Dr Claire T Lundy, Department of Paediatric Neurology, The Royal Belfast Hospital for Sick Children, 180 Falls Road, Belfast, BT12 6BE, Correspondence to Claire.lundy1@belfasttrust.hscni.net
Maybe you’ve always known child health was the career for you. Personally it was the first time that everything really made sense!
WHY SHOULD YOU CONSIDER CHILD HEALTH AS A CAREER?
No two days are ever the same as a trainee when you will assess and treat acutely ill children on the ‘take in’. Paediatrics offers a chance to see how different branches of medicine can integrate both on a scientific and practical level. The inability of the young child to fully communicate their problem is seen as very challenging however working in partnership with a family and utilising your diagnostic acumen can be rewarding. Unlike adults children do not submit willingly to tests so as a doctor you need to choose carefully and wisely. One of the best aspects of children’s medicine is the team approach to both diagnosis and long term care of the child and family.
Paediatrics is a challenging speciality in terms of the very genuine difficulty of dealing with a young child with a life limiting condition or a terrified parent of an acutely unwell infant. Those attracted to paediatrics require excellent communication skills. An ability to think outside the box and an interest in research is a must as many conditions are not yet fully understood and treatment is often evolving and changing. In practical terms working shifts in high pressure environments such as neonatal intensive care and children’s emergency requires the ability to multi task, manage practical procedures and keep a cool head !
THE PATHWAY
As a student there are opportunities to learn about child health during formal placements or electives. Exposure to some other specialities such as genetics, neurology and immunology may also lead to an interest in how diseases manifest in childhood. Research projects as a student are another useful way to develop a more in depth understanding of a particular branch of paediatrics. Most universities including QUB have research opportunities for students.
During the Foundation years some Schools have placements in paediatrics. Foundation doctors can play an active role in the team. It is recommended that a number of cases are studied in detail in order to broaden the trainee’s understanding of the holistic approach required and the long term impact of many conditions.
The entry point for speciality training is currently a national system. The Royal College of Paediatrics and Child Health website is a useful source of up to date information on the application process and training requirements.
During speciality training doctors will have the opportunity to work in subspeciality areas. This will be combined with core general paediatrics including emergencies. Community child health interfaces with primary and tertiary care at many levels. Trainees will engage in child development assessment and the safeguarding work that many community paediatricians are involved in. Community work allows trainees to develop an understanding of the effect of neurodisability and mental health issues affecting children and their families and perhaps most importantly the structures that are in place to help.
In the first three years doctors are currently expected to work toward their RCPCH Membership Exam. The process is a rigorous combination of written and clinical skills based assessment.
SUBSPECIALTY TRAINING IN CHILD HEALTH
The RCPCH provides a guidance document on the current training programmes in Paediatrics. It is advisable to seek advice early in your career as to which training programmes are accessible locally. Competition can be intense and trainees should be realistic about the career path they choose. Flexible and part-time training is available in many deaneries and can be a helpful option for trainees with additional commitments.
Academic paediatrics has a support structure via the RCPCH. A range of academic fellowships in various branches of paediatric medicine are offered throughout the UK each year. These posts generally offer an associated degree programme, typically a PhD. There are local and national training advisors who can be approached for advice.
COMPLETION OF SPECIALIST TRAINING AND BEYOND…
There are a range of options for doctors who wish to be paediatricians. Many hospitals have specialty doctor posts. These may involve subspecialty expertise and are highly skilled. The majority of doctors who go through the Specialty Training programme will become consultants. Most posts have a fairly similar template with the majority of time spent in direct clinical care on ward rounds or in clinics. Some will have an academic appointment. At this stage there may be opportunities to participate in shaping children’s services nationally through organisations such as the RCPCH.
SUMMARY
Being a paediatrician is a privilege. It is an immensely rewarding job which presents a myriad of opportunities to practice high quality cutting edge medicine in an atmosphere of teamwork and humour. I hope it’s the job for you.