Clinical oncology return to training toolkit

As per the SuppoRTT guidance, an absence planning meeting should be organised between the trainee and their Educational Supervisor/Training Programme Director at least 3 months prior to the planned leave. In situations where it is not possible to perform this meeting immediately, for example absence for health reasons, the meeting may be performed remotely as soon as possible after the absence period has started. In such circumstance the trainee should also involve the Occupational Health department.

Points for discussion during this meeting should include:

1. The anticipated period of time away from training
2. Outstanding educational/training assessments/ACRP requirements
3. Provisional plans for the return to training
4. Options for staying up to date (e.g. Keeping in Touch (KIT) days)
5. Funding available on return
6. Discussion regarding Less than Full Time / Full time working on return

We would also recommend discussing and documenting the level of experience of the trainee in specific clinical oncology capabilities during this initial meeting. The clinical oncology prior to absence supplementary form has been developed to enable this and trainees are encouraged to make use of this. 

Please note, for trainees in England, the HEE SuppoRTT planning for absence form should also be completed at this meeting

Planning your return

A meeting between the trainee and Training Programme Director or Educational Supervisor should be arranged ideally at least 6 - 8 weeks prior to the return to work start date, where feasible. This meeting is held to discuss arrangements for the next training placement, any particular areas of concern, and to agree a plan for supported return to training.

Points for discussion during this meeting should include:

1. Educational needs, learning objectives, ARCP requirements
2. Plan for supported return
3. Resources available – refresher courses, return to clinical practice workshops, coaching sessions from the PSU, on line e learning resources for PSU
4. Supervision – funding available for first 3 weeks to support a locum to enable supernumerary role
5. Phased return for out of hours working
6. Trust and Departmental Induction
7. Scheduling meetings with HR and/or Occupational Health – discuss days worked, rotas, occupational health needs

Keeping in Touch (KIT) days can be used to perform supervised clinical work, attend meetings, courses, conferences, local/regional teaching days or to attend departmental induction days. They can be taken as a half or full days.

Please note, for trainees in England, the HEE SuppoRTT planning return to work form should be completed at this meeting.

Supporting your return

It is expected that all oncology trainees will require a period of additional supervision in the first 2-3 weeks of their return irrespective of seniority. The ongoing level of support required will be dependent on the trainee’s prior level of experience and length of time away from training. Every trainee has different needs for their period of re-introduction and needs to feel supported. Be mindful that more senior trainees still require support and may not be able to work independently without any level of supervision immediately.

In addition, it is recommended returning trainees are omitted from the on-call rota for the initial few weeks from their start date back. If possible, provision could be made for the trainee to attend an on-call shift (or part of) in a supernumerary capacity prior to this.

During this period, the trainee should have a meeting with their educational supervisor or TPD, where an individualized programme could be devised regarding the number of radiotherapy plans / systemic treatment to be completed supervised prior to independent practice for the senior trainees or palliative planning for those who have obtained Part 1.

The clinical oncology supported return supplementary form has been developed to enable this and trainees are encouraged to make use of this.

Contact a week after returning to practice would be advised to discuss any initial concerns the trainee has and to provide support in the first days back. This could be by whatever means deemed appropriate e.g telephone, email or in-person. Individual trainees may require differing frequency of contact following this.

At the end of the agreed supported return period the trainee must have a follow up review meeting with their educational supervisor or TPD.

Documenting workplace based assessments completed during this period could support this meeting and evidence the level of supervision required going forward. The clinical oncology review of return supplementary form has been developed to enable this and trainees are encouraged to make use of this. 

This meeting will have one of two possible outcomes:

1. If both the trainee and the supervisor/TPD agree that sufficient progress has been made, the return to work period can be signed off and the trainee should then re-join the normal rota.
2. If both the trainee and the supervisor/TPD agree that the necessary level of confidence and competence has not yet been reached, the supported return period should be extended.

If an extended period of supported training is expected, this should be discussed as early as possible. In the unusual event that this is significantly prolonged, this should be discussed with the TPD/Head of School. Any outstanding occupational health issues should also be addressed and involve supportive processes like Occupational health, Professional Support Unit, Practitioner Health Programme.  A new end date for the supported period should be agreed and at the end of the extension another meeting should take place.

For trainees in England, the HEE SuppoRTT following supervised return form should be completed at this meeting.