Shape of Training August 2018

Shape of Training Considerations Flexibility – OOP, transfer in/out opportunities Need to enhance ability to deal with uncertainty, decision- making, preparation for tier 2 working Learning Together, with RCGP and RCPsych trainees Achieving appropriate balance between general paediatrics and specialty paediatrics Maintaining ability to provide holistic care, with wide participation in unscheduled care services Adaptible & responsive training over career

Specialty Paediatrics Core Paediatrics ST1 ST2a ST2b ST3 Tier 1 Tier 2 Core curricular capabilities in General Paediatrics, Neonatology, Integrated (Primary/Secondary) Care, Public Health, Community Child Health, Child & Adolescent Mental Health May include sub-specialty placements Specialty Paediatrics ST4 ST5 ST6 General Paediatrics includes acute General Paediatrics Paediatric Credential Neonatal Intensive Care Paediatric Intensive Care Paediatric Emergency Medicine Post CCT Career Continuing Professional Development Professional Support Continuing opportunities for post-CCT credentials Continuing opportunities for Special Interest modules Route A 70% CCT Paediatrics CCT Paediatrics Accelerated Core Programme* ST1 ST2 ST3 Tier 1 Tier 2 Pilot sites selected for high quality training support, able to deliver Core curriculum within indicative timescale of 3 years Route B 15% Credential CCT Paediatrics (subspecialty) Route C 15% MRCPCH Theory MRCPCH Clinical  MRCPCH Clinical  START Entry points: post F2, F3, SAS, from other specialty programmes, etc. v3.1 Aug 2018

Core Paediatrics

Core Paediatrics ST1 ST2a ST2b ST3 Tier 1 Tier 2 Core curricular capabilities in General Paediatrics, Neonatology, Integrated (Primary/Secondary) Care, Public Health, Community Child Health, Child & Adolescent Mental Health May include sub-specialty placements Specialty Paediatrics ST4 ST5 ST6 General Paediatrics includes acute General Paediatrics Paediatric Credential Neonatal Intensive Care Paediatric Intensive Care Paediatric Emergency Medicine Core Paediatrics General grounding, including integrated (primary/secondary) care, public health, mental health. Need to enhance ability to deal with uncertainty, decision-making, etc., in preparation for tier 2 working: Learning Together RCGP Thinking Together RCPsych Post CCT Career Continuing Professional Development Professional Support Continuing opportunities for post-CCT credentials Continuing opportunities for Special Interest modules Route A 70% CCT Paediatrics CCT Paediatrics Accelerated Core Programme* ST1 ST2 ST3 Tier 1 Tier 2 Pilot sites selected for high quality training support, able to deliver Core curriculum within indicative timescale of 3 years Route B 15% Credential CCT Paediatrics (subspecialty) Route C 15% MRCPCH Theory MRCPCH Clinical  MRCPCH Clinical  START Entry points: post F2, F3, SAS, from other specialty programmes, etc. v3.1 Aug 2018

Core Paediatrics Entry from Foundation or ST1 ST2a ST2b ST3 Tier 1 Tier 2 Core curricular capabilities in General Paediatrics, Neonatology, Integrated (Primary/Secondary) Care, Public Health, Community Child Health, Child & Adolescent Mental Health May include sub-specialty placements Specialty Paediatrics ST4 ST5 ST6 General Paediatrics includes acute General Paediatrics Paediatric Credential Neonatal Intensive Care Paediatric Intensive Care Paediatric Emergency Medicine Core Paediatrics Entry from Foundation or Transfer in from other specialty, with recognition of previously-acquired transferable capabilities. Post CCT Career Continuing Professional Development Professional Support Continuing opportunities for post-CCT credentials Continuing opportunities for Special Interest modules Route A 70% CCT Paediatrics CCT Paediatrics Accelerated Core Programme* ST1 ST2 ST3 Tier 1 Tier 2 Pilot sites selected for high quality training support, able to deliver Core curriculum within indicative timescale of 3 years Route B 15% Credential CCT Paediatrics (subspecialty) Route C 15% MRCPCH Theory MRCPCH Clinical  MRCPCH Clinical  START Entry points: post F2, F3, SAS, from other specialty programmes, etc. v3.1 Aug 2018

