Paediatrics As A Specialty

One of the specialisms you could follow in medicine is working with children. Now, the people who work most with children are probably GPs. But I’m a paediatrician, so I look after children who have to come to hospital, either as inpatients or as outpatients, for a rather more specialist view. We deal with a wide range of health issues, diseases, and disorders that relate to the growth and development of children. It’s a diverse, stimulating, and very rewarding specialty. So what does a paediatrician do? Well, the key thing is that they, unusually, work with both the patient and their family very closely.

They may see children in hospital, they may see them in community-based settings, or in specialist units, such as special care baby units like children’s cancer units. The broad specialties of paediatrics are general paediatrics, where you see children who are acutely unwell in hospital, and you follow them up in clinic. The other large specialism is looking after newborn preterm babies, or babies who are very sick when they’re born. This is a very high-pressure, intensive care environment, but also very human and very rewarding. And then a third important specialism is community paediatrics.

And these are the doctors who look after, on the one hand, children with disability and, on the other, children who are vulnerable because of child abuse or neglect or problems in their family. So what sort of people should become a paediatrician? Well, obviously, the first rule is you do have to like children. You have to enjoy the challenge of dealing with patients who cry when you look at them and can’t tell you where it hurts. You’ve got to be interested in the process of childhood and, very importantly, the process of parenting. Because as well as your child patient, you spend, in fact, most of your time talking to their parents.

It’s an interesting speciality because a lot of it is very repetitive and ordinary, like any job. But it is peppered with great excitement and great uncertainty because children can become ill very suddenly and also better very quickly. So that’s what makes paediatrics fun as an acute paediatrician. But it’s also very encouraging, because children get better so quickly. Most children are well most of the time. And even sick children are rarely ill for long. It’s only in a few sub-specialties that we regularly deal with children who are ill for a long time or, sadly, likely to actually die. It’s also a very interesting specialty because about half the children we see have rare disorders, which sounds like a paradox.

But there are so many different syndromes and rare conditions that children can be born with, and it’s the paediatricians who have to unravel these and think about them. It’s also very stimulating because you have to think about how the disease process is interacting with the child’s development and growth. And that makes every presentation slightly different from the other. So what could you do to get experience of working with children before and during your medical training? Well, before training and during it, you could work in a youth club or some sort of children’s group. You could teach Sunday school. And during your course, there are opportunities to have special placements in various branches of paediatrics.

There’s the opportunity to spend a whole year doing research in that area. And, of course, you will get training as part of your general medical course. So if you decide to go into paediatrics, even within paediatrics there’s a great diversity of opportunities and skills you can apply. And it’s certainly a most fascinating and rewarding specialty.