ST1-3 Regional delivered training - School of Paediatrics north east - Health Education North East
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ST1-3 Regional delivered training
School of Paediatrics north east
The following programme is an attempt to deliver an integrated teaching practice for trainees
over a two year period. Further details of the level and detail required is continued in the
Framework of Competences for Basic Specialist Training in Paediatrics and is available on
RCPCH website.
Registration and feedback forms are required to be completed and 70% attendance is to be
achieved through the ST1-3 years. Your attendance will be assessed as part of the ARCP
process.
Teaching takes place monthly one full day a month and rotates around the region: Great North
Children’s Hospital, James Cook University Hospital, Sunderland Royal Hospital and University
Hospital of North Tees. Two topics are delivered on one day (each topic half a day 9.00-12.00
and 13.00-16.00) and the programme is advertised on the website.
The sessions are mandatory for all in ST1-3 positions; the ward will be covered by ST4-7
trainees, supported by Consultants.
The sessions are mandatory for all in ST1-ST3 positions, the ward will be covered by GP STRs,
F1s/F2s and ST4-7 trainees, supported by Consultants.
A brief outline of 48 sessions over a rolling 2-year period is enclosed.
A1 - A2 September 2019 – August 2020
A3 - A4 September 2020 - August 2021
A1 A2 A3 A4
Gastroenterology Safeguarding 1 Gastroenterology 2 Gastroenterology 3
1
Nephro-urology 1 Research/eviden Nephro-urology 2 Nephro-urology 3
ce based
medicine
Neurology 1 Neurology 2 Neurology 3 QI
Behaviour 1 Human Factors Behaviour 2 Behaviour 3
ENT Genetics Haematology 1 ID 2
Metabolism Adolescent Opthalmology Dermatology
Health
Public Health 1 Public Health 2 Development/Community 1 Development/Community
2
MSK 1 MSK 2 Nutrition 1 Nutrition 2
Endocrine 1 Endocrine 2 Endocrine 3 Pharmacy/Prescribing
Respiratory 1 Respiratory 2 Respiratory 3 Cardiology 2
Cardiology 1 Palliative care Education and training Allergy
Oncology 1 Oncology 2 ID 1 Haematology 2Rolling programme 2019-2021
Allergy (1 session)
Allergy 1
Recognises and manages anaphylaxis Allergy
Applies knowledge of the features of cow’s milk allergy and initiates Allergy
acute management
Recognises common presentations of food allergy and initiates Allergy
management
Behavioural/CAMHS (3 sessions)
Assessment and history taking in pre-school and school aged child Behaviour
1
Recognises the impact of mental health problems on physical health Behaviour
and the impact of physical health problems on mental health. 1
Recognises children and families with psychological problems Behaviour
1
Recognises the impact of parental mental health problems on the health Behaviour
of CYP 1
Recognises the possibility of a psychological cause for a physical Behaviour
presentation 1
Recognises the implications of compliance with mental health
treatments
Normal preschool emotional development Behaviour
2
Common issues in preschool children (temper, eating, sleeping, crying) Behaviour
with assessment and management strategies – role of MDT, non-health 2
workers)
Manages the CYP presenting with deliberate self-harm Behaviour
3
Recognises the signs and symptoms of common and serious mental Behaviour
health conditions such as attention deficit hyperactivity disorder, autistic 3
spectrum disorder, depression and psychosis
Recognises and initiates the acute management of young people with Behaviour
severe eating disorders 3
Cardiology (2 sessions)
Distinguishes features of murmurs Cardio 1
Applies knowledge of the cardiac associations and sequelae which may Cardio 1
require specialist assessment (e.g. Trisomy 21, 22q11 deletion
syndrome, Marfan syndrome and Duchenne muscular dystrophy)
Recognises non-cardiac causes of palpitations, including emotional and Cardio 1
endocrine causes, substance ingestion and prescribed medications
Recognises and investigates syncope, including “red flags” for Cardio 1
significant pathology
Recognises and applies knowledge about the features of Cardio 2
supraventricular tachycardia as a cause of palpitations
Applies knowledge about ventricular septal defects (VSD) as a cause of Cardio 2
heart failure in infancy
Recognises and investigates heart failure Cardio 2
Recognises that children with cyanotic congenital heart disease are Cardio 2
vulnerable to polycythaemia
2Rolling programme 2019-2021
Child development/community (2 session)
Applies knowledge to monitor the patterns of normal development, Comm 1
including motor, adaptive, language and social components from birth to
