Spending your day with a Lego lanyard, bricks in your pocket and your hospital ID overflowing with Buzz Lightyear and Ironman stickers that make all the kids smile – there is nothing else quite like it! Child medicine requires the silly and light-heartedness in parallel with the calm and intense – if that appeals to you, you’re already halfway there.

Why Choose Paediatrics?

• Unmatched daily joy: Nothing but fun! 
• Strong senior leadership: Very senior led, so always well-supported by registrars and consultants. 
• A unique and welcoming MDT: Where else are actual staff paid to play with patients? 
• True holistic practice: A true biopsychosocial specialty where you can practice medicine as medicine was meant to be practiced, by considering the patient as a whole. 
• Extensive procedural variety: Very practical, with plenty of technical, demanding procedures from newborn heel-pricks to lumbar punctures; cannulas guided by play specialists to ketamine sedation; umbilical lines, cerebral function monitoring (CFM) / amplitude integrated EEG (aEEG), catheters! 
• Run-through Training: The envy of all other specialties – guaranteed job security until you’re a consultant. 
• High clinical complexity: imagine your patients can’t articulate themselves. How do you take a history? How do you examine? Paediatrics relies on a deep integration of clinical skill and depth of medical knowledge to accurately assess and detect an unwell child. All of this is in addition to a broad spectrum of developmental differences from ages 0-18, each age with unique differences.  
• Engaging developmental assessments: My personal favourite – developmental assessments with multicoloured bricks. It doesn’t get much better for me when I’m being paid to build a kaleidoscopic Lego house! 

Portfolio Planning:

Like with any specialty application, you need to show commitment. Here are some suggestions of things you can do prior to applying for the specialty.

Medical school: 

• Join your university’s Paediatric Society (Paeds soc) 

• Join Teddy bear hospital 

• Paediatrics themed SSCs and electives – these are good opportunities for audits and research 

• If intercalating, try to make your project paediatrics related 

• Don’t be afraid to approach paediatricians for help with audits or research opportunities – they’re amongst the kindest doctors! Sometimes an opportunity starts with a simple email. It’s frightening at first, but you certainly don’t lose anything by asking. 

FY1/2: 

• Taster weeks  

• Reaching out to paediatricians – it’s easier to do this once you graduate because you’re working in one place rather than constantly moving around in medical school 

• Don’t worry if you don’t have a paediatrics rotation – this does not go against you when applying because foundation programme rotations do not guarantee exposure to every specialty for each trainee 

The Application Process

Updates from the 2025-2026 application year: 

• Maximum of 5 specialty applications 

• UK medical graduate prioritisation – Please see full details on the BMA and/or UK government websites 

Application process: 

• White Space Answers: 30% (60 marks total) 

• Interview: 70% (160 marks total)  

KEY TIP – You do NOT need to use strictly medicine or paediatrics specific experiences. Use a variety of experiences from in and out medicine, as this demonstrates you are well-rounded and adaptable. 

This is the shortlisting process – the marks gained from your answers to the white space questions determine whether you’re invited to interview. 

• 50-word answers  

• 32 boxes  

• 5 domains  

• 2 assessors  

• Total marks = 60 (x2 assessors) 

2024-2025 cut-off for interview offer = 42/60 
2025-2026 cut-off for interview offer = 52/60 

Domains assessed: 

Transferable clinical capabilities (x5) – scored /8: 

• MUST give 5 examples to maximise points, with max 2 practical procedures/DOPS 

• Draw on a range experiences using your Foundation HORUS portfolio e.g. acute situations, simulations, handover, Mini-CEXs, DOPs etc. 

• Separate the substance of the clinical experience from the reflection on how it prepared you for paediatrics 

Personal achievements & reflections (x5) – scored /8: 

• For example, charity work, community outreach, fundraising, prizes & courses both in/out of medicine, organising major events etc. Show the assessors just how unique you are! 

QIP/audit (x2) – scored /5: 

• Get a QIP done easily – under your control, and less time-consuming than an audit. 

• For example, identify a knowledge gap based on an experience or an article you read etc; create a Google survey on whether people recognise signs/symptoms or if they’d benefit from a learning resource on your chosen topic; create a poster using trusted sources; send it out to your medical colleagues; repeat the survey asking if it improved practice in 2-4 weeks; add to HORUS; repeat the surveys again with further learning interventions too and do some ward teaching around it! 

Academic achievements (x2) – scored /3 (+1 for higher research degree): 

• Do NOT worry if you don’t possess an additional higher research degree – not many F1s/F2s do. It’s a small weighting compared to other domains for this reason.  

