Introducing paediatric training - a world of opportunities

Paediatric training in the UK offers a range of possibilities, so you can take your career in the direction that suits you. An innovative, capability-based curriculum underpins our standard run-through programme, and this will equip you with the skills needed to become a consultant paediatrician.

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 eight years in length, and in three levels. Most paediatricians start their training at ST1 (ST stands for specialty training), though some enter later, at ST3 or ST4, once they've been recruited into a training post. They join the RCPCH as a junior member and register for training, which gives them access to ePortfolio.

  • Level 1 - you'll focus on general paediatrics in acute settings, including emergency duties, in- and out-patients and neonates
  • Level 2  - this includes general paediatrics as well as a minimum of six months each in neonatology and community paediatrics
  • Level 3 - 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 level 2. 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 - although you will need to complete at least four years of training 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 complete their training in around eight years, often more, ensuring they move onto their first consultant role feeling as prepared 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.

The paediatric training curriculum – from Progress to Progress+

In 2018 we introduced RCPCH Progress, an innovative, outcomes-based curriculum. It makes sure that trainees develop the full range of skills and knowledge needed in their day to day work and for progressing to a consultant post.

Building on this work, and speaking with trainees, supervisors and schools around the UK, we're making further updates, following the principles of the General Medical Council's (GMC) Shape of Training review. The GMC has approved our new two-level, run-through specialty training programme, and this will be rolled out from summer 2023. We're calling it RCPCH Progress+ and you can find out more about to expect on our Progress+ pages, including a handy FAQs page, 'training principle of the month' series, blogs and more.

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 Level 1 training, (now ST3, but as of summer 2023, ST5), 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 of Level 3 training. But 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 a 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.

Paediatric sub-specialties

At Level 3 training (ST6-ST8), paediatric trainees may choose to move into the hugely varied area of general paediatrics, or to apply for training in one of 17 paediatric sub-specialties.

Our sub-specialties are: Allergy, immunology and infectious diseases, Child mental health, Clinical pharmacology, Community child health, Diabetes and endocrinology, Emergency medicine, Gastroenterology, hepatology and nutrition, Inherited metabolic medicine, Intensive care medicine, Neontal medicine, Nephrology, Neurodisability, Neurology, Oncology, Palliative medicine, Respiratory medicine and Rheumatology. You can find out more about each on our sub-specialty pages.

Those who complete an approved programme 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 NTN, or 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, first signing off of the posts that are advertised, then 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 the paediatric specialty by taking a Special Interest (SPIN) module. We offer two types of SPIN:

  • SPIN in training for level 3 trainees - 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.

Academic training

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.

A diagram of academic training pathways in paediatrics
Academic training pathways in paediatrics

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 now available for reasons beyond the statutory ones usually required. 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! There are two staff teams who can provide particular support:

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!