Paediatrics
A Career in Paediatrics
Introduction
Paediatrics can be one of the most rewarding of all specialities. However more than most it is one to go into with your eyes open. This article will outline some of the pro's and con's, but if you are serious, go and talk to doctors in paediatric training and consultants in the field.
What is it?
Paediatrics is the last bastion of generalism in hospital medicine. Paediatrician need to be good in all disease areas, and excellent communicators too. We are arguably the best with our hands in medicine outside of plastics. It covers everything from birth to 16, in all specialties. Paediatricians often subspecialise into, say, development, neonatology, oncology or cardiology, picking up extra skills along the way, but the training initially is generic. Above all it is working with children. That means you aren't looking after adults with degenerative disease, but children with (largely) curable conditions. Children are by nature optimistic, and that makes them great to work with and the job very rewarding. Most students and new paediatricians are struck by the friendliness and approachability of other paediatricians. Compared to most other specialties there is less politicking and more teamworking. Perhaps this is because most paediatricians love their job.
What is the career path?
After the F1 year, you can apply to do a paediatric post in F2. This is not essential as it is not part of paediatric training, more of a taster. Some may then opt for entry directly into a paediatric SHO rotation, or others to see other bits of medicine. A+E is particularly popular. You will need to do a minimum of two years in recognised SHO training posts, although many do more, and it is often difficult to get into a rotation if you have not done any paediatrics before. During this time, you must pass the 2 parts of the MRCPCH exam. After this you will seek entry into the Higher Specialist Training years. Here you do 2 years of "core training", in general paediatrics, community paediatrics and neonatology. After this you have 3 years in which you can work in subspecilities to become, say, a paediatric nephrologist, or remain a generalist. At the end of these 5 years you can seek a consultant post. Although this looks like 9 years from qualification, many choose to go outside programmes or do non-training posts for additional experience.
What are the job prospects like?
Paediatrics is one of the more popular specialities, and getting training posts is not easy. You will have choice in general paediatrician jobs at consultant level. Subspeciality posts are harder to find. Many consultants seek to work part time.
What sort of person makes a good paediatrician?
You will need to be a hard worker as it can be pretty busy at times. The exams are not easy either. You must be good in a team, and good at communicating with others at all levels. You must like the excitement of dealing with very sick patients. Airs and graces will not be tolerated by other staff or the patients. Those craving status need look elsewhere. You must be genuinely interested in your patients' well being, as the joy of this speciality lies in getting involved in your patients (and families) problems and solving them. You will need to be good with your hands too - all the procedures are miniaturized. Oh - you need to like the company of children too, not minding the attendant noise and mess!
Aren't the hours terrible?
No worse than any other acute speciality. Like the rest of the hospital, we are cutting down to 48 hours a week. One of our advantages is that the wards and A+E are much less busy in the summer than the winter, so having to stay late on a glorious evening is not common.
Won't I spend my life covered in vomit, listening to screaming kids?
Children only vomit when ill, and screaming is usually a sign there is a problem. A paediatrician will not tolerate these better than anyone else, but will try to sort out the cause. Certainly the job has times when it is fairly chaotic and noisy, so if you need formality to be happy, this could be a problem.
What about the cash?
Not brilliant. Much of paediatrics is acute and so the scope for private practise is limited (and many would say not worth the hassle of all of those fee-paying parents). The consultant salary is much better than it was, but the learjet may be out of your reach.
Want to know more?
It's best to talk to paediatricians. Also, take a look at these websites:
> Royal College of Paediatrics & Child Health
> David Isaacs' studentBMJ article on careers
> BMJ article on Paediatric careers
Dr Jonathan Round
Senior Lecturer in Paediatric Intensive Care
Last updated 25/12/06
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