Paediatric Guidance Checklist
These standards were derived to assist in the assessment of the
paediatric training standards of in your deanery
Specialty:
Paediatric Immunology, Infectious Diseases and Allergy
The Programme (which may consist of several posts) should provide:
1. Supervision - For both allergy and immunology/infectious
/
diseases
1.1 An educational supervisor who is a Consultant paediatric allergist or
Consultant in paediatric infectious diseases/immunology trained in
assessment and appraisal
1.2 An educational supervisor who provides average 4 hours (1PA) per
week of educational supervision
1.3 Evidence that the assessment strategy is being delivered
1.4 Trainers receive appropriate training on the delivery of the assessment
strategy
1.5 appropriate supervision to ensure patient safety
2. Other Personnel
For both allergy and immunology/infectious diseases
2.1 A minimum of 2 consultants in specialty to support & supervise
2.2 More than one ST4 -8 in the children’s department
For allergy only
2.3 at least one paediatric dietician experienced in paediatric allergy
2.4 at least one paediatric allergy clinical nurse specialist trained in allergy
skin testing and administration of specific immunotherapy
For immunology/infectious diseases only
2.5 clinical nurse specialists in HIV + TB +/- others e.g. hepatitis
2.6 clinical nurse specialists in immunology involved in the delivery of
immunoglobulin therapy.
3. Service requirements and facilities - For both allergy and
immunology/infectious diseases
Allergy only
3.1 Specialty specific requirements of subspecialty department:
Full complement of doctors specialist nurses and paediatric dieticians
Full range of allergy diagnostic testing
Day ward facility for drug and food challenges
Established immunotherapy service
3.2 Specialty specific requirements of service departments
relevant to delivery of curriculum
PICU, outpatients clinic in dermatology, paediatric respiratory medicine,
paediatric gastroenterology, feeding clinics and paediatric ENT
3.3 Specialty specific requirements of related clinical departments
that are involved in delivery of the curriculum:
Access to immunology diagnostic laboratory, a pulmonary function
measurement laboratory, paediatric dietetic and psychiatry departments
3.4 Specialty specific requirements of clinical networks:
Established networks with an adult allergy department, clinical
immunology and links with community paediatrics
Immunology and Infectious Diseases
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3.5 Specialty specific requirements of subspecialty department:
Multi-disciplinary support to inpatient management
3.6 Specialty specific requirements of service departments
relevant to delivery of curriculum
PICU, bone marrow transplantation, extensive range of sub-specialties e.g.
orthopaedics, neurosurgery
3.7 Specialty specific requirements of related clinical departments
that are involved in delivery of the curriculum:
Microbiology, virology, immunology laboratories, pulmonary function
testing, dietetics, comprehensive radiology
3.8 Specialty specific requirements of clinical networks:
HIV, TB, General Paediatric Infectious Diseases, adult HIV/TB, community
paediatrics (immunisation), immunoglobulin therapy
4. Educational activities and training
Allergy Only
4.1 Specialty specific clinical exposure required to provide
sufficient learning opportunities(NB if giving workload data ensure it is explicit whether this is number
per annum or number trainee would be expected to be exposed to over entire programme):
Regular opportunities to participate in the inpatient care of children
following sever allergic reactions
Supervise children attending for food and drug challenges – 40 per year
Develop appropriate protocols and drug desensitisation
Supervise the administration of immunotherapy – 70 procedures per year
Opportunity to liaise with community paediatricians, school and
community nurses
4.2 Specialty specific requirements for structured training
opportunities to include courses:
Attend the allergy and immunology modules of BPAIIG training
programme
The allergy training workshop held by BASCI
Attend a basic immunology course or equivalent
Member of the British Society for Allergy and Clinical Immunology
Encouraged to be a member of the European Academy of Allergy and
Clinical Immunology
4.3 Specialty specific requirements for other experiential
learning(excluding clinics and ward rounds):
Facilitate an understanding of the role of voluntary organisations and
support groups
Immunology and Infectious Diseases
4.1 Specialty specific clinical exposure required to provide
sufficient learning opportunities (NB if giving workload data ensure it is explicit whether this is number
per annum or number trainee would be expected to be exposed to over entire programme):
Exposure to severe (transplantable) immunodeficiencies
4.2 Specialty specific requirements for structured training
opportunities to include courses:
75% minimum attendance at:
Infection and Immunity course, PENTA/ESPID HIV course, ESPID case
rounds, BPAIIG modular training days, basic immunology course
4.3 Specialty specific requirements for other experiential
learning(excluding clinics and ward rounds):
Microbiology, virology, immunology laboratory attachments, understanding
of voluntary organisations and support groups
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5. Working patterns - For both allergy and immunology/infectious
diseases
5.1 Safe cover arrangements for paediatric department out of hours in
line with RCPCH guidance
5.2 Evidence of compliance with existing employment working time
5.3 Working intensity and pattern that is appropriate for learning
5.4 It is unlikely that sufficient access to the sub-specialty will be given if
more than 1/3 of hours are spent outside specialty
5.5 the post forms part of a complete paediatric training programme
which provides a minimum of 5 years acute clinical experience, including
out of hours duties
6. Specific Post requirements
6.1 Allergy only
For Specialty Training – minimum of 24 months clinical training to include.