Teaching (x2) – scored /5: 

• Try pairing up with another doctor and find a topic students actually want to learn about. Organise some teaching sessions F2F or online with feedback forms at the end. 

• Include simulation and interactivity so you can discuss this in your white space answers . 

Interview  

The marks gained from your interview determine whether you are offered a job in paediatrics. 

• 4 domains  

• 2 assessors  

• 45 minutes 

• 2 stations, each with 2 scenarios 

• Learn your white space answers well to refer to them at interview 

• Total marks = 160 (x2 interviewers) 

You need 55% (88/160 marks) to be eligible for an ST1 offer. However, competition has increased each year, so the candidates offered a job will likely score higher.  

Domains assessed: 

Communication – scored /40: 

• 5-minutes of pre-reading, followed by an interaction with a role player while assessors observe off-camera, testing your ability to explain clinical conditions, procedures, or transfers of care. This is best prepared for by practicing with peers and trusted senior paediatricians or your Educational Supervisor. 

Repurpose ABCDE! – 

• Explaining a condition – Categorise conditions under each letter to make preparation easier e.g. A (asthma, anaphylaxis); B (bronchiolitis, croup); C (sepsis); D (epilepsy/status); E (DKA, appendicitis) etc 

• Explaining a transfer – Acknowledge/assess understanding; Brief explanation of child’s condition; Clear reasons for transfer; Details of what will happen; Empathy, reassurance & questions 

Career motivation – scored /40: 

• Expect to be asked ‘Why Paediatrics?’ – Draw on the clinical and personal experiences which have led you towards this specialty. Talk from the heart and be honest. Think about why paediatricians are unique to other doctors e.g. the spectrum of patients, biopsychosocial approaches, moulding health from the start of life, the evolving 21st century challenges. 

• Think about your white space questions and how you can incorporate them into interview answers using STARR or CAMP structures. 

Reflective practice – scored /40: 

• Choose a clinical situation you were involved in which has had a dramatic effect on the way you practice medicine AND the way others practice medicine 

• It’s a good idea to mention QIPs/audits you did using the STARR structure, focusing the overwhelming majority of your answer on the final R (Reflection). 

• This is the only station where you can prepare very well in advance – pick something good and learn it ‘parrot fashion’ 

Paediatric clinical reasoning – scored /40: 

• A case-based clinical scenario where you describe the relevant issues and how you’d manage the situation 

• Talk through your emergency assessment- you may ask for observations or results but may not be given any. Assessors are looking for methodical, structured approaches, and always say you’d escalate to seniors early on. 

• Paediatric setting however you do NOT need complex paediatric knowledge beyond the level of FY2  

SPIED is a good structure to use here:  

• S (Seek info): Gather background history, nursing handover, and vital signs. 

• P (Patient safety): Act on immediate safety priorities (e.g. pull the emergency buzzer, call 2222, or move the child to the resuscitation bay). 

• I (Immediate interventions): Perform an A–E assessment and utilize the MDT (nurses, HCAs, play specialists). 

• E (Escalate): Give a clear SBAR handover to your registrar, consultant, or external specialties. 

• D (Document & Debrief): Complete detailed notes and lead a brief team debrief. 

Key Advice

• Prepare a unique answer for why you want to train in paediatrics. Be original and talk from the heart. No one can take away from your personal experiences.  

• Try to speak to paediatricians at different levels – SHOs, SpRs & consultants. You need to know what the job looks like relative to the different phases of your life. You will spend most of your career as a consultant, so their opinion on the current landscape and future of the profession is incredibly valuable.  

• Remember that this is a very senior led specialty – this is an important consideration for the future 

• Have a read through the RCPCH Progress+ curriculum document to get a flavour of what is expected of paediatrics trainees in terms of clinical competence and incorporate this in your interview prep! Demonstrating an understanding of the structure of training is also great too. 

• Keep up to date with specialty developments (e.g. Martha’s Rule) and reflect on their impact 

• Take care of yourself: When the application window opens, do a little bit of the white space answers each day – remember you have 1 month! Start prep for interviews around the same time. Little and often is best. 

Useful Resources 

1. https://tinyurl.com/RCPCH-ST1-guidance
2. https://www.rcpch.ac.uk/sites/default/files/2025-10/paediatrics_st1_2026_0.pdf
3. https://www.rcpch.ac.uk/sites/default/files/2025-10/st1_scoring_guidance_glossary_for_shortlisting_2026-27_v.4_jac_271025.pdf

Written by Dr Kishan Patel, edited by Dr Imogen Laycock (SHO)

Based on orignial article written by Dr Sarah Al-Rawi (Paediatrics ST1), and edited and updated by Dr Bex Evans (Paediatric Registrar) in Feb 2024

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