adulthood, emotional and social development
Communication disorders and speech delay including autism Sensory ??not in
impairment including visual and hearing impairment. new
syllabus
Dermatology (1 session)
General: Derm 1
• Describes rashes using appropriate terminology
• Recognises, investigates and manages non-accidental injury
presenting as a dermatological condition
• Recognises, investigates and manages the complications of
common immunosuppressive drugs used in skin conditions
Eczema and related itchy rashes: Derm 1
• Recognises and initiates management of eczema and its
complications (e.g. eczema herpeticum)
• Recognises and initiates management of infestations such as
scabies
• Skin infections:
• Recognises, investigates and initiates management of viral,
bacterial and fungal skin infections, including cellulitis
Birthmarks and neonatal conditions: Derm 1
• Recognises common birth marks and Mongolian blue spots, and
knows when to refer
• Advises parents about common problems, such as nappy rash
and cradle cap
• Recognises, investigates and initiates management of blistering
skin conditions in the neonate
Skin appendages: Derm 1
• Recognises and investigates the common causes of hair loss and
hypotrichosis
Genodermatoses: Derm 1
• Recognises and investigates skin markers of common genetic
diseases
Systemic conditions: Derm 1
• Recognises rare skin conditions, such as genetic skin fragility,
and their complications
Endocrinology (3 sessions)
• Accurately identifies the stages of puberty in girls and boys Endo 1
• Recognises normal and abnormal patterns of puberty
• Recognises the requirement for condition-specific growth charts
in children with conditions such as Down's syndrome and
3Rolling programme 2019-2021
Turner’s syndrome
• Recognises the negative impact of emotional neglect upon
growth
• Recognises the features of congenital adrenal hyperplasia and Endo 2
initiates early management
• Recognises ambiguous genitalia
• Makes changes to steroid therapy in children with
hypoadrenalism during an acute illness or perioperatively
Recognises features of hypo- and hyper-thyroidism Endo 2
• Recognises and initiates treatment for the early features of a Endo 3
child presenting with diabetes mellitus
• Recognises, investigates and manages diabetic ketoacidosis
• Recognises the causes of polyuria and polydipsia, including
diabetes mellitus and insipidus
• Makes necessary adjustments in insulin therapy in children with
diabetes during an acute illness or perioperatively
• Manages the potential complications of diabetic ketoacidosis and
its treatment, including cerebral oedema
ENT (1 session)
Recognises, investigates and initiates management of common causes ENT
and complications of sore throat and/or mouth, earaches and nose
bleeds
Recognises, investigates and initiates management of snoring and ENT
obstructive sleep apnoea, understanding the association between the
two
Recognises, investigates and initiates management of otitis media with ENT
effusion
Recognises, investigates and initiates management of cervical ENT
lymphadenopathy
Gastroenterology (3 sessions)
Abdominal pain: Gastro 1
• Recognises and initiates management of acute and chronic
abdominal pain, abdominal distention, acute intestinal obstruction
and the acute surgical abdomen
Gastro-oesophageal reflux and dysphagia: Gastro 1
• Recognises, investigates and manages gastro-oesophageal
reflux and reflux oesophagitis with support
Diarrhoea and vomiting: Gastro 1
• Recognises, investigates and manages acute and chronic
diarrhoea and/or vomiting with support
• Recognises, investigates and manages dehydration appropriately
4Rolling programme 2019-2021
Liver disease: Gastro 2
• Recognises, investigates and manages neonatal and childhood
jaundice and acute liver failure and its complications
• Recognises and initiates management of paracetamol poisoning
with support
Investigates and manages prolonged neonatal jaundice Gastro 2
Constipation: Gastro 3
• Recognises, investigates and manages simple constipation, and
identifies red flags
Gastrointestinal bleeding: Gastro 3
• Recognises, investigates and manages upper and lower
gastrointestinal bleeding
Inflammatory bowel disease: Gastro 3
• Recognises, investigates and manages inflammatory bowel
disease and acute colitis and their complications
Genetics (1 session)
Explains patterns of inheritance to families Gen 1
Refers appropriately for chromosome disorders Gen 1
Advises families about genetic screening Gen 1
Constructs a family tree and interprets patterns of inheritance Gen 1
Recognises and initiates investigations for common dysmorphic Gen 1
symptoms and congenital abnormalities
Haematology (2 sessions)
