Health Service Categories and Careers

A-Z OF SERVICES

Paediatrics and Child Health focuses on the health and wellbeing of children, from neonates to adolescents. Medical conditions which affect children often involve congenital defects, genetic variance, and developmental issues. Children require medical care and treatment which considers their physiological characteristics and psychosocial needs. For example, their small body size, maturation, and metabolism can affect the pharmacokinetic properties of medicines and require extra skills and specific equipment. The psychosocial needs of the paediatric patient and their family is of critical importance, and care is structured and coordinated with this in mind. Paediatrics, like adult internal medicine, is very broad. Paediatricians can work in general paediatrics, or subspecialise in Child mental health; Community child health; Neonatal medicine; Paediatric allergy, immunology and infectious diseases; Paediatric clinical pharmacology and therapeutics; Paediatric diabetes and endocrinology; Paediatric emergency medicine; Paediatric gastroenterology, hepatology and nutrition; Paediatric inherited metabolic medicine; Paediatric intensive care medicine; Paediatric nephrology; Paediatric neurodisability; Paediatric neurology; Paediatric oncology; Paediatric palliative medicine; Paediatric respiratory medicine; or Paediatric rheumatology.

Paediatrics and Child Health Jobs

Paediatricians specialise in the care of infants, children and adolescents. They provide medical, clinical and psychosocial care and services to the paediatric population and work across acute, inpatient, outpatient and community settings. They are capable in general practice as well as emergency medicine and intensive care, and they have broad knowledge and skills to assess, diagnose, manage, treat and help prevent paediatric health disorders. They seek to educate their patients and improve their health, development, and wellbeing. They provide holistic and wrap-around support to paediatric patients and their caregivers, and ongoing support to those with congenital or chronic health conditions. They collaborate with a range of medical, health and allied health practitioners to provide integrated healthcare to their patients. They may also provide intervention, court reports, paralegal services, and connection to social care services. To pursue a career in this field, doctors complete foundation and core training (BBT), followed by postgraduate paediatric training– which takes approximately 5-7 years to complete, includes core paediatric and specialty training (either general or sub-specialty paediatrics), and leads to full MRCPC, CCT, and specialty registration with the GMC. At this level, they have training, management and professional development responsibilities. They may pursue a paediatric sub-speciality and registration.

Registrars working in Paediatrics work under specialist and general Paediatricians, gaining valuable work experience in the practice of Paediatrics, and developing clinical and procedural skills and competency in this field. Registrars are very important members of the integrated and multi-disciplinary health care team. They have increasing responsibility for patient care, oversee and support junior doctors and staff, participate in professional development activities and continue to receive important guidance, training, and support from senior staff. Registrars work across general paediatrics, paediatric emergency medicine, paediatric intensive care and neonatal intensive care.

Nurses (Maternal Child Health) work in hospitals and community clinics, including mobile and outreach services. They support mothers, babies and families with health management, well-being and education. They provide health advice, conduct health checks, and can connect families to relevant medical, health and social support services and community groups. They provide community based post-natal care and may run ante-natal clinics.

Child Mental Health Specialists are Paediatricians who specialise in Child Mental Health – a subspecialty of Paediatrics which focuses on working with children, young people and families with mental health difficulties. Conditions include complex presentations, behavioural challenges, neurodevelopmental disorders, eating disorders, mood disorders, anxiety and other mental health conditions. This field applies a biopsychosocial approach to health care, understanding the link between physical and mental health and the psychological, social and neurobiological aspects of care. Management and treatment options aim to improve well-being and development. These paediatricians often advise clinicians, GPs, psychologists and other health and social support teams. To pursue a career in Child Mental Health, doctors complete foundation and core training, followed by postgraduate paediatric training, which takes approximately 5-7 years to complete. In their final years they subspecialise in Child Mental Health, which leads to full MRCPC, a CCT, and sub-specialty registration with the GMC.

Community Child Health Specialists are Paediatricians who specialise in Community Child Health – a subspecialty of Paediatrics which focuses on providing quality healthcare and medical services to individual children and all infants, children and young people in the community. It studies the interplay between human biology and the physical, social and environmental factors that affect the growth and development of young people. Community Child Health Specialists work in areas such as child protection, child development and behaviour, or child population health. They help to provide continuity of care and coordination across primary care, education and social care settings. They undertake investigations and assessments, create care/management plans, prescribe medicines, perform medical procedures, and provide therapeutic treatments. They help children and young people who might be at risk of harm, who are victims of abuse or neglect, who live in out of home care, who have developmental and behavioural problems, learning needs, and/or have chronic and complex conditions, special needs or disabilities. They are mindful of educational, social, family, cultural, spiritual, economic, environmental and political contexts, and their impact on children. They utilise community resources and collaborate with parents, agencies, schools and other practitioners including speech pathologists, occupational therapists, dieticians, family counsellors and other medical specialists. They advocate for the health needs of their patients, families and the community. They implement local strategies which help to reduce health inequities, provide education and protection, prevent injury and disease, and improve overall health outcomes. They keep up to date and knowledgeable about government policies, and provide academic leadership through participation in teaching, training and research, including qualitative measurement of health outcomes and wellbeing within the community population. To pursue a career in Community Child Health, doctors complete foundation and core training, followed by postgraduate paediatric training, which takes approximately 5-7 years to complete. In their final years they subspecialise in Community Child Health which leads to full MRCPC, CCT, and sub-specialty registration with the GMC.

