If you are a foundation doctor who enjoys working with children and young adults, chances are you may be considering a career in paediatrics. However, you may find yourself asking what exactly a career as a paediatrician entails. As such, this article aims to provide you with great insight into this specialty and answer the most common questions one may have.
What Is A Paediatric Doctor?
A paediatrician is a doctor who specialises in managing infants, children, and young adults. With such a variable patient group as well as many different types of paediatric specialists, your work can be as general or specialised as you wish. Currently, there are 17 accredited subspecialties, which include:
Moreover, you can choose to work in clinics, in a hospital, or as a community paediatrician. Paediatrics is one of the few specialties where you get to utilise everything you learnt at medical school.
Does that mean paediatricians also have to do surgery? No, a paediatrician may carry out minor procedures, but surgery is the job of a paediatric surgeon, which is in fact a separate specialty training programme following core surgical training.
What Does A Paediatrician Do On A Daily Basis?
A typical day or week in the working life of a paediatrician is difficult to describe owing to the incredible diversity of the specialty. How many hours do paediatricians work? There is no straight answer to this either; your daily clinical activities, workload, case mix, and shift hours will depend on your rota; the intensive neonatal ward, for example, may require you to work long days in a row, giving you few days off in the week, whereas general paediatrics may be less demanding.
On less intense days you may enjoy working 9-5 and even have the opportunity to dress smartly. Nonetheless, the Royal College of Paediatrics and Child Health (RCPCH) supports the European Working Time Directive (EWTD) and the UK Working Time Regulations (WTR), and subsequently your working hours should not exceed 48h a week.
Trainees rotate jobs every six months and change hospital every year. If rostered as an on-call, depending on which ward you are in, you may respond to bleeps from units such as the emergency department or labour ward/obstetric theatre asking you to attend difficult deliveries and caesarean sections, or sometimes provide life support to an extremely sick child.
Generally, paediatric training is notorious for having one of the highest out-of-hours and on-call commitments. Rotations in acute inpatient care, neonatal intensive care, or A&E in particular may have unsociable shift patterns, making it difficult to incorporate some of your hobbies in your life.
Nevertheless, maintaining a good work-life balance is not impossible and also depends on your stamina and time-management.
Essential Skills For Paediatricians:
No matter which specialty you end up in, the importance of emotional resilience and the ability to handle difficult ethical situations cannot be understated. As paediatrics often involves dealing with extremely sick children, you will be required to demonstrate these traits to an even greater extent.
Adapting quickly through different situations is also part of your job description as caring for an infant is significantly different from caring for a young adult.
A particularly challenging aspect of paediatrics is managing the expectations of the sick child’s concerned family. You may sometimes even find yourself in heated discussions with pushy parents.
In such situations, it is vital you never judge them for it as they only want the best for their child; you must remain non-threatening, friendly, and appreciative as not to frighten the child, all the while exhibiting impeccable communication skills to empathise with the parents.
How To Become A Paediatrician:
Naturally, the first step is completing medical school, where you hopefully would have gained some exposure to paediatrics through university societies and conferences. If not already done so, you may want to become a member of the RCPCH and other associated societies, institutes, or professional bodies.
During your foundation years, aim to do a placement in paediatrics or associated specialties and get involved in relevant audits or research.
Following the foundation programme, you can directly commence the run-through specialty programme, starting at ST1 and generally lasting eight years until ST8. This may be particularly appealing to you if you wish to settle as you will not have to move across the country for another ST3 post.
You do have the option to enter ST3 paediatric jobs following completion of core training, but this route is a lot more competitive, with 9.65 applications per ST3 post compared to 2.09 applications per ST1 post in 2021.
You should also be ready to move to a different location as certain hospitals – such as the Great Ormond Street Hospital (GOSH) in London – are renowned for their excellence in this specialty and would prove beneficial to your career prospects.
The training pathway comprises three levels; the first two levels revolve around the general paediatric curriculum, and the third level allows you to choose whether you wish to continue in general paediatrics or complete training in a subspecialty.
The levels of paediatric training are as follows:
Level 1 – ST1-3: basic knowledge of paediatrics and child health, with placements in acute general, neonatal and community paediatric posts. Full Membership of the RCPCH qualifications (MRCPCH) will be necessary to progress into level 2 training.
Level 2 – ST4-5: mainly in district general hospitals (DGHs) using existing core training posts and rotations including community paediatrics and neonatology.
Level 3 – ST6-8: enter subspecialty training in one of the accredited subspecialties listed above or stay in general training.
At the end of training, you will be awarded the certificate of completion of training (CCT) to go on to work as a consultant paediatrician.
How Much Does A Paediatric Consultant Make?
In the UK, NHS consultant salaries are the same for all specialties but vary between Scotland (highest), England, Northern Ireland, and Wales (lowest) and increase with service (up to 19 years).
In 2020 the salary bands range from £77,779 to £109,849. Salaries can be further enhanced with NHS excellence awards. Full details about NHS pay for all grades can be found here.
Consultant paediatricians may also wish to run private practices to supplement their salary; a “purely” private consultant is rare in the UK. On average, a private paediatrician’s salary can include a profit of an additional 16% of their NHS salary by working in the private sector, which is comparable to a private paediatric surgeon’s salary (additional 18% of their NHS salary). Note, these figures vary across different paediatric subspecialties.
For more information on salaries within the NHS, please feel free to review The Complete Guide to NHS Pay.
If you are interested in deepening your knowledge in paediatrics, you may find it useful to consult relevant journals, such as the ones listed below:
Paediatrics and Child Health Journal
BMJ Paediatric Open
The Journal of Paediatrics
Journal of Paediatric Medicine and Surgery
Journal of Childhood and Developmental Disorders
The following societies and institutes offer a wealth of information on conferences, podcasts, essay prizes, research, tutorials, courses, and learning resources relevant to paediatrics:
Related Job Sources With BMJ Careers
Other Complete Guides By BMJ Careers
Paediatrician. Healthcareer | NHS. Available from: https://www.healthcareers.nhs.uk/explore-roles/doctors/roles-doctors/paediatrics/paediatrician
Paediatrician. Step Into The NHS. Available from: https://www.stepintothenhs.nhs.uk/careers/paediatrician
Sub-specialties. Royal College of Paediatrics and Child Health. Available from: https://www.rcpch.ac.uk/education-careers/sub-specialties
Consultant Working Environments. Royal College of Paediatrics and Child Health. Available from: https://www.rcpch.ac.uk/sites/default/files/Consultant_Working_Environments__Joint_Medical_Consultative_Council_.pdf
Specialty Recruitment Competition Ratios. Specialty Training | NHS. 2021. Available from: https://specialtytraining.hee.nhs.uk/Portals/1/2021%20Competition%20Ratios_1.pdf
Morris S, Elliott B, Ma A, McConnachie A, Rice N, Skåtun D, et al. Analysis of consultants’ NHS and private incomes in England in 2003/4. J R Soc Med [Internet]. 2008 Jul;101(7):372–80. Available from: http://journals.sagepub.com/doi/10.1258/jrsm.2008.080004