Recognises, investigates and initiates treatment for anaemia, and Haem 1
discusses the predisposing factors for, consequences and treatment of
iron deficiency anaemia
Recognises, investigates and initiates treatment of hereditary anaemia, Haem 1
understanding the long-term complications of hereditary anaemia and
the potential consequences of haemolytic anaemia
Recognises, investigates and initiates treatment of sickle cell anaemia Haem 1
and thalassaemia, understanding the hereditary basis for the diseases
and their clinical features
Recognises, investigates and initiates treatment of the following Haem 2
symptoms in the newborn: purpura and bruising, immune
thrombocytopenia and haemorrhagic disease
Recognises, investigates and initiates treatment of polycythaemia in the Haem 2
newborn
Recognises, investigates and initiates treatment of the hereditary basis, Haem 2
presentation, investigations and treatment of haemophilia and other
coagulation disorders
Infectious diseases (2 sessions)
Recognises and initiates investigations and management of sepsis ID 1
• Recognises the early signs of sepsis and initiates appropriate
anti-microbial therapy and supportive management
Follows local and national guidelines on the notification of infectious ID 1
5Rolling programme 2019-2021
diseases, including the policies for notifying communicable diseases
Recognises the possible causes of fever of unknown origin ID 1
Recognises and investigates rashes associated with serious systemic ID 1
conditions (e.g. staphylococcal scalded skin syndrome, toxic shock and
Stevens–Johnson syndrome)
Recognises the clinical implications of maternal-to-foetal transmission of ID 2
infection and recognises the clinical manifestations of these infections
Recognises, investigates and initiates treatment for common infections ID 2
of the foetus, newborn, and child in the United Kingdom (UK) as well as
important worldwide infections (e.g. TB, HIV, hepatitis B, malaria and
polio)
Immunodeficiency syndromes in childhood ID 2
Recognises the conditions and therapies which may predispose to an ID2
immunocompromised state
Metabolic problems (1 session)
Recognises normal and abnormal metabolism, including clinical features Met 1
Approach to investigations and interpretation of biochemical results Met 1
Refers for screening
Understands acid base balance Met 1
Applies knowledge of the causes, complications and treatment of Met 1
hypoglycaemia in the neonatal period and beyond in their initial
management
Musculoskeletal (2 sessions)
Takes a musculoskeletal history from a child and parents or carers, MSK 1
taking into account the child’s developmental stage and growth
Performs a clinical examination of a child with suspected rheumatic or MSK 1
musculoskeletal disorder (including a spinal deformity); performs, as a
minimum, a basic examination such as the paediatric gait, arms, legs
and spine (pGALS) screen
Makes a differential diagnosis for children presenting with MSK1
musculoskeletal symptoms (e.g. joint pain, swelling and limp), including
considering referred pain remote from the site of symptoms
Recognises features in the musculoskeletal system examination of Met 1
vitamin D deficiency and rickets, and understands the risk factors for
them
Recognises red flag features in the clinical presentation, examination MSK 1
and investigation findings which lead to the consideration of serious
musculoskeletal pathology (e.g. malignancy, infection or vasculitis)
Recognises the association of inflammatory diseases in other organ MSK 2
systems and arthritis (e.g. the associations between juvenile arthritis
and eye disease, and between psoriasis and inflammatory bowel
disease)
Recognises the different features present in non-inflammatory and MSK 2
inflammatory musculoskeletal pain
Recognises that normal development of the musculoskeletal system MSK 2
includes features which change with age (e.g. bow legs, knock knees,
in-toeing and flat feet) and features which may lead to non-inflammatory
or biomechanical musculoskeletal pain (e.g. abnormal foot posture and
hypermobility)
6Rolling programme 2019-2021
Nephro-urology (3 sessions)
Urinary tract infection: Nephro-
• Recognises and initiates management of urinary tract infections uro 1
in different ages of children
• Renal imaging
• Chronic renal failure, dialysis, transplantation
Nephrotic, nephritic and tubular presentations: Nephro-
• Manages the child in acute renal failure urology 2
• Recognises and initiates management of oedema and
differentiates between pitting and non-pitting
• Recognises and initiates management of proteinuria and
haematuria and hypertension
Voiding problems: Nephro-
