Learning Experiences Abroad Adding Value in Medical Education (LEAVE): Results From the LEAVE Trainee Experience Survey.

introductionTo facilitate professional development, resident doctors (RDs) in UK training programmes are contractually entitled to take study leave to pursue activity related to progression of training, at the discretion of their Training Programme Director. In Scotland, NHS Education for Scotland (NES) is responsible for managing training delivery and allocating study budgets. In 2024, NES announced a temporary change to study leave policy restricting the use of international study leave for RDs before reversing this decision after pressure from interest groups. Increasingly, RDs in training are reporting high rates of stress, burnout and mental health issues. There are many reasons for this, including reports of financial difficulties, access to study leave and variation in institutional policies. There is relatively little data regarding RD views on funding or the use of international study leave. We are the first to present UK data, highlighting viewpoints on international study leave and funding use by RDs in Scottish training programmes.

methodsRDs in Scotland's medical specialty training programmes were surveyed using a questionnaire that included both closed and open response questions, designed with collaborative input from authors in diverse medical fields. Descriptive statistical analysis of quantitative data was conducted using Microsoft Forms. Qualitative analysis of free-text responses was conducted with the aid of Google Gemini software.

resultsIn total, 348 responses were obtained from a variety of medical specialties and levels of seniority. International study leave had been used by 42% (n = 146) of RDs since commencement of training, with 77% (n = 269) intending to utilise international leave in the future. An overwhelming majority (98%, n = 342) felt concerned about potentially losing the opportunity to take international study leave. RDs reported estimated personal costs to continue training of up to £3,000 (39%, n = 133) and up to £1,000 (47%, n = 159) per annum. Most (80%, n = 278) felt that the study budget in Scotland was not appropriate to support training needs and aspirations. Responses to questions about international study leave on the Likert scale were generally favourable.

conclusionThis national survey is the largest of its kind in detailing the opinions of RDs regarding international study leave, specifically in terms of perceived value and cost. The data represent a wide range of medical specialisms and grades of seniority.
 Overall, the majority of RDs seek to utilise international study leave in the future. The study budget in Scotland does not cover the RD needs and aspirations in the majority of cases, with individuals incurring high personal costs to continue specialty medical training. There is overall support for the use of international study leave and a high level of concern regarding the potential removal of this learning opportunity. Responses highlighted multiple benefits international study leave brings to research and collaboration. Respondents reported reduced levels of stress and increased enthusiasm on return to work. RDs felt international study leave was cost-effective and allowed them to access learning opportunities not available within NHS Scotland. It is of paramount importance to address funding and accessibility concerns regarding international opportunities, ensuring equitable access and preparing future consultants for independent practice.