Intended for healthcare professionals


Early planning is key to neonatal training success

BMJ 2015; 351 doi: (Published 09 September 2015) Cite this as: BMJ 2015;351:h4003
  1. Gaurav Atreja, locum consultant neonatologist, Imperial College Healthcare NHS Trust, London
  1. gaurav.atreja{at}


Candidates wishing to enter the neonatal grid training scheme must prepare early in their paediatric training, says Gaurav Atreja

Paediatric trainees considering neonatology as a career need to apply to their chosen subspecialty via the national subspecialty training (NTN grid) scheme. Application to the scheme is highly competitive, and candidates should start preparing their application early in paediatric training. They also need to show a range of attributes, skills, and experience to gain entry to the scheme.

There are two important stages in the paediatric training period when potential candidates need to start thinking about subspecialisation. At the end of level 1 training—specialty training level 3 (ST3)—a paediatric trainee should start considering a subspecialty interest in addition to general paediatric training. By the end of ST4, trainees should have made up their minds either to pursue this as an interest or opt to do grid training.

Trainees who need more time to make up their minds can go out of programme for a maximum of three years, possibly in an area related to the same subspecialty, but this needs a lot more planning. The process is managed by the local education and training board, with the Royal College of Paediatrics and Child Health supporting the application. Going out of programme also gives an opportunity for research, although it is not mandatory to go out of programme or do research to get a grid post. Most successful neonatal grid applicants choose their subspecialty early on, giving them plenty of time to do targeted activities to make their grid application successful.

The second important stage is when the trainee decides he or she is ready to apply for grid training. The application process is online, opening in September and closing in October, and is managed by the royal college. Extensive information is available on the royal college’s website about eligibility, the application process, and various programmes available around the United Kingdom.

Doctors can apply during ST5 on the basis that they will be able to complete level 2 training by the time they enter the grid programme. If unsuccessful, applicants can have another go the next year. It is important to apply during ST5, even if the application is not strong enough. The advantage is that by applying for the grid programme, trainees can show their intentions to their educational supervisor, training programme director, and other relevant people. They can then put candidates in suitable locations, such as a paediatric intensive care unit or another tertiary neonatal unit.

It is important to refer to the grid person specification while filling out the application form. Here, candidates will see that a lot of planning and preparation are required to fulfil the essential and desirable criteria demanded. Trainees should ideally start working towards this when they reach stage 1, as mentioned above. Trainees should be aiming to show they have the clinical knowledge, skills, and attributes to complete training and become a competent consultant. In other words, show their commitment to the subspecialty. Suitable experience includes:

  • Satisfactory feedback from workplace based assessments or supervised learning events

  • Showing keen interest in the concepts of neonatology—for example, ability to manage common neonatal emergencies, good aptitude for neonatal procedures, family centred care

  • Completion of courses in areas such as ventilation, cranial ultrasound, neonatal transport, safeguarding children

  • Neonatal audits.

Candidates also need to show that they understand the value of multidisciplinary working, can reflect on personal skill development, and have experience of administrative duties and other management skills. A lot of these skills will be assessed not only in the application form but also at the interview.

Candidates should show a commitment to education, training, and teaching, as well as some involvement in research. Candidates do not need to have completed a research project; simply being on the delegation log for ongoing research trials can be enough. A course in good clinical practice will also help trainees. Publications in peer reviewed journals will earn extra points to be shortlisted.

It is important that candidates ask senior colleagues and recent successful grid applicants to review their application. Successful candidates come from a range of backgrounds but have one thing in common: they began planning their application early.


  • Competing interests: I have read and understood BMJ’s policy on declaration of interests and have no relevant interests to declare.

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