Section 2: Study Leave Details

• Form to be signed by trainee and trainer prior to forwarding form to: Rob Cooper, West Midlands Workforce Deanery- fax0121 695 2541in order for final approval to be given and onward transmission for payment to be made. A copy of the signed form will be returned to you confirming approval.

SECTION 1: PERSONAL DETAILS

SpR

NAMESHO

SpT

PLACEMENT

LOCATION

SECTION 2: STUDY LEAVE DETAILS

CourseConferenceHome StudyOther (please state)

Number of days requestedTotal Cost£ ______

Cost Breakdown (see notes On page 2)

Conference fee (if applicable)£ ………………

Subsistence costs (if applicable)£ ………………

Estimated Travel cost£ ………………

Overnight Hotel accommodation £ ……………… Maximum Allowance £55.00 per night

COURSE/CONFEENCE DETAILS:-

Course Name:………………………………………………………………

Course Date:………………………………………………………………

Course Location:………………………………………………………………

Please indicate if a place has already been reserved. Yes No

SECTION 3: AUTHORISATION

I confirm that this application does not exceed my Study Leave Allowance.

Trainee Signature: ……………………………………………… Date …………………………

Your Trainer’s Authorisation...... Date…………………………

Programme Director’s Authorisation

STUDY LEAVE GUIDANCE

Year of Scheme / Total Study Leave Available / Set Study Days / Flexible Study Leave Days
Tutorial days
equivalent / CPD Events
1 / MPH organized Events / 10 approx / 3 / 0
2 / 25 days / 6 / 3 / 16
3 / 30 days / 6 / 3 / 21
4 / 30 days / 6 / 3 / 21
5 / 30 days / 6 / 3 / 21

• The study leave year runs from 1 August each year.

• Part time Trainees to have flexible study leave days pro-rata to their whole time equivalent

• For organised tutorials which are for half a day each and, therefore, any arrangements with trainers whereby the whole day is taken as study leave will mean that the remaining half day should be deducted from the flexible study leave total

• For all private study leave days used for examination preparation (i.e. MPH, Part I or Part II) objectives should be agreed with trainer and evaluated afterwards

• A maximum of 10 days per annum can be taken for private study and a maximum of 5 days at any one time

• If the Trainee attend in excess of 3 CPD days in a year, the remainder should be deducted from the flexible study days

• Mileage claimed as a travel expense for study leave days is paid at ‘public transport rate’

• All Trainees are encouraged to attend the Faculty’s Annual Conference at least twice during training

• A study leave day should be taken on the day of the examination

STUDY LEAVE EXPENSES

Please note costs for overnight hotel accommodation will be reimbursed ONLY up-to Whitley Council rates (currently £55.00 per night) and travel up to equivalent of 2nd class Rail. Cheap deal travel should be utilised where possible considering travel times.

Mileage to attend business meeting for the PCT or other Placement organization – is claimed at business rate. All other mileage is claimed at PTR – rate (eg tutorials, modules).

Flight costs are reimbursed at economy class rate – on a maximum and only up-to the level of 2nd class rail.

Subsistence is reimbursed at Whitley Council rates level ONLY.

ANY EXCESS TO THESE AMOUNTS WILL NEED TO BE COVERED FROM TRAINEES OWN FUNDS

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