Picture this: a foundation doctor with paediatrics in their heart but not on their rota.
That was me.
Less than 10% of Foundation Year placements involve a paediatric rotation, and with the UKFPO's new Preference Informed Allocation system limiting rotation choices, more aspiring paediatricians are left navigating a path without the traditional stepping stone of a paediatrics post (1). This can lead to a lack of hands-on experience in managing paediatric patients, understanding safeguarding complexities, and collaborating with paediatric consultants and multidisciplinary teams—critical for mentorship and networking (2). Without this exposure, confidence in managing paediatric cases (3) and preparing competitive specialty training applications can falter.
Nevertheless, despite not having a formal paediatrics rotation, I have actively sought opportunities in child health such as arranging a taster week in my Trust's paediatrics department (4), focusing on specialty clinics that align with my interests like epilepsy and cystic fibrosis. Additionally, opting to cover paediatric rota gaps has provided valuable exposure to acute care.
Beyond the hospital, two other ways to engage with the specialty are in academia and policy. A week with the RCPCH—arranged by a paediatric consultant I met during medical school—introduced me to the policy and child engagement teams, how they shape child health outcomes and expanded my awareness of current paediatric research priorities.
It is also crucial now more than ever to express an interest in paediatrics to Educational Supervisors and consultants on other rotations. As such, I have been referred onto paediatric colleagues who have involved me in research and quality improvement projects (QIPs). These opportunities have now broadened my network of paediatricians and given me more chances to attend conferences to present and connect. Submitting to prizes and essay competitions like this one have also kept me engaged with developments in the field.
Currently, the RCPCH, interest groups like PEDSIG and YPHSIG and The London School of Paediatrics offer valuable resources, training, blog posts, mentoring, prizes and e-learning modules that early-career paediatricians can access to aid in carving our career paths.
Yet, more can be done.
Imagine a national 'jobs board' listing paediatric taster weeks, where NHS Trusts, organisations, and doctors could submit opportunities. Alternatively, RCPCH could also launch a 'Flexible Paediatrics Experience Programme' for short-term placements in paediatrics, offering exposure to the specialty, which could be supported by the foundation doctor’s programme director. A 'Paediatrics Leadership and Policy Fellowship' could also give foundation doctors an added chance to contribute to QIP for their specialty applications.
Furthermore, a 'National Paediatrics Project Bank' could centralise research projects, encouraging multi-centre studies. Foundation trainees could promote the current RCPCH Trainee Research Network as regional representatives, unifying research efforts, expanding global health initiatives and raising awareness of opportunities (5).
While the new allocation system presents challenges, it offers opportunities to innovate. Through personal initiative and stronger institutional support, foundation trainees can still gain the skills and experiences needed for a successful paediatrics career. With creativity and collaboration, the pathway to paediatrics remains open.
References:
Royal College of Paediatrics & Child Health. Interested in paediatrics? Guidance for Foundation doctors. Available: https://www.rcpch.ac.uk/resources/interested-paediatrics-guidance-foundation-doctors (Accessed 10 Jan 2025)
Mallett P., Thompson A., Bourke T. Addressing recruitment and retention in paediatrics: a pipeline to a brighter future. Archives of Disease in Childhood - Education and Practice 2022; 107:57-63.
Teh J.J., Cheung K.Y., Patrick Y., et al. Self-Perceived Confidence of Medical Students Communicating with Pediatric Patients in a 7-Week Pediatric Placement: A Pilot Survey. Adv Med Educ Pract. 2020 Feb 24;11:163-169. doi: 10.2147/AMEP.S234856.
Byrne M.H., Nitiahpapand R. How to organise a successful foundation training taster week. Postgrad Med J. 2020;96:560–563. doi: 10.1136/postgradmedj-2020-137711.
Mustafa K., Murray C.C., Nicklin E. et al. Understanding barriers for research involvement among paediatric trainees: a mixed methods study. BMC Med Educ 18, 165 (2018). https://doi.org/10.1186/s12909-018-1263-6
