Sub-specialty training programmes – Training requirements Paediatric trainees completing level 3 training successfully in a recognised sub-specialty training programme will be eligible to enter the GMC Specialist Register as a Paediatrician with sub-specialty recognition. Sub-specialty training is undertaken within the NTN grid, following formal appointment through the NTN Grid matching process. Programmes of sub-specialty training are prescribed by the College Specialty Advisory Committee’s (CSAC) and there is a specific curriculum for each sub-specialty. Training Requirements Specialty Trainees (ST) - Competence based training The below requirements are a guide to show how long it will commonly take to gain subspecialty competences. Grid programmes are generally 24-36 months; this time may be adjusted depending on the trainee’s progression. Any trainees wishing to complete subspecialty training in less time than the guide (i.e. they feel they already possess a number of sub-specialty competences) will be carefully considered by the CSAC at the time of application to the NTN Grid. ST5 trainees may apply to 24-36 month programmes (providing there is clear evidence that they will have completed level 2 competences by the time of commencing the grid post). Trainees appointed to grid programmes will generally be expected to gain their competences and complete the programme in the guided time. Occasionally trainees will require additional training time; a relevant post will be found for the further 12 months. Trainees must complete all general and sub-specialty specific competences prior to CCT. Sub-specialty Paediatric Clinical Pharmacology and Therapeutics Child Mental Health Training Programme Requirements 24-36 months 12m paediatric pharmacology research is essential. 24-36 months 36 months Community Child Health Minimum 24m community child health clinical training. The remaining 12m may be in a specialty relevant to community child health, a specific area of community child health or approved research. The CSAC will be flexible about the nature of the ‘relevant specialty’ or research but it must help the trainee to enhance their competences in community child health. 24-36 months Paediatric Diabetes and Endocrinology A minimum of 24 months training is required in Endocrinology and Diabetes. Additional training/research is advantageous 24-36 months Paediatric Emergency Medicine 12 months in paediatric emergency medicine 3m minimum experience required in anaesthetics/ paediatric intensive care, 3 months in each of orthopaedics and surgery. Paediatric Emergency Medicine can be completed from within a Paediatrics or Emergency Medicine training programme – CCT will be dependent on the route of training. 36 months Paediatric Gastroenterology, Hepatology and Nutrition Themed training with gastroenterology emphasis (24m gastroenterology, 6m hepatology, 6m nutrition) or hepatology emphasis (30m hepatology, 6m gastroenterology) 24-36 months Paediatric Immunology, Infectious Diseases and Allergy Themed training with an emphasis in one of Paediatric Immunology, Paediatric Infectious Disease and Immunology or Paediatric Allergy and Immunology. 24-36 months Paediatric Intensive Care Medicine Paediatric Inherited Metabolic Medicine 6 months anaesthetic training (to be undertaken as OOPE) is essential which will be organised upon appointment if not already completed. 24-36 months 36 months Minimum 24m neonatal clinical training. The remaining 12m may be in neonates, approved research or in an allied sub-specialty1 Neonatal Medicine Neonatal trainees must complete the neonatal assessment framework during their training – a CCT with sub-specialty recognition will not be achieved without the framework completed. Paediatric Nephrology 24-36 months 36 months Paediatric Neurodisability For trainees starting Grid programmes from September 2013 onwards: 36m including 12m (or modular equivalent) in paediatric neurology and 3m (or modular equivalent) in child psychiatry. For trainees starting Grid programmes up to September 2013: 24m including 6m (or modular equivalent) in paediatric neurology and 3m (or modular equivalent) in child psychiatry 42 months Paediatric Neurology 6m will be added to CCT on appointment for the completion of required adult neurology (if not already achieved). Clinical experience should include 24m paediatric neurology, 12m neurodisability and within this time the equivalent of a day per week for one year in child psychiatry. 