Taking the scenic route - variety in paediatrics

As a trainee paediatrician, Dr Emma Coombe has had opportunities to look after tiny patients in neonatal intensive care, learn the ropes around community paediatrics and work in fantastic emergency departments... Paediatrics has given Emma the chance to mould her own training journey.
Emma Coombe

Is there a specialty that offers more opportunity for variety in your working life than paediatrics?

I’m biased, but I’m not sure there is one.

Some might describe my journey through paediatric training as having taken the scenic route... I’ve constantly sought out opportunities to mould a career and training journey that has suited my own interests, and paediatrics has given me the flexibility to do so.

I’ve been so well supported with formal debriefs, supportive chats over coffee and access to counselling if I’ve needed it

Thanks to Out of Programme (OOP) opportunities I’ve worked across four countries and three continents. Undertaking some training at Massachusetts Institute of Technology as part of a leadership fellowship was just one of the highlights on my travels!

Within the UK, I’ve worked across four deaneries in such a variety of environments. Paediatrics offers everything from primary care to quaternary services, so in one rotation I’ve been observing joint clinics between a GP and paediatrician in primary care, the next I’ve been staffing the regional paediatric intensive care, looking after children who’ve had complex cardiac surgery, or in the back of an ambulance helping to transfer critically ill children from regional hospitals.

I’ve had opportunities to care for looked after children, sitting in on adoption panels and learning the ropes of community paediatrics, but also had the chance to look after tiny patients in neonatal intensive care, my smallest patient born at just over 500 grammes! I’ve also been able to learn the craft of children’s emergency medicine in some fantastic emergency departments - some patients 18 hours old, some 18 years old and everything in between. If procedures are your thing, there’s plenty of opportunities to emphasise that aspect of your training, too.

It would be wrong to say that there is never a bad day working in paediatrics, but the variety means you’re riding a rollercoaster that is thankfully many more ups than downs. The child deaths are rare, but they happen, but I’ve been so well supported with formal debriefs, supportive chats over coffee and access to counselling if I’ve needed it. The safeguarding work can feel hard core at times, but it is an absolute privilege to be an advocate for children in a way that helps keep them safe from harm and elevates their voice.

 The variety means you’re riding a rollercoaster that is thankfully many more ups than downs 

There truly is something for everyone in paediatrics. It allows you to be a true generalist and practice in the holistic way we are all taught to at medical school, but sometimes have difficulty delivering as doctors to our patients given the constraints and pressures of NHS systems. It’s also possible to build a portfolio career in paediatrics, combining clinical work with research, teaching, public health or anything else that floats your boat,. Although I do wonder how Ranj Singh (or 'Dr Ranj') convinced his training director to give him time out of training for Strictly Come Dancing

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Dr Emma Coombe is a trainee paediatrician working in Bristol. @dr_emmacoombe