The Allocation Hurdle:
Supporting Paediatric Aspirations in Foundation Training
Aspiring paediatricians face a potential new hurdle: the UKFPO's Preference Informed Allocation system. By reducing individual autonomy in post selection, this system can prevent trainees from securing the crucial experience of a dedicated paediatric rotation during their foundation years.
The most significant challenge is reduced direct clinical exposure. A dedicated rotation is crucial for developing essential skills such as paediatric-specific history taking, physical examination, and interpretation of investigations. Observing experienced paediatricians offers insights into daily practice, building confidence for specialty training applications, despite a dedicated foundation post not being a formal prerequisite.
Despite this, foundation year doctors can enhance their paediatric experience through several avenues. The allocated Taster Week in foundation year can be allocated to paediatrics. This provides valuable firsthand insight, allowing observation of daily practice, interaction with multidisciplinary teams, and networking with paediatricians and consultants, potentially leading to mentorship.
Critical reflection and demonstrable personal development are essential throughout foundation year training. Rotations in related specialties, such as General Practice and Emergency Medicine, also offer opportunities to encounter paediatric patients. Trainees can showcase transferable skills, including communication, teamwork, and leadership skills. Attending outpatient clinics during non-paediatric rotations further broadens exposure to diverse paediatric conditions. Leadership and teaching experience are essential for paediatric training applications and career progression. Foundation year doctors can strengthen their portfolios by teaching and presenting on paediatric topics. Building a professional network through local or national paediatric societies provides access to educational resources, networking opportunities, and updates on advancements in the field.
Demonstrating commitment to paediatrics is key. Discussing career aspirations with supervisors provides tailored guidance. Undertaking paediatric-focused audits or Quality Improvement Projects (QIPs), even within non-paediatric settings, provides strong evidence of this commitment. For instance, during a general surgery rotation, an audit of pre-operative assessments of paediatric surgical patients. Another example is assessment of adherence to tetanus prophylaxis guidelines across all ages with tetanus-prone wounds, which can be linked to paediatric immunisation schedules.
The RCPCH provides comprehensive support through resources on their website, including information on conferences, career guidance, online learning modules, and events. Local paediatric departments also offer mentorship programs and engagement opportunities with their teams. To mitigate the allocation system's challenges, the RCPCH and other organisations can implement robust support structures. Formalised taster and shadowing schemes are crucial for structured clinical exposure. A national mentorship program connecting aspiring paediatricians with experienced consultants or trainees would provide invaluable guidance. Standardised portfolio guidance for trainees without a paediatric foundation rotation is essential for equitable applications, outlining suggested audits, QIPs, and other relevant activities. The RCPCH should also advocate for sufficient paediatric training posts and collaborate with foundation schools to promote paediatric experience opportunities.
In conclusion, while the Preference Informed Allocation system presents challenges, proactive engagement from trainees and robust organisational support, particularly from the RCPCH, can mitigate these. By maximising opportunities, building strong portfolios, and utilising available resources, aspiring paediatricians can effectively prepare for specialty training and contribute to paediatric care.
