Paediatrics

Paediatrics is a large and diverse specialty, which includes high-technology specialties such as neonatology and paediatric intensive care as well as community-based specialties such as neurodisability. Trainee paediatricians gain experience in many areas of practice that helps them decide where their interests and strengths lie. They gain experience of working in multidisciplinary teams, which is fundamental to paediatric practice. The number of consultant paediatricians is increasing by over seven per cent per year. There are now around 2,900, of whom about 17 per cent work part time.

Training pathway

The training pathway is flexible to accommodate the training of general and subspecialist paediatricians, and to cater for the variable rates of progress amongst trainees. The length of training in the future will be five to eight years. The MRCPCH examination was modernised recently and a framework of the competences that need to be acquired in training has been developed to meet the needs of the Modernising Medical Careers agenda, see the Royal College of Paediatrics and Child Health for more details. Research is encouraged and can be undertaken at any stage. Trainees can also undertake part of their training abroad. One way to do this is through the joint RCPCH/VSO (Voluntary Service Overseas) fellowships.

Key skills and aptitudes

Paediatricians need to be good communicators who enjoy working with children and their families. Good teamworking is crucial and a good sense of humour is welcome. Having the potential to become an excellent diagnostician is important because infants and children often present with undifferentiated illness, which they may not be able to describe. Emotional resilience, patience and sensitivity are needed when managing critical illness or disabilities in infants and children. An aptitude for managing neonatal and paediatric emergencies is required as well. Fortunately consultant paediatricians are renowned for providing good support and supervision, which allows trainees to develop these skills without feeling vulnerable. 

Training posts and competition

Training takes place in hospital and community-based posts in district and tertiary centre hospital settings. This provides a good mix of broad-based general experience and in-depth subspecialty experience. Currently there are 1,540 specialist registrar posts in the UK and greater numbers of SHO posts. Competition varies each year and advice about this can be obtained from paediatric college tutors (each department has one) or regional advisers, and from the Royal College of Paediatrics and Child Health. Part time training is well established to suit family or other commitments.

Best and worst

Paediatrics is not an easy option but it is intellectually challenging, diverse and offers great rewards including the satisfaction of working with a delightful and entertaining patient group. To be an advocate for infants and children who cannot fight their own corner is a privilege.

Specialties and subspecialties

Currently 39 per cent of consultants are mainly hospitalbased general paediatricians and 22 per cent mainly community-based paediatricians. 37 per cent of consultants are subspecialists in the following: endocrinology and diabetes; neurology; neonatology; gastroenterology, hepatology and nutrition; respiratory medicine; paediatric intensive care; metabolic medicine; nephrology; oncology; neurodisability; rheumatology; clinical pharmacology and therapeutics; allergy, immunology and infectious disease.

Key information resources

• Royal College of Paediatrics and Child Health

Links to paediatric subspecialty societies can be found on the website. 

Dr Claire Smith MBBS, MD, FRCPCH, FRCP, DCH and Donald Court Fellow, is officer for general professional training for the Royal College of Paediatrics and Child Health. She is also a consultant paediatrician at Queen's Park Hospital, Blackburn.