General paediatric training in the United Kingdom

Training of general paediatricians in the UK has produced high quality doctors with skills to deliver holistic care to the broad range of children presenting to secondary services with undifferentiated illness. They also play a key role as part of a regional network of care involving deployment of subspeciality knowledge and skills. Current recommendations from the Shape of Training review (Oct 2013) from Professor Greenaway emphasise the importance of the generalist who has important skills to deal with the majority of problems presenting to hospitals and community services and to filter those children requiring expert specialist services and direct them appropriately. There are significant problems with this vision of a shorter training time which coupled with current overproduction of CCT holders and subspecialists means that revision of the balance of training between generalists and subspecialists is needed. Changes in population needs mean that a revision of the current content of general paediatric training is also required. This should include more skills to deal with the rising tide of emotional and mental health problems and skills in the areas of quality improvement, team leadership and system analysis.