In a 3 year programme a further 12 months maybe clinical or research in
appropriate settings
6.2 Immunology/Infectious Diseases only
For Specialty Training - minimum of 24 months clinical training to include
6 months gastroenterology. In a 3 year programme a further 12 months
maybe clinical or research in appropriate settings
6.3 Immunology emphasis
Within a 24 month programme a minimum of two months in a Paediatric
BMT unit, minimum of two months attached to Adult immunology
7. Enabled to learn new skills, necessary skills and curriculum
coverage (speciality specific)
7.1 Allergy - Specialty specific marker conditions trainee should be
exposed to:
Food allergy (IgE and non-IgE mediated)
Eczema
Urticaria / angioedema
Asthma / recurrent wheeze
Rhinoconjunctivitis
Allergic rhinitis requiring treatment with immunotherapy (minimum 5
cases per year)
Venom allergy
Drug allergy
Vaccine reactions
Latex allergy
Idiopathic anaphylaxis
Exercise induced anaphylaxis
Oral allergy syndrome
Vocal cord dysfunction
7.2 Specialty specific skills/procedures trainee needs to complete:
skin prick testing, intradermal testing, atopy patch testing, administration
of subcutaneous and sublingual immunotherapy, pulmonary function
measurement, interpretation of levels of specific IgE, food and drug
challenge
7.3 Immunology/Infectious Diseases - Specialty specific marker
conditions trainee should be exposed to:
Common infectious diseases in different age groups.
Unusual infections including tropical diseases, opportunistic infections,
infection in immunocompromised host.
HIV
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TB
Hepatitis
Organ specific infections, e.g. osteomyelitis, cerebral TB etc.
Primary Immunodeficiencies including minor, moderate (requiring
immunoglobulin replacement) and severe (requiring bone marrow
transplantation or gene therapy).
Secondary immunodeficiencies complicated by infections.
For those training with emphasis on immunology:
autoimmune and immunodysregulatory disorders
Hereditary angio oedema
common allergic disorders,
7.4 Specialty specific skills/procedures trainee needs to complete:
Tuberculin skin test, skin biopsy, bone marrow aspiration
8. Access to clinics and ward rounds & long term care of patients
8.1 Allergy - Specialty specific numbers and types of clinics
expected to attend::
At least 2 supervised allergy clinics per week (80 per annum)
Attendance at 20 gastroenterology clinics
20 respiratory clinics
10 paediatric dermatology clinics
10 adult allergy clinics
10 paediatric ENT clinics
8 paediatric immunology clinics
8.2 Specialty specific combined clinics trainee is expected to
attend:
8.3 Specialty specific ward rounds
8.4 Specialty specific involvement in transitional care gastroenterology:
Involvement in the transition of care to an adult allergy service
8.5 Immunology and Infectious Diseases - Specialty specific
numbers and types of clinics expected to attend including outreach
clinics:
At least 1 supervised clinic per week during 2 year programme to cover
exposure to HIV, TB, general infectious diseases and immunology
8.6 Specialty specific combined clinics trainee is expected to
attend:
Mother and child HIV clinic
8.7 Specialty specific ward rounds:
Minimum of 1 ward round per week to include MD/microbiology joint
rounds and immunology/BMT rounds
8.8 Specialty specific involvement in transitional care hepatology:
HIV transitional care; transition of long-term immunoglobulin dependent
patients
8.9 Inpatient consult service for other sub-specialties to include PICU,
NICU and range of organ specific subspecialties
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9. Meetings
9.1 Allergy - Specialty specific number and types of MDT meetings
expected to be exposed to:
Weekly team meetings
9.2 Specialty specific multi-professional meetings trainee is
expected to be exposed to:
Opportunities to meet with community paediatrics and dietetics
Member of an appropriate regional paediatric allergy group
9.3 Speciality specific other meetings:
Academic meetings/journal clubs
9.4 Immunology/Infectious Diseases - Specialty specific number
and types of MDT meetings expected to be exposed to:
Weekly HIV MDT
Monthly TB
9.5 Specialty specific multi-professional meetings trainee is
expected to be exposed to:
9.6 Speciality specific other meetings:
Academic meetings/journal clubs
10. Clinical audit
For both allergy and immunology/infectious diseases
10.1 Evidence of trainees participation in clinical governance (at least 1
full audit/year and attendance at critical incident meetings)
10.2 Evidence of trainees participation in clinical guideline development
10.3 Specialty specific audit requirements e.g. participation in national
CHIPS (HIV) audit or allergy audit
11. Teaching appraising and assessing
For both allergy and immunology/infectious diseases
11.1 Opportunities for formal and informal teaching
11.2 For senior trainees: opportunities for involvement of assessment of
others
11.3 For senior trainees: opportunity to be involved in the appraisal of
others
12. Research
For both allergy and immunology/infectious diseases
12.1 Provide formal teaching on research ethics and research
methodology
12.2 Provide opportunities to be involved in clinical research
12.3 access to laboratory based research facility
12.4 Completion of higher degree and/or publication of at least one
research paper as first author
12.5 opportunity to present at national/international meetings
13. Management
For both allergy and immunology/infectious diseases
13.1 Opportunities to be involved in management e.g. participation in
management meetings and projects including attendance at specialty
business meetings
13.2 participation in Trainees group, opportunity to stand or vote for
trainee’s representative in PGHAN CSAC, BSPGHAN and organise postgraduate and associate members day at BSPGHAN winter meeting
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