• Initiates management of nocturnal enuresis, daytime enuresis uro 3
and other voiding disorders
Acute scrotal pain and foreskin problems Nephro-
uro 3
Neurology (3 sessions)
Fits, faints and “funny turns”: Neuro 1
• History, investigations and diagnosis
• Initiates management of seizures in CYP
Recognises that headache can indicate serious illness and knows the Neuro 1
red flag symptoms and signs
Recognises, investigates and initiates treatment of neonatal abnormal Neuro 2
neurology and understands the possible causes of abnormal findings
Neurodisability and neurodevelopment: Neuro 2
• Recognises how the environment can effect peri-natal
development and its impact on long term health
• Recognises and initiates investigations of developmental delay,
disordered development, learning difficulties and disability
Acute neurological problems: Neuro 3
• Head injury - Recognises and initiates investigations for head
injury
• Impaired level of consciousness- meningitis, encephalitis, other
cerebral infections, head injury, raised ICP and other causes of
coma.
• Ataxia
Head shape and size: Neuro 3
• Recognises and initiates investigations and management of the
common causes of hydrocephalus, macrocephaly and
microcephaly
Nutrition (2 sessions)
Assesses nutritional status and knows normal requirements for growth Nutrition
1
Adheres to the local and national guidelines for the management of Nutrition
breastfeeding and knows when to refer to a breastfeeding counsellor or 1
accredited lactation consultant
Applies the national guidelines on breastfeeding, local formula and Nutrition
7Rolling programme 2019-2021
Department of Health policy on soya milk supplement 1
Weaning and common problems in infancy Nutrition
1
Applies knowledge of the relationships among physical, emotional, Nutrition
intellectual and social factors and their influence on development and
health, including the impact of how an infant is fed
Recognises and begins to manage abnormal growth Nutrition
2
Nutrition and malnutrition: Nutrition
• Recognises, investigates and manages the common causes of 2
malabsorption and malnutrition and their consequences (e.g.
iron, zinc and vitamin deficiencies)
• Applies knowledge of the relevance of nutritional requirements for
healthy and sick children and considers the principles and
methods of dietary supplementation
• Recognises the need for enteral and parenteral nutrition and is
aware of the complications
Presentation, investigation and management of growth faltering/ Nutrition
malnutrition 2
Oncology (2 sessions) – (may need to reduce to 1 session in the longer term)
Recognises the complications of neutropenic fever Onc 1
Presentation, investigation, initial management including red flags Onc 1 –
• Epidemiology NB not in
• Leukaemia new
• Lymphoma domain 4
Presentation, investigation, initial management including red flags Onc 2 –
• Neuroblastoma NB not in
• Nephroblastoma new
• Brain tumours domain 4
Ophthalmology (1 session)
Eye history and examination Ophth 1
Recognises visual impairment and diseases of the eye and refers Ophth 1
appropriately
• Including red eye and infections
Screens for visual impairment in children Ophth 1
Identifies those babies at risk of retinopathy and cataracts for screening Opthal 1
Palliative care (1 session)
Symptom control: Palliative
• Identifies and treats pain in CYP according to the World Health 1
Organisation (WHO) pain guidelines for children
• Initiates management of the following:
• Nausea, vomiting, constipation and diarrhoea in CYP
Management: Palliative
• Understands that the last few days of life necessitate specific 1
approaches to therapy that are different from the rest of the
8Rolling programme 2019-2021
palliative phase
Withdrawing/withholding treatment – ethics, legal issues Palliative
• child death and consent to PM, 1
• advocacy and impact of religious believes
Pharmacy and safe prescribing (1 session) – (links to domain 7)
Prescribing
Establishes the importance of safe prescribing, and is able to prescribe Prescribing
commonly-used medication in an appropriate manner. 1
Recognises when a patient has been exposed to risk and escalates in Prescribing
accordance with local procedures. 1
Recognises, investigates and manages different patterns of drug Prescribing
reactions 1
Applies knowledge about the addictive potential of alcohol and other Prescribing
drugs, including prescribed and over-the-counter medicines, to the 1
management of CYP
Public Health (2 sessions) – (links to domain 5)
Understands the factors which contribute to child health inequalities and PH 1
the consequences of those inequalities in terms of disability, life
expectancy and health economics.
