For those interested in a career in Paediatrics, what can be done during Foundation Training to best prepare for a Paediatrics application, and what could be put in place to support this?
As I started my General Paediatrics rotation in August, on my first day as a Foundation Year Two doctor, I felt a sense of anticipation. I had prioritised this rotation after an interest in paediatrics, sparked during my Child Health rotation in fourth year of medical school.
My cohort was the last with a perceived level of control over the rotations in our Foundation Programme, although exploration of the new allocation method (1, 2) is beyond the scope of this essay.
Working in paediatrics during foundation training is associated with choosing paediatrics as a speciality (3). Being familiar with a speciality also influences speciality decision making (4), which has been reflected in my own experiences. Working in paediatrics, I gained an understanding of the job and learnt how I respond to diSicult situations. Paediatrics has a challenging training programme; five percent of trainees leave paediatrics every year (5). Without a foundation rotation in paediatrics, it may be diSicult for doctors to evaluate their personal suitability to the speciality.
Yet, the Royal College of Paediatrics and Child Health (RCPCH) does not require paediatrics experience for ST1 application (6), and there are multiple opportunities available to explore the speciality and to help foundation doctors prepare for application to paediatrics.
A foundation doctor could organise a taster week, giving them time to observe activities in paediatrics. Asking to attend paediatric teaching sessions when able would give exposure to paediatric clinical cases. The RCPCH provides opportunities through its website ‘#ChoosePaediatrics’: a wealth of information, the annual conference, prizes and volunteering for START (trainee) assessments. By seeking out opportunities during the foundation programme to lead teaching, perform quality improvement projects or get involved in research, foundation doctors will also gain points needed for an application to paediatrics.
However, ‘seeking out’ is key here: many of these opportunities require an individual to know that the opportunity exists. I believe that there is scope for organisations to improve paediatric career outreach. This is important particularly given the diSerences recognised in opportunity to build a portfolio between medical students from more and less advantaged backgrounds (7) and the emphasis from the General Medical Council on the importance of tackling diSerential attainment (8).
There are two approaches which I consider would support aspiring paediatricians. Mentorship is important to foster interest in a speciality (9), so firstly I suggest that the design of a national mentorship programme by the RCPCH, advertised by deaneries, would encourage increased interest in the speciality and create networking opportunities which are otherwise lost if the doctor does not have a paediatrics rotation. Secondly, I suggest that named deanery leads on the RCPCH website would make it simpler for foundation doctors to get in contact with the local team for opportunities within paediatrics, and get involved in projects which would build their application.
In conclusion, proactive exposure to paediatrics, structured mentorship, and clearer signposting would enable foundation doctors to understand the specialty’s demands, appreciate its rewards, and confidently pursue paediatrics as a fulfilling career option.
References
1. UKFPO. UKFP 2024 Applicant Guide to Allocation Preference Informed Allocation (PIA). 2024.
2. Leaf N. New allocation system for foundation training leaves doctors demoralised before they've even started work. Bmj. 2024;384:q720. 3. Collins H, Eley C, Kohler G, Morgan H. Foundation rotations in medical training: is it love at first sight? Postgrad Med J. 2022;98(1163):689-93.
4. Scanlan GM, Cleland J, Johnston P, Walker K, Krucien N, Skåtun D. What factors are critical to attracting NHS foundation doctors into specialty or core training? A discrete choice experiment. BMJ Open. 2018;8(3):e019911.
5. RCPCH. 2020. [06/01/25]. Available from: https://www.rcpch.ac.uk/news events/news/making-paediatric-training-work-trainees.
6. RCPCH. Applying for paediatric specialty training at ST1 - guidance 2024 [ 7. Ashley L, McDonald I. When the Penny Drops: Understanding how social class influences speciality careers in the UK medical profession. Social Science & Medicine. 2024.
8. Council GM. Tacking DiSerential Attainment [Available from: https://www.gmc uk.org/education/standards-guidance-and-curricula/guidance/tackling-diSerential attainment.
9. Center NEJoMC. Physician Mentorship: Why It’s Important, and How to Find and Sustain Relationships NEJM2018 [06/01/25]. Available from:
https://resources.nejmcareercenter.org/article/physician-mentorship-why-its important-and-how-to-find-and-sustain-relationships/.
