Neonatal medicine - sub-specialty

Neonatologists are paediatric specialists whose expertise is looking after newborn infants or those born prematurely.

Read about this clinical area and download the syllabi for both sub-specialty and for generic specialty training. 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.

Training in this sub-specialty

In summer 2023, we launched RCPCH Progress+, our updated, two-level paediatric training programme in the UK.

Paediatricians start in core training, and then move on to specialty training - when some choose to apply to train in a paediatric sub-specialty, such as neonatal medicine.

The Progress+ curriculum provides a framework for paediatric training, and outlines the Learning Outcomes and Key Capabilities required at each stage before attaining the Certificate of Completion of Training (CCT).

The RCPCH Progress+ syllabi support the curriculum with further guidance on how the Learning Outcomes can be achieved and demonstrated, with sub-specialty Learning Outcomes. You can download the Progress+ syllabi for this sub-specialty and for specialty training (generic) below. 

Trainees due to CCT by September 2024 continue to use the Progress curriculum and syllabi; you can also download the the Progress syllabi below.

Advice from the CSAC

Note: This advice was written for Progress, and will be updated for Progress+.

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 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

Accordion content 2.

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 grade ST6 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 two years must be spent as neonatal sub-specialty trainee after appointment via competitive interview. There must be at least 24 months whole time equivalent left before a CCT date for a trainee to enter the specialty training in neonatal medicine.
  4. There is no currently recognised equivalent to UK neonatal medicine 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 sub-specialty 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 sub-specialty 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 sub-specialty training. 

CCT enquiries should be directed to either the CSAC Training Advisors – see contacts on the CSAC page - or to the RCPCH Training & Quality team on