Neonatologists are Paediatricians who specialise in neonatal and perinatal medicine. They diagnose, manage, treat and provide specialist care for critically ill new-born or premature babies. Typical problems they treat are breathing disorders, organ displacement and serious infections. These specialists coordinate care for infants who may need surgery or who are placed in the Neonatal Intensive Care Unit (NICU). Practice involves caring for healthy newborns in the post-natal ward, as well as those requiring intensive care. Neonatologists provide counselling to parents who have a foetus at significant risk, and they provide ongoing and follow up antenatal and postnatal care, which may involve ethical and medicolegal advice. They work closely with obstetricians, general physicians and general paediatricians. They are also involved in teaching, training and research activities. To pursue a career as a Neonatologist, doctors complete foundation and core training, followed by postgraduate paediatric training, which takes approximately 5-7 years to complete. In their final years they sub-specialise in Neonatal Medicine, which leads to full MRCPC, a CCT, and sub-specialty registration with the GMC.

Paediatric specialists in Allergy, immunology and infectious diseases (PAIID) specialise in providing medical care to paediatric patients who are suffering from allergies, immune system disorders, infection, or infectious disease. They work in both inpatient and outpatient settings, managing acute and chronic conditions, and advising and collaborating with other clinicians and health care teams, including those in ambulatory, primary care, or community settings. They diagnose, manage, treat and prevent conditions such as food, insect, and drug allergies; anaphylaxis, eczema and asthma; autoimmune diseases – including Celiac disease, inflammation, or juvenile dermatomyositis; immunodeficiencies, which may be present at birth, acquired or the result of treatment/organ transplant; complex or persistent infections, including hepatitis, meningococcal disease or joint infections; and infectious diseases, including hospital and community outbreaks or pandemics. They take medical histories, perform clinical examinations, conduct and order diagnostic tests, design management plans and tailor treatment which considers the psychosocial and individual needs of the child. They provide education, disease prevention and long-term management. They work in multidisciplinary teams providing on-going medical care, which may include integration of community and allied health care services. They collaborate with, and make referrals to, other medical and paediatric specialists, and laboratory microbiology and virology teams. They usually develop expertise in an area of interest, for example, paediatric vaccine immunology, research, education and training, diagnostic laboratory operations and research, intensive care management, or public health advisory and infection control. To pursue a career in this field, doctors complete foundation and core training, followed by postgraduate paediatric training, which takes approximately 5-7 years to complete. In their final years they sub-specialise in Paediatric Allergy, Immunology and Infectious Diseases (PAIID), which leads to full MRCPC, a CCT, and sub-specialty registration with the GMC.

Specialists in Paediatric Clinical Pharmacology and Therapeutics have expert training in the development and administration of medicines and their safe and proper use in the paediatric population. They are involved in research, clinical trials, ethics, drug regulation and education. They help to create policies, administer medicines and provide advice on adverse drug reactions, toxicity, poisoning or substance abuse. They can adapt drug advice to the paediatric population. They apply principles of pharmacokinetics and pharmacodynamics to drug dosing regimens for preterm neonates, neonates, infants, children, and adolescents, as well as during pregnancy and lactation. They interact with laboratory scientists, and government agencies and authorities. They discuss principles of consent and other ethical issues relating to the paediatric population and pharmacology. They work in clinical, laboratory, research, education and industry settings. In hospitals, they work in paediatric inpatient and outpatient clinics. They provide advice to parents about drug administration to their children, investigate and manage medication-related health issues, monitor outcomes, and provide pharmacology expertise to other medical staff treating paediatric patients. To pursue a career in this field, doctors complete foundation and core training, followed by postgraduate paediatric training, which takes approximately 5-7 years to complete. In their final years they sub-specialise in Paediatric Clinical Pharmacology and Therapeutics, which leads to full MRCPC, a CCT, and sub-specialty registration with the GMC.

Paediatric Endocrinologists diagnose and manage disorders of the endocrine system in children. These include metabolism, hormone and thyroid disorders, childhood obesity, bone and growth disorders, adrenal gland issues, diabetes and puberty disorders. They work in inpatient and outpatient settings, and consult with a range of medical specialists, including paediatricians, surgeons, gynaecologists, geneticists and adult endocrinologists, in order to provide coordinated and comprehensive care. They clinically manage paediatric patients with diabetes mellitus, involving blood glucose control, intensive insulin regimes, glucose monitoring and insulin infusions, and they provide education and advice to families. To pursue a career in this field, doctors complete foundation and core training, followed by postgraduate paediatric training, which takes approximately 5-7 years to complete. In their final years they sub-specialise in Paediatric Diabetes and Endocrinology, which leads to full MRCPC, a CCT, and sub-specialty registration with the GMC.