2 years in acute paediatric neurology 1 year in neurodisability (with at least 6 months at a tertiary level) 6 months in adult neurology 3 months equivalent child and adolescent psychiatry (generally undertaken during other attachments) Paediatric Oncology Paediatric Palliative Medicine 1 24-36 months 24-36 months For the Neonatal assessment framework and further information on what can be included within the additional 12m please refer to the Neonatal CSAC approval for level 3 training document available on the RCPCH website. 24-36 months Paediatric Respiratory Medicine Minimum of 24m grid training in paediatric respiratory medicine if previous experience of paediatric respiratory medicine / PICU / relevant research. 36m if no previous experience in these areas 24-36 months Paediatric Rheumatology Training should be completed in 2 recognised centres for training Gaining approval for sub-specialty training completed before grid appointment To be eligible for CCT in paediatrics (sub-specialty) you need either to have been on the UK national grid or to have completed a recognised training programme in (sub-specialty) in another country. Sub-specialty training outside of the grid is not supported by the Royal College of Paediatrics and Child Health. Trainees wishing to seek a sub-specialty CCT are expected to complete training in an approved sub-specialty programme following appointment to the NTN grid via the NTN grid matching process. Trainees who have completed a sub-specialty post within Level 3 prior to their appointment to the NTN grid may (under certain circumstances) be permitted to count this time towards their sub-specialty training. If a trainee would like to do this, they must receive approval from the relevant CSAC at the point of application to the grid. Certain CSACs may ask for a letter from the training centre so they can consider if the training received in the sub-specialty post would equate to training that would be received by a grid trainee. See the below table for the requirements of each CSAC. Community Child Health Paediatric Clinical Pharmacology and Therapeutics Child Mental Health Paediatric Diabetes and Endocrinology Paediatric Emergency Medicine Paediatric Gastroenterology, Hepatology and Nutrition Paediatric Immunology, Infectious Diseases and Allergy Paediatric Intensive Care Medicine Paediatric Inherited Metabolic Medicine Neonatal Medicine Paediatric Nephrology Paediatric Neurodisability Paediatric Neurology Contact CSAC directly by email Contact CSAC directly by email Contact CSAC directly by email Contact CSAC directly by email Contact CSAC directly by email CSAC require letter from centre Contact CSAC directly by email Contact CSAC directly by email Contact CSAC directly by email Contact CSAC directly by email Contact CSAC directly by email Contact CSAC directly by email Contact CSAC directly by email Contact CSAC directly by email Contact CSAC directly by email Contact CSAC directly by email CSAC require letter from centre Paediatric Oncology Paediatric Palliative Medicine Paediatric Respiratory Medicine Paediatric Rheumatology Post CCT Sub-specialty Experience Those who complete a CCT in paediatrics without sub-specialty accreditation can acquire further experience in their chosen sub-specialty post CCT in non training grade posts. It is not possible to have this additional experience retrospectively recognised to obtain sub-specialty recognition on the GMC specialist register. Specialties not available within the Paediatric NTN Grid Specialty How to apply Entry routes Audiovestibular Medicine (formerly Audiological Medicine) ST3 available through the Royal College of Physicians Paediatrics, ACCS, General Practise, ENT surgery Child and Adolescent Psychiatry ST4 available through the Royal College of Psychiatrists Core Psychiatry Training (CPT) Clinical Genetics ST3 available through the Royal College of Physicians Paediatrics, ACCS or CMT Clinical Neurophysiology ST3 available through the Royal College of Physicians Paediatrics, ACCS or CMT Dermatology ST3 available through the Royal College of Physicians Paediatrics (with 12m medicine experience), ACCS or CMT Haematology ST3 available through the Royal College of Physicians Paediatrics, ACCS or CMT Paediatric Cardiology ST4 available through the Royal College of Physicians. Paediatrics, ACCS or Core Medical Training (CMT) Paediatric Surgery ST3 available through the Royal College of Surgeons Core Surgical Training (CST) Clinical Radiology ST1 available through the Royal College of Radiologists Can apply directly from Foundation Programme. Also welcomes applicants from ST and CT trainees in acute care clinical specialties, such as medicine, surgery and paediatrics (these candidates would be required to complete the full 5 year training programme)