Depending upon your level of training, rules surrounding sick leave may vary. Often, there is a maximum number of sick days allowed in any given training year which will vary depending upon your level, your scheme and your deanery location. Once this maximum is exceeded, you are typically expected to pay back additional days which are commonly added to the end of you’re your particular training scheme or training year. This will subsequently delay your progression to the next ‘phase’ of training or the award of you Certificate of Completion of Training (CCT)
You should not be asked to ‘pay back’ any on calls, nights, out of hours working that you have taken as sick leave upon your return to work. The total number of days taken in excess of the maximum allowed will simply be added to the end of your training/year. If you are asked to do so, we advise you to contact HR in the first instance and/or your clinical supervisor or educational supervisor. If this is not helpful, escalate according to trust grievance procedure (see section on How to cope when being challenged/discriminated against)
It can also be helpful to explain to your colleagues that, sometimes, sick leave can be predicted. In such cases, always try to give them advanced warning with as much notice as is possible if you feel you are going to need to take sick leave in the foreseeable future.
In terms of advice about when to take sick leave, which may seem like a ludicrous concept to our fit and well colleagues, we offer the following. As a doctor with a chronic illness, we generally set the bar rather high for taking sick leave. As someone who typically has daily symptoms which can vary on a day to day basis, maybe even more frequently than this, it can be very difficult to make a judgement about our fitness for work
That is not to say that we are poor at assessing our fitness to practice, which is different to fitness to work in some aspects. As a cohort, we are usually more aware of our fitness to practice than our fit and well colleagues because we often have to assess and judge our fitness to practice on a daily basis. However, what do you do if you assess that your concentration and mental focus is adequate for safe practice and your mobility is adequate for work but you just feel so unwell that you are having to force yourself out of bed and the idea of dragging yourself into work wants to make you cry?
Some useful analogies may be comparing yourself to your patients. If you think that you are more unwell than the majority of your patients are likely to be that day, then maybe you should consider not going to work. If a patient reported your level of illness to you, what advice regarding work attendance would you give them? What do you think Occupational Health would say today about your fitness to work?
If you are still struggling to make a decision about taking sick leave, try answering the following questions:
Is going to work today likely to result in you being made more unwell?
If you go to work today, are you likely to make yourself poorly enough to not be able to honour upcoming on-call/out of hours responsibilities? Which would be easier to cover, today or those shifts?
Do you feel like you can realistically manage a complex patient with multiple interruptions and be unlikely to make an error?
Clearly the above questions may apply to some specialities more than others and are simply intended as a guide for you to make a decision about your fitness to work