It's taking me a bit longer to become a consultant but the things I’ve seen and experienced are completely worth it!

Dr Chris Hands explains how working less than full time gave him a chance to support children's charities and help rebuild paediatric emergency care structures in Sierra Leone.

When I began specialist training, I didn’t imagine that I would choose to go less than full-time, and I’ve been lucky that the level of flexibility for working LTFT (less than full time) and taking time out of training is fantastic in paediatrics. Through working LTFT, I managed to balance my training with work for children’s charities and overseas.

While at medical school, I was involved in a student group that provided support for refugee children and families in South West London. When the group started to grow beyond our expectations we registered as a charity (now called CARAS). Soon I was directing the strategy and sharing the responsibility for managing the staff with a colleague, and while it had some links to my ‘day job’, trying to juggle the work at the charity and my training was getting increasingly tricky.

Looking back, not all of my decisions were wise as, despite already being too busy, I also became involved with the Moroccan Children’s Trust, an amazing small charity that works on child protection systems, and specifically with children who live and work on the streets in Morocco. We built a local social work programme that continues to reunite children with their families and helps keep them safe, and have delivered wider policy initiatives, including a national birth-registration programme. The organisation is going from strength to strength, and we are now running the first ever government-backed fostering programme in Morocco in partnership with Unicef.

I juggled my work with both charities - including working out more sustainable options - and my training

The pressure of work reached a point where I realised it was impossible to balance all the different parts of my life (and to try to see friends and family once in a blue moon too) so I decided to look at whether I could start training less than full time. Thankfully, the deanery agreed and I moved to 60% so that I could continue my training but also devote some time to both charities. So, from 2013-2015 (for my Specialty Training 4 and 5 years), I just about juggled my work with both charities – including working out more sustainable options and handing over when needed – and my training.

In 2015, I was all set to go back to full time training, except… the College had an amazing opportunity to go to Sierra Leone to help rebuild paediatric emergency care structures in Freetown after the Ebola crisis. So my wife and I spent two years working in Freetown in Sierra Leone, improving emergency paediatric care in the tertiary children’s hospital, and gaining funding for a national ETAT+ (Emergency Triage Assessment Training plus) programme that trained staff in every government hospital.  The successes of the 2017 programme have led to three further years of funding, and we have handed over the in-country management to Emma Bailey, but we still sit on the programme board and support strategy and development of the work.

Working LTFT and taking time out of my training has given me some extraordinary experiences and skills

So, finally, I’m back to training full time. But working LTFT and taking time out of my training has given me some extraordinary experiences and helped me to develop different skills. My work with the two charities has given me management skills and I’ve learnt different strategies for supporting colleagues. The ETAT+ programme has made a big difference to paediatric care in in Sierra Leone, and I hope that the work of both charities has helped and supported kids both here and abroad.

Okay, so it’s not been easy. Life has been incredibly busy, it’s hard to maintain a balance, and it has been tough on personal relationships at times. But, if you’re considering moving to LTFT or have other commitments be it other work or family, I’d say go for it. Yes, it's taking me a bit longer to become a consultant but the skills I’ve learnt, things I’ve seen and experienced, are completely worth it!


Find out more about how you can get involved in RCPCH global child health programmes, and read our guidance on working less than full time.

Interested in applying for a post in paediatrics? Read our guidance for ST1 and ST2 posts.