You'll have opportunities for academia, research and sub-specialty training, as well as flexible working and other experiences set outside the programme itself.
This page gives an overview of all of this and provides the links and contacts to find out more about your future career in paediatrics.
The paediatric training pathway
The current standard training pathway is nominally seven years in length, and set out over two levels; Core and Specialty training.
Most paediatricians start their training at ST1 (ST stands for specialty training), though some enter later, at ST3, once they've been gained a training post, through the National Recruitment process. They join the RCPCH as a junior member and register for training, which gives them access to ePortfolio.
- Core Training (ST1 - ST4) - you'll initially focus on general paediatrics in acute settings, including emergency duties, in- and out-patients and neonates
- Specialty Training (ST5 - ST7)- you'll either continue in general paediatrics, or choose to train in one of 17 sub-specialties, as introduced below
This diagram describes the training pathway in detail:
Paediatric training is a run-through programme, which means that trainees do not need to go through an examination or recruitment process to move through each year or each level. The only stipulation is that you need to pass your MRCPCH to progress to Specialty Training. You'll have a yearly assessment of progress through training via the Annual Review of Competency Progression (ARCP) process.
At the end of training you will gain your Certificate of Completion of Training (CCT) in paediatrics and can move straight into a consultant post.
The training is capability-based, not time-based, so trainees do move through the pathway at different speeds. You will need to have at least two completed, satisfactory ARCPs, in order to be eligible for a CCT. In reality, most trainees will take advantage of all the opportunities afforded by paediatric training in the UK and will therefore complete their training over at least seven years - and therefore several more completed ARCPs. In fact, this is the case more often than not, and is no bad thing at all, as it allows trainees to ensure they move into their first consultant role feeling as prepared and capable as possible. Our Stepping Up programme supports trainees with the transition from trainee to consultant.
The paediatric training pathway runs across all four UK nations, and posts for England, Scotland, Wales and Northern Ireland will be available when you apply to enter training. Do take the opportunity to read up on what the regions have to offer before committing to your location. Our regions pages include useful contact details for training in each College region of the UK.
Progressing training and supervision
Once you start training, you'll get access to RCPCH ePortfolio, an online system that allows you to log your progress against the curriculum.
You'll have an educational supervisor who will work with you to gather evidence and register any work-place based assessments on your ePortfolio.
You'll also also have a named clinical supervisor for each placement, who will oversee your clinical work and provide constructive feedback, as well as make sure that educational governance requirements are met.
Exams and assessment
To progress from Core Training at the end of ST4, you'll need to have passed the MRCPCH (membership exam). There are four parts:
- Foundation of Practice (FOP) - theory exam
- Theory and Science (TAS) - theory exam
- Applied Knowledge in Practice (AKP) - theory exam
- MRCPCH Clinical exam
You'll need to pass the three theory exams before you can sit the MRCPCH Clinical exam.
There is no exit examination at the end training. However, before you complete training and move on to your first consultant post, you'll sit an assessment called RCPCH START. START stands for Specialty Trainee Assessment of Readiness for Tenure, and it's an entirely formative assessment that tests your abilities relating to clinical decision-making as a new consultant. It will help you address any gaps that you may have in your training.
During Specialty Training (ST5-ST7), paediatric trainees may choose to train in the hugely varied area of general paediatrics, or to apply for a more specific training programme, in one of the 17 paediatric sub-specialties.
Our sub-specialties are: Allergy, immunology and infectious diseases, Child Mental Health, Paediatric Clinical Pharmacology, Community Child Health (CCH), Paediatric Diabetes & Endocrinology, Paediatric Emergency Medicine (PEM), Paediatric Gastroenterology, Hepatology & Nutrition (PGHAN), Paediatric Inherited Metabolic Medicine, Paediatric Intensive Care Medicine (PICM), Neonatal Medicine, Paediatric Nephrology, Paediatric Neurodisability, Paediatric Neurology, Paediatric Oncology, Paediatric Palliative Medicine, Paediatric Respiratory Medicine and Paediatric Rheumatology. You can find out more about each on our sub-specialty pages.