Will require suitable support, supervision and assessment Core Paediatrics ST1 ST2a ST2b ST3 Tier 1 Tier 2 Core curricular capabilities in General Paediatrics, Neonatology, Integrated (Primary/Secondary) Care, Public Health, Community Child Health, Child & Adolescent Mental Health May include sub-specialty placements Specialty Paediatrics ST4 ST5 ST6 General Paediatrics includes acute General Paediatrics Paediatric Credential Neonatal Intensive Care Paediatric Intensive Care Paediatric Emergency Medicine Core Paediatrics ST3 Tier 2 rota Will require suitable support, supervision and assessment MRCPCH theory (not clinical) Entrustable Professional Activity (EPA) assessments Recognises that currently many pre-MRCPCH ST3 and ex-ST3 trainees are on tier 2 rotas. Post CCT Career Continuing Professional Development Professional Support Continuing opportunities for post-CCT credentials Continuing opportunities for Special Interest modules Route A 70% CCT Paediatrics CCT Paediatrics Accelerated Core Programme* ST1 ST2 ST3 Tier 1 Tier 2 Pilot sites selected for high quality training support, able to deliver Core curriculum within indicative timescale of 3 years Route B 15% Credential CCT Paediatrics (subspecialty) Route C 15% MRCPCH Theory MRCPCH Clinical  MRCPCH Clinical  START Entry points: post F2, F3, SAS, from other specialty programmes, etc. v3.1 Aug 2018

Core Paediatrics ST1 ST2a ST2b ST3 Tier 1 Tier 2 Core curricular capabilities in General Paediatrics, Neonatology, Integrated (Primary/Secondary) Care, Public Health, Community Child Health, Child & Adolescent Mental Health May include sub-specialty placements Specialty Paediatrics ST4 ST5 ST6 General Paediatrics includes acute General Paediatrics Paediatric Credential Neonatal Intensive Care Paediatric Intensive Care Paediatric Emergency Medicine Core Paediatrics Potential re-entry into training programme for SAS doctors / clinical fellows (without MRCPCH), depending upon capability. Post CCT Career Continuing Professional Development Professional Support Continuing opportunities for post-CCT credentials Continuing opportunities for Special Interest modules Route A 70% CCT Paediatrics CCT Paediatrics Accelerated Core Programme* ST1 ST2 ST3 Tier 1 Tier 2 Pilot sites selected for high quality training support, able to deliver Core curriculum within indicative timescale of 3 years Route B 15% Credential CCT Paediatrics (subspecialty) Route C 15% MRCPCH Theory MRCPCH Clinical  MRCPCH Clinical  START Entry points: post F2, F3, SAS, from other specialty programmes, etc. v3.1 Aug 2018

Accelerated Core Programme* Core Paediatrics ST1 ST2a ST2b ST3 Tier 1 Tier 2 Core curricular capabilities in General Paediatrics, Neonatology, Integrated (Primary/Secondary) Care, Public Health, Community Child Health, Child & Adolescent Mental Health May include sub-specialty placements Specialty Paediatrics ST4 ST5 ST6 General Paediatrics includes acute General Paediatrics Paediatric Credential Neonatal Intensive Care Paediatric Intensive Care Paediatric Emergency Medicine Accelerated Core Programme* Same curriculum and assessment strategy. Sites selected and accredited by RCPCH as those able to deliver: Core curriculum in indicative timescale of 3 years, including ST3 Tier 2 rota High quality educational support Post CCT Career Continuing Professional Development Professional Support Continuing opportunities for post-CCT credentials Continuing opportunities for Special Interest modules Route A 70% CCT Paediatrics CCT Paediatrics Accelerated Core Programme* ST1 ST2 ST3 Tier 1 Tier 2 Pilot sites selected for high quality training support, able to deliver Core curriculum within indicative timescale of 3 years Route B 15% Credential CCT Paediatrics (subspecialty) Route C 15% MRCPCH Theory MRCPCH Clinical  MRCPCH Clinical  START Entry points: post F2, F3, SAS, from other specialty programmes, etc. v3.1 Aug 2018

