Who should use the guidance?

This guidance is for doctors in training returning to practice after a period of absence. All doctors have a professional duty to ensure that they are safe to return to practice and therefore must identify and address issues arising from absence and help set in place necessary processes to support them to update their skills and knowledge.

How should this guidance be used?

Evidence gathered by the Return to Practice Working Group suggested that the longer the period out of practice, the more robust the process of return to practice should be; however, all return to practice assessments should be robust, appropriate and commensurate with the period of absence.

Shorter absences (three months or less) are less likely to present significant problems, but may still affect confidence and skills levels. In the majority of cases the trainee doctor will be able to return to work safely and successfully.

Longer term absences (of three months or more) are more likely to significantly affect skills and knowledge therefore the assessment and approach should be commensurately robust the longer the period of absence to ensure patient safety and to support the trainee doctor.
There are a number of reasons why a doctor in training may be absent for a prolonged period of time (more than three months); these include maternity leave, career break, health issues, GMC suspension etc. It is not possible in all cases for the trainee doctor to maintain their knowledge and skill levels and therefore may require a period of refreshment of skills before the trainee doctor formally returns to the training programme.

Return to practice action plan

A clear and supportive process for the return to practice of the trainee doctor should be in place within the employing Trust. Equally the trainee doctor has a professional responsibility to ensure they are safe to return to practice and follow the recommendations.

When formulating a return to practice action plan input may be required from the following:-

  • Postgraduate Dean (or nominated deputy)
  • Head of School and /or Training Programme Director / Foundation Programme Director
  • Director of Medical Education
  • Educational Supervisor
  • Occupational Health (if absence is health related)
  • Human Resources at the employing Trust or Practice

Consideration should be given to:-

  • Period of phased return to the work environment
  • Supernumerary arrangements for a period of time, if needed
  • Flexible working arrangements as delineated in the ‘less than full time working policy’
  • Setting up formal or informal mentoring arrangements
  • Offering coaching to improve well-being and performance

A review of the progress made by the trainee doctor should be conducted after a reasonably short period of time to ensure there are no causes for concern and assess level of competence so the ‘training clock’ may recommence.

South West Peninsula Postgraduate Medical Education would like to acknowledge the work undertaken by the Return to Practice Working group whose report facilitated this guidance. The report is available is available from the Academy of Medical Royal Colleges website.