There are several reasons why pharmacy preregistration trainees switch placements during their training. Often, trainees can feel aggrieved, despondent and generally unhappy when the training experience fails to meet their expectations.
The Pharmaceutical Journal recently highlighted the increasing number of switches made by preregistration trainees in recent years. However, it would be a mistake for all trainees to view switching training sites as commonplace, or the best solution, if dissatisfied with their training experience.
In all situations, the first person that trainees should approach in an attempt to resolve any issues is their tutor; but where a trainee feels their tutor is not handling their training or concerns in a satisfactory manner, or if the grievance is with their tutor, Box 2 provides alternative sources of help and advice.
This is not a decision that should be taken lightly; there are several factors every trainee should consider before making the decision to change training sites.
1. Level of expectations
Undergraduate pharmacy students rely on information provided by prospective employers through Oriel, the centralised recruitment portal for preregistration training, or through external job advertisements, to decide on a potential training provider. A trainee may experience disappointment if what was promised in an advert — for example, being able to shadow pharmacists during patient consultations — is not what is being delivered.
Before considering a switch to a new site, individuals should speak to other trainees from a range of settings to compare expectations and experiences. Trainees should also approach experienced tutors who are not affiliated with the same training provider, or a trusted lecturer from their university, for impartial advice. This can be useful in determining whether their expectations of their training provider are realistic and whether their experiences warrant a switch to a new preregistration training site.
2. Support offered
Trainees expect to be allocated a suitably qualified and experienced tutor to support them. It is a requirement from the General Pharmaceutical Council (GPhC) that tutors are experienced and have worked in the sector they are tutoring in for at least three years before becoming a tutor. Tutors are also required to comply with the preregistration tutor suitability policy, which sets out the requirements for pharmacists who wish to become tutors. This means that no concerns regarding becoming a tutor should be found following an assessment carried out by the GPhC.
To ensure adequate support during the training year, both the tutor and their trainee should discuss and sign a learning contract. This is a written agreement which covers the main aspects of working together. It clarifies what is expected in preparation for, and during, the preregistration training year.
Trainees have the right to expect support from their tutors and, at the very least, trainees should be receiving regular constructive feedback and guidance regarding professional development and action plans. If the tutor is unable to provide adequate support, then the trainee is at a disadvantage and it would not be unreasonable to decide to continue their training elsewhere.
3. Learning opportunities
Trainees may be allocated protected learning time in the community, or regular teaching time in hospitals, as part of their programme, but on-the-job learning can be absent in some placements.
If trainees feel that they are not learning from the pharmacy team while performing their required day-to-day activities, this can lead to significant levels of dissatisfaction. There may be instances where trainees are expected to perform tasks in the pharmacy, such as filling dosette boxes, without their supervisors providing opportunities to develop clinical skills or improve their knowledge of the medicines.
Both trainees and tutors should be clear in their expectations of how learning will be supported from the outset. This can be done through the agreed and signed learning contract. Where there is still little opportunity for learning and/or reflection, despite a discussion taking place between the trainee and their tutor, a switch to a new training site may be appropriate.
4. Distance from home
Personal issues which require the trainee to relocate are difficult to manage for both the trainee and the employer.
Trainees often misjudge the length of their commute to their workplace and cite this reason for wanting to switch placements to somewhere closer to home. However, this is not a legitimate reason to switch training placements as it is the responsibility of the prospective trainee to undertake this type of basic research before accepting or preferencing a training location through Oriel.
However, where reasons for switching include family or health-related issues, it is necessary for trainees to raise any potential issues with their tutor as soon as possible (see Box 1).
Box 1: Case study
This case study is based on a real scenario and has been anonymised.
Alan, a trainee, has accepted a pharmacy preregistration training placement offer at a hospital in Wales. He lives in Manchester and had ranked the hospital sector as high in his preferences. He has a medical condition which requires him to see a specialist frequently in Manchester. He does not want to work in community, but has received an offer in a large multiple in Manchester near his home.
Alan is faced with a difficult situation: his medical condition has deteriorated recently, which has resulted in a change of circumstances. He has the option of going to Wales, but the travel to and from Manchester will compromise his training and will be expensive on top of his living costs.
He has not yet informed his employer in Wales as he is worried about the potential consequences. He has also not informed the community pharmacy of his circumstances and is considering his options. If he declines the hospital in Wales, they will have a vacant post as the Oriel process has now closed and all appointable candidates have been placed.
In the first instance, Alan should contact the appropriate person at the hospital in Wales — for example, the pharmacy training and education lead — to explain his situation and change of circumstances. It may be that they can be more helpful than he thought and may be able to support him with reasonable adjustments to suit his needs. For example, they may be able to refer him to the occupational health service at the hospital. If he does not inform the hospital, he will not know where he stands and will worry unnecessarily. He should be open about his situation and explain his concerns. He should also do this before formalising a contract with the community pharmacy in Manchester, should he choose that route instead.
5. Relationship with tutor
In all situations, the first person that trainees should approach in an attempt to resolve any issues is their tutor; however, where a trainee feels their tutor is not handling their training or concerns in a satisfactory manner, or if the grievance is with their tutor, Box 2 provides alternative sources of help and advice.
Box 2: Where to go for more information and advice
If a trainee feels their tutor is not handling their concerns satisfactorily, additional advice can be sought from a training lead (if a large company), or line manager who can act as an intermediary or facilitate a face-to-face conversation.
External, confidential advice is also available from:
- The General Pharmaceutical Council — national preregistration facilitators who are extremely helpful and experienced;
- Pharmacist Support — a pharmacy charity with a wealth of experience providing advice and support on such issues;
- RPS Professional Support — free and impartial advice for RPS members.
A working relationship between preregistration tutors and their trainees can break down due to mismatched personalities or expectations which, despite attempts at a resolution, can result in a trainee wanting to leave. This is not uncommon and some employers with multiple branches may be able to accommodate a switch to a new site without compromising the training year.
A good way to avoid miscommunication or a relationship breakdown is by having a well-planned induction period, where the trainee is involved in their training plan from the start, with ongoing monitoring and constructive feedback delivered by the tutor.
Where the trainee is being subjected to inappropriate behaviour or bullying — whether physical or verbal, and including abusive behaviour or inappropriate conversations relating to any of the protected characteristics (i.e. race, religion/belief, age, gender, disability, sex, sexual orientation, maternity/pregnancy, marriage/civil partnerships) — the trainee has every right to request a switch to a new placement site and/or raise a concern with the GPhC.
6. Adjustment period
Transitioning from a university environment to a working environment can cause many trainees to question their choices. This is perfectly normal and often a period of adjustment is all that is needed.
Trainees thinking of switching sites should consider that most places of work will have similar physical demands and will require full working days, much of which are spent standing. Therefore, switching training sites for this reason is unlikely to result in the desired outcome.
Of course, trainees are well within their right to switch placements where they experience breaches of their employment contract. For example: breaches related to payment, annual leave, working hours or if the trainee is required to work at a site which engages in unsafe or illegal practices.
The decision to switch training sites during the preregistration training year should not be made lightly. Trainees must be certain the issues causing their desire to leave cannot be resolved, and confident that the training site they are moving to will better meet their needs.
In general, life and work are rarely smooth and devoid of obstacles, and the preregistration training year is no different. Not everything will be to the trainee’s liking — success comes from communicating early and getting good advice from experienced, trusted sources.
About the authors
Aamer Safdar is pharmacy, education, training and workforce development team lead at Barts Health NHS Trust
Khalid Khan is head of training and professional standards at Imaan Healthcare and preregistration training programme director at Health Education England