Specialty Paediatrics

Specialty Paediatrics Core Paediatrics ST1 ST2a ST2b ST3 Tier 1 Tier 2 Core curricular capabilities in General Paediatrics, Neonatology, Integrated (Primary/Secondary) Care, Public Health, Community Child Health, Child & Adolescent Mental Health May include sub-specialty placements Specialty Paediatrics ST4 ST5 ST6 General Paediatrics includes acute General Paediatrics Paediatric Credential Neonatal Intensive Care Paediatric Intensive Care Paediatric Emergency Medicine Post CCT Career Continuing Professional Development Professional Support Continuing opportunities for post-CCT credentials Continuing opportunities for Special Interest modules Route A 70% CCT Paediatrics CCT Paediatrics Accelerated Core Programme* ST1 ST2 ST3 Tier 1 Tier 2 Pilot sites selected for high quality training support, able to deliver Core curriculum within indicative timescale of 3 years Route B 15% Credential CCT Paediatrics (subspecialty) Route C 15% MRCPCH Theory MRCPCH Clinical  MRCPCH Clinical  START Entry points: post F2, F3, SAS, from other specialty programmes, etc. v3.1 Aug 2018

Specialty Paediatrics Core Paediatrics ST1 ST2a ST2b ST3 Tier 1 Tier 2 Core curricular capabilities in General Paediatrics, Neonatology, Integrated (Primary/Secondary) Care, Public Health, Community Child Health, Child & Adolescent Mental Health May include sub-specialty placements Specialty Paediatrics Capability-based progression; indicative training time 3 years Need mechanisms to facilitate trainee career decisions and credential choices, starting in Core Training. Specialty Paediatrics ST4 ST5 ST6 General Paediatrics includes acute General Paediatrics Paediatric Credential Neonatal Intensive Care Paediatric Intensive Care Paediatric Emergency Medicine Post CCT Career Continuing Professional Development Professional Support Continuing opportunities for post-CCT credentials Continuing opportunities for Special Interest modules Route A 70% CCT Paediatrics CCT Paediatrics Accelerated Core Programme* ST1 ST2 ST3 Tier 1 Tier 2 Pilot sites selected for high quality training support, able to deliver Core curriculum within indicative timescale of 3 years Route B 15% Credential CCT Paediatrics (subspecialty) Route C 15% MRCPCH Theory MRCPCH Clinical  MRCPCH Clinical  START Entry points: post F2, F3, SAS, from other specialty programmes, etc. v3.1 Aug 2018

Specialty Paediatrics Core Paediatrics ST1 ST2a ST2b ST3 Tier 1 Tier 2 Core curricular capabilities in General Paediatrics, Neonatology, Integrated (Primary/Secondary) Care, Public Health, Community Child Health, Child & Adolescent Mental Health May include sub-specialty placements Specialty Paediatrics All trainees to gain the generic Learning Outcomes, as specified in Generic Paediatrics syllabus Specialty Paediatrics ST4 ST5 ST6 General Paediatrics includes acute General Paediatrics Paediatric Credential Neonatal Intensive Care Paediatric Intensive Care Paediatric Emergency Medicine Post CCT Career Continuing Professional Development Professional Support Continuing opportunities for post-CCT credentials Continuing opportunities for Special Interest modules Route A 70% CCT Paediatrics CCT Paediatrics Accelerated Core Programme* ST1 ST2 ST3 Tier 1 Tier 2 Pilot sites selected for high quality training support, able to deliver Core curriculum within indicative timescale of 3 years Route B 15% Credential CCT Paediatrics (subspecialty) Route C 15% MRCPCH Theory MRCPCH Clinical  MRCPCH Clinical  START Entry points: post F2, F3, SAS, from other specialty programmes, etc. v3.1 Aug 2018

