If you asked me to describe my life as a paediatrics trainee in one word, I would say ‘busy’! Fortunately for you, I have been given a few more words than that, so let me give you an overview of what it’s like to work in the busy, yet fun and exciting, world of paediatrics. My name is Kate and I am coming towards the end of my second year as a paediatrics trainee at a large teaching hospital in London.
In this blog post I will briefly cover what the paediatrics training programme looks like, try to explain what I do every day using three days this week as an example, talk about my hours and answer the most common question I get asked about my job. Enjoy!
How does paediatrics training work?
Unlike many other specialities, paediatrics is a ‘run through’ training programme which you can apply to start immediately after your F2 year. Run-through means you start as an ST1 (ST = speciality trainee) and, as long as you meet the required competencies each year and pass your exams, you automatically progress each year to become an ST2, ST3 etc… all the way to ST8 after eight years, without having to apply for registrar jobs in the middle.
This is different from many other specialities where you do 2-3 years of ‘core’ training after F2 before applying to a speciality. If you wanted to be a cardiologist, for example, you would do 2-3 years ‘core medical’ training and then apply to cardiology at the registrar level. This could mean having to move across the country for a job in your desired speciality, which many people do!
Knowing I will be in London for the whole eight years of my training has allowed me to settle and buy a flat in South London last year, which was very exciting and definitely a benefit of the stability of run-through training in a small geographical area such as London.
The application process for paediatrics training consisted of an application form and MMI interview – much like most medical schools! Stations included giving a presentation, talking through a clinical scenario and a communication station. (Don’t worry I’m not giving away any secrets, this is all available on the !)
Some people might think the length of training (eight years!) is a downside to paediatrics. Yes, friends in my year at medical school who are doing GP training will be fully qualified a whole five years before me, but there is so much to learn in paediatrics that I am very happy to have a whole eight years to train!
What do I do every day?
Depends on the job! Over the course of eight years, we rotate jobs every six months and change hospital usually every year. Everyone must spend time in general paediatrics, neonatal medicine and community paediatrics, but we also have opportunities to experience different paediatric specialities, depending on our interests. In my first three years, I will have tried: paediatric infectious diseases, hepatology, neurology and intensive care. After ST5 I could apply to sub-specialise in any paediatric speciality and just do that for my final three years, or continue as a general paediatrician.
So, what have I been up to this week? I currently work as an ST2 in a tertiary neonatal intensive care unit. I spent two days working on the high dependency unit (one step down from intensive care) and carrying the labour ward bleep. When the bleep goes off, it usually means I need to go to the labour ward and attend the delivery of a baby who may need help after birth. This is my favourite part the job! Most babies are fine but occasionally I need to intervene.
Here is a brief summary of the some of the most interesting things I have done:Attended the delivery of a very premature baby.
When we know we are expecting a very premature baby, we go to the delivery as a team of doctors and nurses and allocate roles before the baby is born - an excellent example of teamwork! My role was to manage the airway, which is the most important area for me to master before becoming a registrar. Once the baby arrived, I put a hat on and placed her body into a plastic bag (this may sound bizarre but it is important to keep the baby in moisture and heat until they are in a humidified incubator).
My colleagues changed umbilical clamps, listened to her heart and applied monitoring while I gave some breaths via facemask until she started to breathe for herself. She did well and, once she was breathing regularly, I just held the mask on her face to provide some oxygen and pressure until we transferred her to intensive care in our transport incubator.
The most premature birth I have seen was at exactly 23 week’s gestation – that’s 17 weeks early! He weighed about 600g. He was too premature to stay in the hospital I was working in at the time, so was transferred out and came back to us several months later weighing over 3kg, which I thought was amazing!I attended a few more deliveries.
Most required no help but one I had to give some breaths via facemask to inflate his lungs. This is usually enough to bring up a baby’s heart rate and make them start to cry and breathe for themselves. In this instance it worked well, but a couple of weeks ago I had to put out an emergency call when it didn’t.Inserting IV Lines
A couple of babies were at risk of infection so I put in IV lines, took blood samples and prescribed antibiotics.Perform Lumbar Punctures
Two others had high infection markers so I did lumbar punctures to take samples of their spinal fluid to test for meningitis.
Attending deliveries and doing practical procedures like this is definitely the highlight of my current job! Back on the high dependency unit, when not being bleeped to labour ward, I do routine jobs like attend ward rounds, take blood tests, prescribe medication and request investigations for our inpatients.
Today, I was working on the post-natal ward. Here I review babies who are mostly well, including doing routine new-born checks on babies before discharge. It may be less exciting than attending deliveries and working in intensive care but it’s also nice to spend time with healthy, well babies. I love talking to new parents and showing them how to do things like changing nappies and holding their new baby (I often spend too long chatting and end up leaving late, so need to learn to cut down!).
Although I have enjoyed working with neonates, the thing I enjoy most about my job is the interaction with children who are old enough to talk and play games. Paediatrics definitely has the most fun patients in the hospital! Playing hide and seek in A+E or singing along to the Moana/Frozen soundtracks is what makes my job fun, so I will probably end up specialising in general paediatrics. The variety of patients in general paediatrics is also very exciting: one minute I could be reviewing a small baby, the next a teenager taller than me or anything in between!
What are the hours like?
Again, this is very variable depending on the job. On my current rota, shifts vary from 5 to 13 hours with an average of 46.5 hours per week. Most of the time we do several ‘long days’ in a row which adds-up to much more than this so to keep the average down (the new junior doctor’s contract states the average week must be under 48 hours), we get quite a few days off during the week. Obviously, this isn’t the same as time off at the weekend (I work four out of every nine weekends so have missed a lot of events, birthday parties etc.) but I do enjoy a day off in the week too, especially walking around the shops when it’s quieter than at the weekend! We also do quite a lot of night shifts which was been a shame while it’s been so warm because I’ve missed a lot of the sun!
I go back to general paediatrics from September and my new rota is much more forgiving – I will work about half as many weekends and a quarter as many nights, so the hours can be very variable.
Isn’t it sad?
A very common question I get asked when I tell people I am a paediatrics trainee is “but isn’t it really sad?”. In all honesty, yes it can be. I am sure working with children and young people will always be emotional when we can’t help them to get better. I have cried at work several times. I have also woken up the next day and continued to cry.
What has been really great, however, is the support I have received from colleagues at the exact right moments. I may be biased but in my experience only the nicest people become paediatricians, which is another highlight of the job. Yes, it’s tough, but I have always felt supported and able to talk to my colleagues if needed. In one of my previous jobs, we had monthly resilience sessions where we talked through cases we found emotionally challenging. We always have a team debrief after a major event and are encouraged to have outside interests to help us switch off. Maybe it’s running, baking or music - everyone has their thing. Very few specialities won’t involve sad cases, so I actually think this is very important for everyone.
Overall, is it worth it?
Yes, the training and the hours are long, and there can certainly be emotional days but, for me, it’s the patient group that makes a career in paediatrics worth it. From looking after a tiny premature baby to chatting with a child about their favourite school subject/food/Disney character (I do a lot of chatting!), paediatrics has it all.
Next step for me: pass my clinical exams and become a paediatric registrar.
Next step for you: getting into medical school so you can become a paediatrician too! First, you need to write your personal statement, so check out our free blog on the top ten tips to avoid here.
If you would like to find out about other medical specialities, life as a Junior Doctor or life at medical school, take a look at the rest of this blog series.