Developing or changing specialty as a career grade

 Paediatricians are less and less likely to remain in the area of clinical practice they started in after initial training. This is due to both service demands and the wish of the career grade paediatrician to develop within a long-term career.

While it may have previously been challenging to develop into new areas of clinical practice, the changing landscape now allows for transition between specialties. However paediatricians should think carefully about their reasons for wanting to change – BMJ Careers provides a useful article about changing specialty.

Developing into new areas of clinical practice is and will be facilitated by:

  • SPIN modules for subspecialty competence acquisition post-training
  • Credentialing 

Special Interest (SPIN) modules

SPIN modules  are the additional  training/experience a paediatrician completes  so that they can be the local lead and part of the clinical network providing for children who need paediatric specialist care.

Paediatricians providing expert care are able to seek training in an area of special interest or in aspect(s) of sub-specialty care. This involves training, assessment, experience and supervised care. SPINs vary in breadth and depth, but will often equate with the training received during a full time 12 month placement. SPINs in a range of subspecialties are available to SAS and consultant paediatricians as well as trainees.

Further information is available on the SPIN webpages


Credentialing is defined as a process that formally accredits a doctor attaining competence (including knowledge, skills and performance) in a defined area of practice. They should achieve a level of competence that gives confidence that they are fit to practise in that area with effective clinical governance and appropriate supervision.

Doctors may want to enhance their career by gaining additional expertise in special interest areas and subspecialty training through formal and quality assured training programmes, leading to a credential in that area. 

Credentialed programmes will encourage flexibility by allowing doctors to enhance their careers in specific specialty areas. It also encourages cross-specialty development.

The development of SPIN modules will assist the RCPCH in developing credentialed programmes suitable for SAS doctors and consultants to allow them to demonstrate expansion of expertise beyond their current areas of practice.

The GMC website provides information about the credentialing process so far.