Health promotion: PH 1
• explains the principles and is knowledgeable of current health
promotion activities and universal screening
Disease epidemiology and principles of child public health PH 1
Injury prevention PH 1
Recognises and initiates management of obesity including its PH 2
complications
• e.g. Promotes a healthy heart lifestyle through healthy eating,
appropriate exercise, early recognition of excess body mass
index (BMI) and the avoidance of potentially harmful activities,
including smoking and substance misuse
Knows the immunisation schedule that applies in the UK PH 2
Applies knowledge of the indications, contraindications and
complications of routine childhood immunisations
Respiratory (3 sessions)
Cystic fibrosis: Resp 1
• Recognises, investigates and initiates management of cystic
fibrosis
• Recognises and initiates investigations of respiratory failure
associated with predisposing chronic illness
Respiratory tract infection: Resp 1
• Recognises, investigates and manages upper and lower
respiratory tract infections
• Recognises, investigates and initiates management of common
presenting symptoms of tuberculosis (TB)
Asthma: Resp 2
• Applies the current British Thoracic Society (BTS) guidelines for
management of both acute and chronic asthma
• Recognises, investigates and initiates management of viral-
9Rolling programme 2019-2021
induced wheeze and bronchiolitis
Chronic lung disease (CLD) of prematurity: Resp 2
• Recognises, investigates and initiates management of CLD of
prematurity and its complications
Airway obstruction: Resp 3
• Recognises, investigates and manages allergic and infective
causes of acute upper airway obstruction
• Recognises, investigates and initiates management of foreign
body inhalation
Sleep medicine: Resp 3
• Uses normal sleep physiology to explain common sleep problems
to children and their families
• Recognises, investigates and initiates management of sleep
problems and recognises the importance of sleep routine and
'sleep hygiene'
Young people’s health (1 session)
Engages young people effectively in consultations Adoles 1
Accurately and sensitively takes an age-appropriate history that Adoles 1
routinely includes biological, psychological, educational/vocational and
social factors (home, employment, eating activities, drugs and alcohol,
sexuality, suicide and depression, and safety assessment, or
HEADDSS)
Develops the skill of routinely consulting with a young person on their Adoles 1
own
Promotes the elements of a young-people-friendly health service emodule
Considers issues relating to gender and sexual identity, including Adoles 1
specific health risks as well as issues such as acceptance
Uses inclusive language when interacting with adolescents and their Adoles 1
families
Advises on contraceptive and sexual health issues, including lesbian, Northern
gay, bisexual and transgender (LGBT) young people, and advises region
patients where to go for further advice service
Demonstrates sensitivity to the issues faced by families with same Adoles 1
gender or transgender parents
Recognises the effects, common presentations and potential for harm of Adoles 1
alcohol and other drugs on CYP
Human Factors (1 session)
Research (1 session)
Adopts an evidence-based approach to paediatric health practice and Research
critically appraises existing published research. 1
Carries out a simple literature review, evaluating evidence and
demonstrating the ability to identify strengths and weaknesses in all
evidence sources.
Interprets research results Research
1
Safeguarding (1 session) – (linked to Domain 9, in addition to CPRR and local teaching)
Case based session to include: Safeguarding
10Rolling programme 2019-2021
• LAC 1
• Adoption
• Vulnerable children
Teaching (1 session) – (will be based on Domain 10 key capabilities and illustrations)
Conducts planned teaching and learning events under guidance Teaching
• Plans and delivers small group teaching sessions (e.g. case 1
presentation and journal club).
• Provides evidence of obtaining feedback on teaching delivered
and being able to reflect on and learn from this.
Quality Improvement (1 session) – (will be based on Domain 8 key capabilities and
illustrations)
Applies quality improvement methods (e.g. audit and quality QI 1
improvement projects) under guidance.
• Demonstrates the ability to follow the local and national clinical
guidelines and protocols.
• Undertakes a quality improvement project under guidance.
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