Specialty Paediatrics Core Paediatrics ST1 ST2a ST2b ST3 Tier 1 Tier 2 Core curricular capabilities in General Paediatrics, Neonatology, Integrated (Primary/Secondary) Care, Public Health, Community Child Health, Child & Adolescent Mental Health May include sub-specialty placements Specialty Paediatrics Paediatric Credentials Community Child Health Diabetes and Endocrinology Gastroenterology, Hepatology & Nutrition Inherited Metabolic Medicine Nephrology Neurodisability Neurology Oncology Palliative Medicine Respiratory Medicine Rheumatology Yet to be decided: Child Mental Health? Clinical Pharmacology? Specialty Paediatrics ST4 ST5 ST6 General Paediatrics includes acute General Paediatrics Paediatric Credential Neonatal Intensive Care Paediatric Intensive Care Paediatric Emergency Medicine Post CCT Career Continuing Professional Development Professional Support Continuing opportunities for post-CCT credentials Continuing opportunities for Special Interest modules Route A 70% CCT Paediatrics CCT Paediatrics Accelerated Core Programme* ST1 ST2 ST3 Tier 1 Tier 2 Pilot sites selected for high quality training support, able to deliver Core curriculum within indicative timescale of 3 years Route B 15% Credential CCT Paediatrics (subspecialty) Route C 15% MRCPCH Theory MRCPCH Clinical  MRCPCH Clinical  START Entry points: post F2, F3, SAS, from other specialty programmes, etc. v3.1 Aug 2018

Specialty Paediatrics Core Paediatrics ST1 ST2a ST2b ST3 Tier 1 Tier 2 Core curricular capabilities in General Paediatrics, Neonatology, Integrated (Primary/Secondary) Care, Public Health, Community Child Health, Child & Adolescent Mental Health May include sub-specialty placements Specialty Paediatrics Routes A & B Trainees will also gain the capability to provide acute unscheduled care in General Paediatrics CCT Paediatrics +/- Credential Specialty Paediatrics ST4 ST5 ST6 General Paediatrics includes acute General Paediatrics Paediatric Credential Neonatal Intensive Care Paediatric Intensive Care Paediatric Emergency Medicine Post CCT Career Continuing Professional Development Professional Support Continuing opportunities for post-CCT credentials Continuing opportunities for Special Interest modules Route A 70% CCT Paediatrics CCT Paediatrics Accelerated Core Programme* ST1 ST2 ST3 Tier 1 Tier 2 Pilot sites selected for high quality training support, able to deliver Core curriculum within indicative timescale of 3 years Route B 15% Credential CCT Paediatrics (subspecialty) Route C 15% MRCPCH Theory MRCPCH Clinical  MRCPCH Clinical  START Entry points: post F2, F3, SAS, from other specialty programmes, etc. v3.1 Aug 2018

Specialty Paediatrics Core Paediatrics ST1 ST2a ST2b ST3 Tier 1 Tier 2 Core curricular capabilities in General Paediatrics, Neonatology, Integrated (Primary/Secondary) Care, Public Health, Community Child Health, Child & Adolescent Mental Health May include sub-specialty placements Specialty Paediatrics Route C Trainees contribute to acute unscheduled care rota in respective subspecialty (unless undertaking other specialty placements) CCT Paediatrics (subspecialty) Specialty Paediatrics ST4 ST5 ST6 General Paediatrics includes acute General Paediatrics Paediatric Credential Neonatal Intensive Care Paediatric Intensive Care Paediatric Emergency Medicine Post CCT Career Continuing Professional Development Professional Support Continuing opportunities for post-CCT credentials Continuing opportunities for Special Interest modules Route A 70% CCT Paediatrics CCT Paediatrics Accelerated Core Programme* ST1 ST2 ST3 Tier 1 Tier 2 Pilot sites selected for high quality training support, able to deliver Core curriculum within indicative timescale of 3 years Route B 15% Credential CCT Paediatrics (subspecialty) Route C 15% MRCPCH Theory MRCPCH Clinical  MRCPCH Clinical  START Entry points: post F2, F3, SAS, from other specialty programmes, etc. v3.1 Aug 2018

