Paediatric Medicine

Why specialise in Paediatrics?

Paediatrics is the branch of medicine which deals with the health and wellbeing of children and young people. It is a broad and diverse discipline, covering many subspecialties, and one in which there can be great job satisfaction and personal reward. Having an affinity for working with children is clearly advantageous.

Career prospects

Could include:

  • Paediatrician working in general or subspecialty paediatrics, neonatology, paediatric oncology or academic paediatrics
  • General practitioner with interest in paediatrics - very useful to have some paediatric knowledge and experience.
  • Emergency Medicine, Anaesthesia, Surgical specialties, etc. all of these areas of medicine encounter paediatric patients. It is very helpful to have some basic experience in treating paediatric patients in these fields, prior to entering other long term training programmes.

Medical staff in our service

The paediatric department employs house officers from PGY2 onwards. All house officer runs are 6 months in duration and cover paediatric medicine, paediatric general surgery and paediatric relief runs. Our house officers are encouraged to enrol for the Diploma of Child Health with the University of Otago.

If you enjoy your time in Paediatrics, you may wish to continue training at a registrar level. These positions require applicants to have at least 6 months of paediatric experience and a registrar position is for 12 months. We have a combination of “Basic Training” registrars (pre exams) and “Advanced Training” registrars (some of our registrars are not enrolled with a training programme either). Our House Officer numbers are 6.5 at any one time (one house officer shared with O&G) and we currently have 26 paediatric registrar positions. There are 8 registrars working at Christchurch Women’s Hospital doing a NICU rotation for 6 months at any one time.

The SMOs within Child Health include 8 Neonatologists, 6 Paediatric surgeons and 4 Paediatric Oncologists/Haematologists. The remainder of the SMOs number ~26 and include General Paediatricians and subspecialists covering areas such as Gastroenterology, Genetics, Infectious Diseases, Respiratory Paediatrics, Developmental Paediatrics, Endocrinology and Neurology.

Christchurch provides tertiary level care for paediatric oncology patients for the South Island, as well as the lower part of the North Island. We also provide tertiary level care for paediatric neurology, gastroenterology and paediatric surgery for the South Island.

All about our service

As a house officer, you will be rotated through 3 runs over six months, at least one of which will be an acute inpatient team. Your team will also have on-call days and as part of that team you will assist in the assesment and management of acute admissions through the Children’s Acute Assessment unit (CAA). Over your six months you will gain experience in history taking, clinical examination and procedural work. The procedures you should get exposure to include venepuncture, iv lines, bladder aspirates and possibly lumbar punctures. At all times you will be supported by a registrar and an SMO. There is an on-call roster and you will be expected to have a rostered long day 1-2 days a week. Every 6 weeks, you will have one weekend long day shift (both Saturday and Sunday). 

Registrar attachments rotate every 6 months. As a junior registrar your attachments are likely to include an acute inpatient run, relief run and a stint in NICU. As your experience in paediatrics increases, you will be rotated through outpatient runs which can be of a general paediatric or subspecialty nature. Many of the outpatient runs are mixtures of various specialties. All procedural skills mentioned for house officers are also expected at a registrar level. Those working in NICU will also get exposure to other procedures including intubation, long lines, umbilical lines and chest drains. There is not an expectation of proficiency in these skills prior to working in the NICU. NICU registrars also are rostered on for retrieval service, which can include flying to other locations around New Zealand for transport and retrieval of unwell newborn infants.

On-duty rosters for paediatric registrars at Christchurch hospital include long days, weekends and nights.  The frequency and type of shifts you do depend upon what your job allocation is usually.  As at January 2017, the frequency of after hours duties is as below, though this may change in the future.

  • Weekday night shifts (Monday –Thursday) = 1:7 weeks for inpatient and CHOC registrars
  • Weekend nights (Friday – Sunday) = 1:7 weeks for outpatient registrars
  • Ward weekends = 1:7 weekends
  • CAA weekends  = 1:8 weekends
  • Senior Reg Weekends = 1:3.5 weekends (SR does not work nights)
  • Long days = 1:7.5 weekdays
  • Winter Sunday shift = 1:15 Sundays (mid April through mid December)
  • Winter weekday evenings = 1:14 weeks (mid April through mid December)


All RMOs working in the paediatric service are allocated a named SMO supervisor to provide support and mentorship during your paediatric attachment.

Training in our service

As mentioned earlier, house officers are encouraged to enrol with the University of Otago for the Diploma of Child Health.

Paediatric training as a long term career option is under the governance of the Royal Australasian College of Physicians (RACP). Training takes minimum of six years of accredited training time and is divided into basic training and advanced training. One can only enter advanced training after successfully passing the RACP college exams (written and clinical), as well as having fulfilled a number of other mandatory requirements, including having a minimum of three years of accredited basic training time. We are a level three accredited site for training purposes.

Advanced training also takes a minimum of three years. At this time trainees need to decide whether they wish to become general paediatricians or subspecialists. Each area has individual training requirements under the governance of select committees. At the completion of training, you will be awarded with a Fellowship of the Royal Australasian College of Physicians (FRCAP). Anyone wishing to discuss paediatric training in more detail is welcome to contact Dr Cameron Dickson, Director of Paediatric Training for an informal chat.

We have an active education programme including journal clubs, x-ray review meetings, weekly “grand round” presentations, teleconferenced education sessions from Starship hospital, simulation sessions and regular formal tutorial sessions on various topics.

Research

Within our service we have active research programmes and a number of individuals being supervised by SMO staff for higher awards (e.g. Master’s, PhD, etc).
Research is encouraged at a junior level and opportunity for audit projects are available.

SMO / Kaimahi (staff) support

As detailed earlier, all RMOs working within paediatrics have a named SMO supervisor to provide support and mentorship during their time with our service. During normal working hours, the on take team’s registrar will take calls from GPs and ED as to patients either needing admission/ review or for advice. The on take SMO will be available to provide assistance at all times. Out of normal working hours, there will be two registrars (three in Winter) and a house officer on site together until 2300 hours. Overnight, there are two paediatric registrars on site. The on call SMO is available 24 hours of the day for advice, support and patient reviews.

Advantages to training in Paediatrics at Canterbury District Health Board

The child health service at Christchurch hospital is perfect in terms of its size and scope to provide ideal exposure and support for trainees. It is large enough to provide excellent exposure to most areas of paediatric medicine and yet not too large to be impersonal. We are a supportive department and take a very active role in education. We have most subspecialties covered, and those where we don’t, one of the general paediatricians take active roles in overseeing these patients with support from adult colleagues and peripheral specialists who also provide outreach clinics to Christchurch.

Christchurch based candidates have been extremely successful in the RACP exams over time.

Enquiries

Dr Clare Doocey
Clinical Director Paediatrics
Email: Clare.Doocey@cdhb.health.nz

Dr Cameron Dickson
Director Paediatric Training
Email: Cameron.Dickson@cdhb.health.nz

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