COVID-19 and paediatric training

Since March 2020 the COVID-19 pandemic has caused unprecedented disruption to training and assessment in paediatrics in the UK as well as significant stresses to everyone's working and personal lives. We hope that, two years on, we are beginning to return to normal or at least to readjust to a new normal. However, we recognise that during the 2021-22 training year, COVID-19 continues to have an impact.

We have reviewed and updated our advice regarding the impact of COVID-19 on all aspects of training, assessment and exams.
Last modified
3 May 2022

There may be individual circumstances which are not addressed here. If that is the case, please get in touch at training.services@rcpch.ac.uk.

Paediatric training and redeployment during COVID-19 surges

Many trainees were redeployed to adult services during the first waves of the pandemic. Things have moved on considerably since 2020 and we expect that very few trainees have been redeployed during the 2021-22 training year.

We continue to monitor the evolution of the pandemic and advise accordingly, but at present there should not be a need for any paediatric trainees to be redeployed to non-paediatric settings. If the situation changes, trainees are reminded that redeployment should not happen unless agreed with the Head of School and Postgraduate Dean in discussion with the trainee, and that individual training needs must be considered.

We have developed guidance and best practice around redeployment, which remains pertinent.

As Omicron emerged during 2021 and into 2022, the impact of COVID-19 on paediatric services has been considerable and the workforce has been impacted by COVID-19-related absence, putting unprecedented pressure on services and rotas. The effect of this on morale and wellbeing cannot be underestimated. Looking after yourself and other members of the team, working together and maintaining kindness and courtesy must be a priority; however, this is often easier said than done.

Sources of support include your Educational Supervisor, College Tutor, Training Programme Director (TPD) and Guardian of Safe Working. In November 2021, we recorded a webinar with practical advice around managing the winter pressures, including advice around exception reporting.

Disruption to placements and experience during COVID-19

Although much has returned to a more normal way of working and training, some trainees have continued to have their placements and experience disrupted during 2021-22.

There are no minimum requirements for time spent in specific placements as the curriculum is capability-based.  For example, RCPCH does not dictate that a trainee does six-month placements in community or neonatal medicine during their level 2 training. Trainees have to demonstrate that they have achieved the key capabilities at a particular level in order to progress. A lot of deaneries use six-month placements to allow trainees to gain these capabilities but it is not mandated that a trainee requires six months in a community post. 

At Annual Review of Competency Progression (ARCP), panels should not take a rigid time-based approach to assessing progress through a level - find out more here.

If you have missed a placement and would like to get more exposure in that area, speak to your TPD to explore how you could get some experience in this area. This may include modifications to your placements or using your study leave to spend time in that sub-specialty.

Shielding

Some trainees have continued to shield or undertake modified roles during the 2021-22 training year. This includes shielding in the short term (for instance due to pregnancy) or longer term; the principles of managing trainees in this situation are similar.

Many capabilities do not require direct patient contact. For instance, it is possible to fulfil some of the leadership, teaching or health promotion capabilities from home. Many services are now using phone or video clinics and it may be possible for trainees to undertake these from home.

Trainees who are shielding for whatever reason, must have regular supervision and an appropriate Personal Development Plan (PDP) to enable them to acquire and evidence capabilities. As training is capability rather than time-based, there should not be a strict time-based consideration of a trainee’s shielding period. Rather there must be a careful assessment of capabilities achieved and outstanding training needs on return to patient-facing work. Trainee and supervisor should then agree a clear plan to address any outstanding training needs before the end of the relevant training level.

Occupational health input and consideration of reasonable adjustments may be needed.

HEE has produced good guidance, covering many aspects of shielding during COVID-19.

Curriculum coverage and evidencing training

During the challenges of the last two years in training, we recognise that recording and evidencing training may have been difficult to keep up with. Nevertheless there have been lots of diverse training opportunities, even for those who were deployed.

We have updated our advice around evidencing training during COVID-19, including practical ideas of how to use the unique experiences of the last years to link to each domain of the portfolio.

Maintaining the portfolio can be time consuming at a time when energy for this is scarce. The Trainee Charter expects each trainee to have protected development time which includes time to update the portfolio, and we would remind trainees and trainers that beyond the minimum requirements outlined in the assessment table, there are no minimum numbers of assessments or portfolio entries and we advocate a smaller number of quality entries with good reflection to demonstrate the curricular learning objectives rather than concentrating on quantity of entries.

Recognising that portfolio time and energy have been depleted over the last two years, the modified assessment table remains in place for the 2021-22 training year with realistic and achievable minimum requirements.

Annual Review of Competency Progression (ARCP)

All trainees should expect an ARCP at the appropriate time in their training. ARCP panels will continue to meet remotely and trainees should receive feedback as per Gold Guide (v8). As noted in the 'Disruption to placements and experience during COVID-19' section, ARCP panels should be looking for quality entries rather than quantity and should be mindful of the disruption trainees have experienced over the last two years.

The modified assessment table and agreed derogations remain in place for the 2021-22 training year. Outcomes 10.1 and 10.2 remain for trainees whose progression has been affected by COVID-19. All other outcomes will also be used where appropriate.

Examinations

Trainees are expected to pass all parts of the theory exam by the end of ST3. Under GMC-agreed COVID-19 derogations, if COVID-19 has affected exam progress, trainees may move to ST4 without the clinical MRCPCH with an outcome 10.1 as long as their supervisor and the ARCP panel judge that they are ready for middle grade working and there are no other training concerns.

Supervisors must agree that learning outcomes and key capabilities around ward round, acute paediatric management and neonatal care have been observed and deemed satisfactory in order for trainees to progress to ST4 and middle grade working if they do not have the full MRCPCH Clinical exam. See our page, Supporting the COVID-19 responses - managing ARCPs.

These derogations will remain for the 2021-22 training year and will continue in the subsequent training years as RCPCH Progress+ moves the requirement for the clinical MRCPCH exam to the end of ST4.

See our exams pages for updates on how exams will be delivered over the next diets.

RCPCH START

During COVID-19 START (Specialty Trainee Assessment of Readiness for Tenure) assessments moved online. This has been well received by trainees and assessors, and START will continue online for the time being. Three START sittings are planned for 2022.

There is advice about how and when to apply on our RCPCH START page.