Specialty Paediatrics Core Paediatrics ST1 ST2a ST2b ST3 Tier 1 Tier 2 Core curricular capabilities in General Paediatrics, Neonatology, Integrated (Primary/Secondary) Care, Public Health, Community Child Health, Child & Adolescent Mental Health May include sub-specialty placements Specialty Paediatrics SAS / Clinical Fellows Potential to enter directly into Specialty Paediatrics (providing passed MRCPCH) if they so wish. Specialty Paediatrics ST4 ST5 ST6 General Paediatrics includes acute General Paediatrics Paediatric Credential Neonatal Intensive Care Paediatric Intensive Care Paediatric Emergency Medicine Post CCT Career Continuing Professional Development Professional Support Continuing opportunities for post-CCT credentials Continuing opportunities for Special Interest modules Route A 70% CCT Paediatrics CCT Paediatrics Accelerated Core Programme* ST1 ST2 ST3 Tier 1 Tier 2 Pilot sites selected for high quality training support, able to deliver Core curriculum within indicative timescale of 3 years Route B 15% Credential CCT Paediatrics (subspecialty) Route C 15% MRCPCH Theory MRCPCH Clinical  MRCPCH Clinical  START Entry points: post F2, F3, SAS, from other specialty programmes, etc. v3.1 Aug 2018

Post CCT Paediatrics

Post CCT Paediatrics Post CCT credentials Core Paediatrics ST1 ST2a ST2b ST3 Tier 1 Tier 2 Core curricular capabilities in General Paediatrics, Neonatology, Integrated (Primary/Secondary) Care, Public Health, Community Child Health, Child & Adolescent Mental Health May include sub-specialty placements Post CCT Paediatrics Post CCT credentials Can be offered to consultants, to support changing population health needs and changing professional development needs over a career. No requirement to re-enter training as already accredited in Paediatrics Specialty Paediatrics ST4 ST5 ST6 General Paediatrics includes acute General Paediatrics Paediatric Credential Neonatal Intensive Care Paediatric Intensive Care Paediatric Emergency Medicine Post CCT Career Continuing Professional Development Professional Support Continuing opportunities for post-CCT credentials Continuing opportunities for Special Interest modules Route A 70% CCT Paediatrics CCT Paediatrics Accelerated Core Programme* ST1 ST2 ST3 Tier 1 Tier 2 Pilot sites selected for high quality training support, able to deliver Core curriculum within indicative timescale of 3 years Route B 15% Credential CCT Paediatrics (subspecialty) Route C 15% MRCPCH Theory MRCPCH Clinical  MRCPCH Clinical  START Entry points: post F2, F3, SAS, from other specialty programmes, etc. v3.1 Aug 2018