Paediatric Emergency Physicians (PEM) are trained in the initial and short-term emergency management and treatment of children, from neonates to adolescents. This field is a subspecialty of both Paediatrics and Emergency Medicine. These specialists experience a broad range of emergency and critical care situations and have well developed clinical skills to manage children who are suffering from acute and life-threatening injury or illness. Paediatric emergency physicians provide care across primary, secondary, and tertiary conditions in the paediatric population. They have a leadership role, coordinating emergency care teams and consulting with subspecialty physicians, and managing potential conflicts to care. They always consider the psychosocial needs of their paediatric patients and caregivers, and their role often extends to educational consultation within the medical and general communities. They may also provide expert medico-legal opinion. They work in Paediatric Emergency Departments (PEDs), Paediatric Intensive Care Units (PICUs), as well as mixed EDs. To work in this field, doctors complete foundation and core training, followed by core paediatric training, or core emergency medicine training. In their final years they sub-specialise in Paediatric Emergency Medicine (PEM), which leads to a CCT, and sub-specialty registration with the GMC.

Specialist Paediatric Gastroenterologists and Hepatologists specialise in the diagnosis, prevention, treatment and management of rare and complex gastroenterology and liver disorders in the paediatric population. They understand the structure and function of the gastrointestinal (GI) tract and associated organs, including their physiological and anatomical principles, and their molecular and cellular physiology and genetics. They are experts in developmental gastroenterology, including the assessment and management of congenital and early onset disorders, neonatal and inherited disorders, paediatric abnormalities affecting absorption and metabolism, and other GI paediatric conditions include gastro-oesophageal reflux, ingested batteries, feeding difficulties, constipation, childhood obesity, chronic pancreatitis, and failure to thrive. They provide emergency and intensive care to paediatric patients suffering from GI emergencies, including neonatal and childhood liver diseases and hepatic failure. They conduct clinical assessments and interpret specialised diagnostic processes such as imaging, gastroscopy/upper endoscopy procedures, liver biopsy, and other radiology and histopathology investigations. Management and treatment involve education, nutrition support, pharmacotherapy, and collaboration with other medical and allied health practitioners with expertise in allergy, immunology and dietetics, paediatrics or paediatric surgery. Paediatric hepatologists provide care for liver and small bowel transplantation patients, and Paediatric Gastroenterologists provide nutritional support for patients, including management of services for home parenteral nutrition. As paediatricians, they are mindful of the psychosocial aspects of gastrointestinal medicine. To pursue a career as a Specialist Paediatric Gastroenterologist and Hepatologist, doctors complete foundation and core training, followed by postgraduate paediatric training, which takes approximately 5-7 years to complete. In their final years they sub-specialise in Paediatric Gastroenterology, Hepatology and Nutrition, which leads to full MRCPC, a CCT, and sub-specialty registration with the GMC.

Respiratory Paediatricians provide specialist and holistic care to babies, children and young people with conditions affecting their respiratory system, breathing and respiratory health. They can clinically manage complex acute and chronic conditions, including difficult-to-treat asthma, cystic fibrosis or rare lung disease. They undertake diagnostic studies, including assessments of lung function, fitness to fly, investigations for allergies or sleep-disordered breathing, and other immunology, biopsy or radiological testing. They have technical skills to undertake emergency procedures such as flexible bronchoscopy, replacement of a tracheostomy, and other invasive airway clearance. They provide non-invasive breathing support and therapies, and can operate long-term ventilation and monitoring technology. Respiratory Paediatricians interact with and provide advice to many medical and surgical specialties to improve outcomes in children and young people with lung disease in acute and chronic and community settings. They may be involved in research, education and public health advocacy. They work in tertiary and secondary care settings, and in acute care settings in hospitals. To work in this field, doctors complete foundation and core training, followed by postgraduate paediatric training, which takes approximately 5-7 years to complete. In their final years they sub-specialise in Paediatric Respiratory Medicine, which leads to full MRCPC, a CCT, and sub-specialty registration with the GMC.

Paediatric Rheumatologists care for children and young people with a range of rheumatological conditions, including mechanical pain, juvenile arthritis, and complex multi-system inflammatory disorders. Practice involves history-taking, examination and communication with other professionals due to limited diagnostic testing for these specific conditions. Management and treatment can involve joint injections, pharmacology which targets the inflammation, and integrated care with allied health and community/education services. Paediatric rheumatologists work in multidisciplinary teams with specialist nurses, physiotherapists, occupational therapists and psychologists. They support collaborative clinical networking, and are often involved in clinical and scientific research, including data collection and trials, education and training. To work in this field, doctors complete foundation and core training, followed by postgraduate paediatric training, which takes approximately 5-7 years to complete. In their final years they sub-specialise in Paediatric Rheumatology, which leads to full MRCPC, a CCT, and sub-specialty registration with the GMC.