The Royal College of Emergency Medicine has published new guidance for EM clinicians who may be planning to pause their training.
Time Out of Training (TOOT), refers to a temporary break from training that a resident doctor can take for reasons such as carer’s leave, ill health, research leave, alternative training or a career break.
RCEM’s new document on TOOT, published today (27 January 2026), acts as a best practice guide for resident doctors, as well as a reference for what education supervisors and training programme directors must consider if a trainee decides to take TOOT.
It features a checklist of steps to consider before taking the time out, such as reviewing ePortfolios and considering pay implications of taking the break.
The guidance also includes a checklist for returning, and guidance on a smooth transition back into training.
While aimed at resident doctors, the principles of the document can also apply for locally-employed doctors (LEDs) and consultants opting to take a break from their roles.
Our guidance also acknowledges the importance of having TOOT as an option for EM clinicians, due to the high intensity of training in this specialty.
The document was developed alongside the NHS England London Supported Return to Training team, RCEM Vice Presidents for Scotland, Wales and Northern Ireland, and the College’s Gender Equity Committee and Training Standards Committee.