with regards to my future career plans. Not only should we support non-training junior doctors, but should actively encourage junior doctors to explore the wide variety of experiences that non-training can offer.

Emma Toman is a neurosurgery West Midlands Academic Clinical Fellow (ST3) and a part time PhD student at the University of Central Lancashire. Her interests include traumatic brain injury, polytrauma and multi-disciplinary team working.

Competing interests: None declared


[1] Checkley, E. and S. Remington, The new F3 year.BMJ, 2016. 354: p. i4041.