Neonatal medicine - sub-specialty

Neonatologists are paediatric specialists whose expertise is looking after newborn infants or those born prematurely. Access the current syllabus for training in this clinical area, as well as the revised syllabus coming in August/September 2021. We also provide detailed guidance on trainee reviews and training time.

What makes a neonatologist?

A neonatologist provides comprehensive care to the critically-ill infant in the neonatal intensive care unit whilst ensuring the care of well term infants on the postnatal ward. The spectrum of clinical conditions and the care required is vast, from the term baby with feeding issues on the postnatal ward to the sick, fragile, extremely preterm baby with multiple problems.

Neonatologists often face difficult discussions with families in the antenatal and postnatal environment regarding counselling about care, management, prognostication and, potentially, palliative care. Ethical and medicolegal knowledge and its application are central to many of these discussions.

Whilst providing team leadership and clinical and skills training, the neonatologist is also expected to be able to perform challenging technical procedures.

Long-term follow-up with developmental screening until two years of age is provided in this role. It is the combination of intensive care skills, ethical and emotional support, and clinical follow-up that make this a unique speciality.

RCPCH Progress curriculum and syllabi for level 3 training

Since August 2018, trainees in this sub-specialty use the RCPCH Progress level 3 generic syllabus alongside the RCPCH Progress neonatal medicine sub-specialty syllabus. Download both documents below

In addition to the generic learning outcomes for level 3, neonatal medicine trainees must fulfil the following sub-specialty learning outcomes:

  • Provides comprehensive care to the critically ill infant on the neonatal intensive care unit, whilst ensuring the care of well term infants on the postnatal ward.
  • Communicates expertly with parents or carers and other staff in the antenatal and postnatal environment.
  • Demonstrates effective and appropriate follow-up of babies following neonatal intensive care.

Revised syllabus coming in August/September 2021

We spoke with clinicians working in this sub-specialty, and agreed some enhancements to the sub-specialty syllabus. The revised version is approved by the General Medical Council (GMC) for use as of August/September 2021. Download the revised syllabus below

A summary of the changes:

  • Learning Outcome (LO) 1, Key Capability (KC) 5 amended to bullet points. LO3, KC amended and three additional KC’s added. 
  • The Assessment Grid has been updated to reflect changes to the KCs. 

You can find out more about the updates to this and other sub-specialty syllabi. If you have any questions contact us on qualityandstandards@rcpch.ac.uk.

CSAC process for trainee reviews

We worked with Heads of Schools and trainees around the UK on the yearly CSAC progression form, with the aim of achieving some external review for trainees. After gathering feedback, the revised process focuses on local supervisor curriculum assessment to encourage more formal progress review. This will be followed by remote CSAC panel review. Videoconference or teleconference discussion with the trainee will be conducted at this time to avoid travel. Download our Neonatal ARCP guide below

If you have any questions, please approach the Head of School or Neonatal Grid Coordinator in your College region - see contacts for your region. Then, if no response, contact the CSAC Assessment Advisor - see contacts on the CSAC page.

Training time and curriculum guidance

Level 3 sub-specialty training in neonatal medicine has an indicative training time of 3 years. As training is assessed by an outcomes based curriculum, it may be possible for trainees to demonstrate all learning outcomes and key capabilities more quickly. This is not guaranteed and requires prospective discussion with the CSAC and relevant Head of School. The onus will be on the trainee to demonstrate and evidence the fact that they have achieved all the required neonatal generic and sub specialty outcomes and key capabilities for level 3. 

Prior to applying for neonatal specialty training

  1. Placements at grades ST6 or ST7 in recognised neonatal training centres or approved allied specialties prior to starting official subspecialty training may count if reviewed and agreed by the CSAC.
  2. Locum posts do not count towards training in neonatal medicine.
  3. A minimum of one year must be spent as neonatal subspecialty trainee after appointment via competitive interview. There must be at least 12 months whole time equivalent left before a CCT date for a trainee to enter the specialty training in neonatal medicine.
  4. Trainees can apply twice for neonatal subspecialty selection. If they are deemed appointable on either attempt at interview and there is no post available then they can apply on a third occasion; this needs to be confirmed in advance by CSAC Chair / Training Advisor.
  5. There is no currently recognised equivalent to UK neonatal subspecialty training.

General training considerations

1. Level 3 training is ideally 3 years in total - either 3 years neonatal medicine, or 2 years neonatal medicine and 1 year allied specialties or research or overseas posts. Research/ oversees posts must be prospectively approved and agreed by CSAC.

Current posts which can be counted towards higher specialist training in neonatology are: 

  • Neonatal neurodevelopmental (UCH) 
  • Paediatric cardiology +/- ECMO - please be aware that most cardiology centres suggest a 1 year placement.
  • Paediatric neurology 
  • Paediatric intensive care 
  • Respiratory paediatrics (in tertiary centres) 
  • Neonatal transport 
    • ANTS 
    • Centre
    • ConnectNW
    • Embrace 
    • NEST Bristol
    • Royal London NETS 
    • West Midlands Transport Service
    • West of Scotland Transport Service 
  • Neonatal Intensive Care - Great Ormond Street Hospital
  • Clinical genetics
  • Paediatric Palliative Medicine

Please note only an indicative 6 months of each of these areas can count towards the additional 1 year of allied training. If a trainee would like to develop a special interest, it may be possible to permit up to 12 months in that area with prospective CSAC approval. If a trainee would like to potentially count another training post that is not included in the list above, prospective approval is required from Neonatal Medicine CSAC.  

2. Research posts obtained after securing a grid post may contribute to training time only if:

  • Trainees ensure capabilities are kept up to date during research time 
  • Any specific clinical capabilities gained during the research time are specified in the CSAC progression form and ARCP panel report so that they are documented within the ARCP outcome 8 (OOPR)
  • Research posts are Deanery and GMC prospectively approved as OOPR 
  • Posts are prospectively approved by the Neonatal CSAC before starting 
  • Level 2 training has been completed
  • Research post may count up to a maximum of 1 year towards subspecialty training, depending on type of research and ability to keep capabilities up to date with relevance to neonatal medicine

Trainees counting the maximum of 1 year of research time towards level 3 grid training must meet the other requirements of neonatal medicine to complete training.

3. Overseas posts

  • Approval must be sought prospectively for trainees wishing to count an overseas post towards training. 
  • The post must be based in the equivalent of a tertiary neonatal centre and evidence of appropriate educational supervision and achievement of capabilities must continue to be achieved. 
  • Appropriate centres often include the major perinatal centres in Canada, Australia and New Zealand, though the CSAC would review other institutions. 
  • Only one year of overseas training can count towards grid training. 

CCT enquiries should be directed to either the CSAC Training Advisors – see contacts on the CSAC page - or to the RCPCH Training Services team on training.services@rcpch.ac.uk.