Credentials for career grade (SAS) doctors Core Paediatrics ST1 ST2a ST2b ST3 Tier 1 Tier 2 Core curricular capabilities in General Paediatrics, Neonatology, Integrated (Primary/Secondary) Care, Public Health, Community Child Health, Child & Adolescent Mental Health May include sub-specialty placements Post CCT Paediatrics Credentials for career grade (SAS) doctors Potential to offer credential training to SAS doctors. Similar principle to offering them to consultants – ability to receive recognised training but without changing specialty register status Specialty Paediatrics ST4 ST5 ST6 General Paediatrics includes acute General Paediatrics Paediatric Credential Neonatal Intensive Care Paediatric Intensive Care Paediatric Emergency Medicine Post CCT Career Continuing Professional Development Professional Support Continuing opportunities for post-CCT credentials Continuing opportunities for Special Interest modules Route A 70% CCT Paediatrics CCT Paediatrics Accelerated Core Programme* ST1 ST2 ST3 Tier 1 Tier 2 Pilot sites selected for high quality training support, able to deliver Core curriculum within indicative timescale of 3 years Route B 15% Credential CCT Paediatrics (subspecialty) Route C 15% MRCPCH Theory MRCPCH Clinical  MRCPCH Clinical  START Entry points: post F2, F3, SAS, from other specialty programmes, etc. v3.1 Aug 2018

Special Interest Modules Core Paediatrics ST1 ST2a ST2b ST3 Tier 1 Tier 2 Core curricular capabilities in General Paediatrics, Neonatology, Integrated (Primary/Secondary) Care, Public Health, Community Child Health, Child & Adolescent Mental Health May include sub-specialty placements SPIN modules Special Interest Modules SPINs to continue as presently, offered pre- and post-CCT. Potential to offer them to other groups in future: SAS doctors Non-paediatricians Allied Health Professionals Specialty Paediatrics ST4 ST5 ST6 General Paediatrics includes acute General Paediatrics Paediatric Credential Neonatal Intensive Care Paediatric Intensive Care Paediatric Emergency Medicine Post CCT Career Continuing Professional Development Professional Support Continuing opportunities for post-CCT credentials Continuing opportunities for Special Interest modules Route A 70% CCT Paediatrics CCT Paediatrics Accelerated Core Programme* ST1 ST2 ST3 Tier 1 Tier 2 Pilot sites selected for high quality training support, able to deliver Core curriculum within indicative timescale of 3 years Route B 15% Credential CCT Paediatrics (subspecialty) Route C 15% MRCPCH Theory MRCPCH Clinical  MRCPCH Clinical  START Entry points: post F2, F3, SAS, from other specialty programmes, etc. v3.1 Aug 2018

Credentials

GMC: threshold for credentials (DRAFT: as of 2nd May 2018) Discrete approved training Where there is no approved training pathway Recognition on LRMP but not Specialist Register Driver - patient safety 2 Component of approved training To extend scope in areas not included in a doctor’s specialty training GMC oversight of education, not recognised on LRMP Driver – patient flexibility and service/patient need 3 Discrete practice additional skills Not part of postgraduate training pathway or could be taken out of CCT GMC oversight not needed Driver – efficiency, fairness, value (BUT if high patient safety risk, this would move to category 1)

Specialty Paediatrics Core Paediatrics ST1 ST2a ST2b ST3 Tier 1 Tier 2 Core curricular capabilities in General Paediatrics, Neonatology, Integrated (Primary/Secondary) Care, Public Health, Community Child Health, Child & Adolescent Mental Health May include sub-specialty placements Specialty Paediatrics ST4 ST5 ST6 General Paediatrics includes acute General Paediatrics Paediatric Credential Neonatal Intensive Care Paediatric Intensive Care Paediatric Emergency Medicine Post CCT Career Continuing Professional Development Professional Support Continuing opportunities for post-CCT credentials Continuing opportunities for Special Interest modules Route A 70% CCT Paediatrics CCT Paediatrics Accelerated Core Programme* ST1 ST2 ST3 Tier 1 Tier 2 Pilot sites selected for high quality training support, able to deliver Core curriculum within indicative timescale of 3 years Route B 15% Credential CCT Paediatrics (subspecialty) Route C 15% MRCPCH Theory MRCPCH Clinical  MRCPCH Clinical  START Entry points: post F2, F3, SAS, from other specialty programmes, etc. v3.1 Aug 2018