Flexible rheumatology training gives ‘work-life balance’ without job sharing

A pilot program of flexible training for advanced rheumatology trainees has been a great success in providing work-life balance without the need to ‘job share’.

One of the program leads Associate Professor Ana Ananda told the limbic that despite the complications of COVID-19, the program had worked incredibly well for trainees managing the competing priorities of career progression and family responsibilities.

“And from a departmental point of view it allowed us to completely meet all of our responsibilities in terms of outpatient care, reducing waiting lists and waiting times, and improving access to public clinics.”

She explained that historically people who needed more work-life balance have had to job share.

“One of the disadvantages of job share is that it is incumbent upon the trainees to find the other half of the pair and if you don’t find them you are often stuck trying to do a full time job when you really don’t have capacity or just take a year off which has enormous implications,” she said.

“The rationale for flexible training was that we can still have two 0.5s but they don’t have to be a job share. They are two independent people and that way their performance is also not linked to each other.”

Associate Professor Ananda, senior staff specialist in rheumatology, said the trainees each work 2.5 days per week but overlap on 1.5 of those days when core departmental, educational and ward round activities were happening.

“That was the novel part of it in that it allowed for trainee needs to be met – their teaching, networking and educational opportunities – while allowing them to get all the clinical experience they needed.”

“That was critical for us because that is when a lot of the banter and discussion about patients happens, the nuances, the little things that you pick up on a ward round that you don’t necessarily pick up in a text book.”

She said programs like this would deliver opportunities not just to young women and men with parenting responsibilities but to others who might have to care for elderly parents or who might have their own medical issues.

“So it allows people for all sorts of reasons to have a 0.5 position and not feel guilty about it – which is hard in medicine.”

Dr Bethan Richards, chief medical wellness officer at Sydney Local Health District, told the limbic it was a little surprising that people were celebrating having dedicated flexible training positions in 2020.

“It does speak to a culture that is somewhat archaic and needs to change.”

“We’ve got a pilot that works, we’ve got admin engaged. We just need to show some pilots in other fields and take the fear out of it for everyone in order to achieve a cultural shift,” she said.

“We’ve proven it in an outpatient based model, and it would certainly be easier to replicate in any of the other medical specialties that have a predominately OPD based service.”

She said they were also talking to the surgeons about how it might work within their training model.

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