Outline of training in paediatrics within the Severn School of Paediatrics

There are eight nominal years of paediatric training from entry into the programme until award of a Certificate of Completion of Training (CCT) in Paediatrics. Progression is dependent upon a trainee gaining the competencies required (as defined in the Royal College of Paediatrics and Child Health [RCPCH] curriculum) and is assessed annually at the trainee’s ARCP (Annual Review of Competency Progression).

In addition, other opportunities for supplementing this training with experience out-of-programme may be sought, including placements abroad and in research .

Training in paediatrics is divided into three levels. For more information about training in paediatrics please also see the RCPCH website.

Level 1 Training (ST1, ST2 and ST3)

Trainees usually enter our programme at ST1 and the majority are placed in training centres outside Bristol, in order to get a basic grounding in paediatrics. The training centres for ST1 are:

  • Gloucester
  • Bath
  • Swindon
  • Taunton

Recently we have been placing ST1s in the second half of their year in Bristol, where they remain for 2 years. This is to allow the second half of the ST3 year to be back in a DGH environment and improve readiness to become a middle grade at ST4. We will plan to move all ST1 (and ST3 posts) to this pattern over the coming years.

In level 1 trainees are given the opportunity of gaining experience in some of the paediatric sub-specialties. The placements with sub-specialty experience are located in Bristol, as below. Specific placements in the medical sub-specialties at the Children's Hospital are planned by the clinical tutor there in conjunction with trainees' preferences. All trainees will gain experience in tertiary neonatal medicine.

  • Bristol Royal Hospital for Children (most paediatric sub-specialties)
  • Southmead and St Michael’s Hospitals (tertiary neonatology)
  • Community child health in Bristol

Trainees need to pass all parts of the MRCPCH exam to then progress to ST4.

Level 2 Training (ST4 and ST5)

Trainees gain level 2 competencies by undertaking placements in general paediatrics, neonatology and community paediatrics over a two year period, acting as a registrar or middle grade, in one of the following training centres:

  • Gloucester
  • Bath
  • Swindon
  • Taunton
  • Yeovil

Level 3 Training (ST6 and ST7)

Trainees are offered the opportunity to gain further experience in sub-specialties at ST6 and ST7. The sub-specialties are located in the Bristol hospitals. Trainees are placed for 6 to 12 month periods in each sub-specialty, depending upon trainee preferences and post availability. This provides training for those training in general pediatrics to develop an special interest in a sub-specialty. There are also opportunities to undertake a Special Interest Module (SPIN) in level 3 training - see the RCPCH website for more details of SPIN modules.  Trainees who wish to train to become sub-specialists will need to apply to the RCPCH GRID system (see below).

Level 3 Training (ST8)

Those training to become general paediatricians will be placed in one of the District General Hospital training centres in the final year up to the point of gaining the CCT and for the 6 month grace period after CCT. During this time, the trainee will be given the opportunity of taking on a more senior role and developing interests in the non-clinical activities (usually management, clinical governance, teaching, etc), which are useful before applying for a consultant post.

Level 3 GRID Training (ST6, ST7 and ST8)

In addition to gaining a CCT in Paediatrics, trainees may wish to gain accreditation in certain paediatric sub-specialties (for a full list of RCPCH recognised sub-specialties, see RCPCH GRID website). Many of these sub-specialty training programmes are available within the Severn Deanery, although a few require rotation to other tertiary centres within the UK. These programmes are offered to trainees nationally and most schemes encourage trainees to apply during ST5 so that they will be ready to start the sub-specialty training programme it the beginning of ST6.

For more details of the grid application process see the RCPCH website.

Grid training applications, interviews and the selection process are managed nationally by the RCPCH. If candidates are successful, they will be matched to the available sub-specialty GRID rotations, in accordance with the candidates stated preference and availability. For Severn trainees, this may be outside of Severn, dependent on availability and a competitive ranking process.  Once on a rotation, the trainee is then guaranteed the placements within the rotation that enable training towards their particular sub-specialty. Trainees will remain in the sub-specialty rotation until they are granted their CCT.

Sub-specialty Training

The Severn School of Paediatrics offers training in the following sub-specialties (note: not all sub-specialties are available every year):

  • Paediatric Emergency Medicine
  • Paediatric Intensive Care Medicine
  • Paediatric Respiratory Medicine
  • Paediatric Endocrinology (rotation with Welsh Deanery)
  • Paediatric Gastroenterology (rotation with West Midlands Deanery)
  • Paediatric Rheumatology (rotation with another deanery)
  • Paediatric Nephrology
  • Paediatric Neurodisability
  • Paediatric Neurology
  • Paediatric Oncology
  • Paediatric Infectious Diseases and Immunology
  • Neonatal Medicine
  • Community Child Health