Those who complete one of these approved programmes of sub-specialty training are eligible to enter on the GMC Specialist Register as a Paediatrician with a sub-specialty.
The College manages the national sub-specialty recruitment process, which you might hear being mentioned as 'Grid'. Each year, sub-specialty posts are advertised and trainees complete an online application via the Oriel system. Applications are followed by a shortlisting process and, if successful at that first stage, final appointments are decided via a panel interview. You can see more detail on our sub-specialty training application guidance page.
The CSACs (College Specialty Advisory Committees) oversee the development and delivery of sub-specialty training in the UK. These groups of senior sub-specialty consultants are also involved in the recruitment process, signing off of the posts that are advertised and sitting on the shortlisting and interview panels.
Special interest (SPIN) Modules
As a general paediatrician, you can gain additional experience and training in a specific area of a paediatric sub-specialty by taking a Special Interest (SPIN) module. We offer two types of SPIN:
- SPIN in training for Specialty Trainees (ST5 - ST7) - additional training and experience in a clinical area, which you complete in 12 to 18 months of clinical time. If you do a SPIN module and complete your training, you can apply for posts as a General Paediatrician with a special expertise
- Post completion SPIN for paediatricians on the GMC specialist register - additional training or experience, which you complete usually over a 12 month to five-year period, whilst working as a consultant
SPINs enable a paediatrician to lead in a particular area, as part of meeting a service need and act as the local lead and part of the clinical network providing for children who need specialist paediatric care.
Paediatrics offers a wealth of opportunities for research or for pursuing an academic career. If following the standard paediatric training pathway described above, you'll undertake research projects. But some enter into academic training, through an Academic Clinical Fellowship (ACF) post.
This diagram shows the academic training pathways available.
To apply for academic training, you'll need to register via National Institute for Health Research (NIRH). The recruitment round typically takes place just before the full national recruitment process for specialty training. You will combine your studies with clinical work, so you will also and subsequently need to complete the national recruitment process, as a benchmarking exercise, before you are formally appointed to your academic training post.
An established network of Academic Regional Representatives throughout the UK are on hand to provide guidance and support to academic trainees and those wishing to undertake research alongside their clinical training. You can find out more on our academic training page. And our research activities page includes more resources, including our Trainee Research Network, plus research opportunities and our research eBulletin.
Flexibility in training
There are so many options to add flexibility to your paediatric training. Whether it is through additional training opportunities such as the SPINs, adapting your working patterns to suit your own needs or taking time out to complete higher education, gain exposure to specific areas of paediatrics or other out of programme experiences both in the UK or overseas - it is all possible.
Less than full time training (LTFT) is widely supported within paediatrics, and is available for reasons beyond the statutory ones typically required across medical training. So, if working at a slightly lower WTE (whole time equivalent) works best for you, to ensure your best work/life balance, you can discuss arrangements with your supervisor and training programme director.
If you would like to take time of your training - to gain additional training experiences or for higher education - it's possible to go Out Of Programme (OOP). Applications for OOP approval are governed by the Gold Guide rules and local requirements from your Head of School or postgraduate dean. Processes and timeframes may differ slightly for each region, so be sure to check locally for those that will apply to you. Examples of OOP include OOP Approved Training (OOPT) and OOP Research (OOPR), both of which are governed by the GMC. Others are OOP Experience (OOPE), which cannot contribute to your training, and OOP Career break (OOPC). Most trainees take OOP between ST3-ST5.
Contact us and more information
For any additional information on paediatric training in the UK, contact us! The following staff teams can provide a range of support and advice:
- Careers - ChoosePaediatrics@rcpch.ac.uk
- Medical Recruitment - firstname.lastname@example.org
- Training Services - email@example.com
Of course, we also recommend speak to paediatricians where you're working or in your professional networks. They're often very happy to give more details on what training and working in paediatrics is like.
You can also check more trainee resources on our training and assessment page, including our training guide, assessment guide and trainee charter. And, if you're still unsure, check out our Choose paediatrics content with information for medical students and foundation doctors, blogs by members and more!