The Paediatric Emergency Medicine (PEM) subspecialty training consists of an extra year taken after the completion of the ST4 training year. It comprises of six months in a paediatric Emergency Department (ED), three months on a general paediatric ward, and three months in paediatric critical care. The entry is competitive. Although the post does not require previous paediatric experience, demonstration of interest/commitment to PEM is advantageous.
Paediatricians can also get dual accreditation (in Paediatrics and in Paediatric Emergency Medicine) by completing a two-year training programme, which also includes surgical specialties and anaesthetics. Posts for these gird training post are also available in University Hospital of Wales (UHW), Cardiff. The co-location of both paediatric and emergency medicine (EM) trainees allows for the sharing of skills and knowledge across the two backgrounds.
The centre accredited for PEM subspeciality training in Wales is UHW, Cardiff. UHW sees over 34,000 children a year and there are currently eight PEM Consultants and four dual accredited EM/PEM Consultants to help support education and supervision. The Paediatric Emergency Department operates twenty-four hours a day, seven days a week and is situated adjacent to the adult ED with a well-established paediatric nursing workforce, including Emergency Nurse Practitioner (ENPs) and a play specialist. Within the on-site Children’s Hospital for Wales, there are many learning opportunities, including an acute assessment unit for general practice (GP) expected patients, a large general paediatric service, a wide array of tertiary specialist paediatric services and a Paediatric Critical Care Unit.
The general paediatrics placement encompasses the acute assessment and management of patients within the assessment unit and on the wards. The paediatric critical care service based at UHW is a regional service for south Wales. It is a fifteen bedded paediatric critical care unit (paediatric intensive care unit (PICU) and high dependency units (HDU) combined) with a combined throughput of over 700 patients per year. Trainees will keep in touch with their EM supervisor throughout their time outside the ED.
There is a weekly teaching programme within each department consisting of simulation and practical skills-based teaching, with management opportunities via monthly quality and safety, joint PICU/ED feedback sessions and weekly multidisciplinary safeguarding meetings. There is an expectation for trainees to be involved in audit, clinical guideline and service development. All trainees are expected to work towards presenting work at one of the annual national meetings and are fully supported in this. Participation in local and national research is actively undertaken within the department.
Successful trainees will be involved in the teaching and supervision of medical students, junior colleagues and nursing staff. There are many opportunities for teaching, both undergraduate and postgraduate, both locally and regionally. There are close links to Cardiff University and as such trainees are actively encouraged to assist with the running of the paediatric module on the Emergency Medicine BSc.
Management experience includes the handling of critical incidents and complaints, rota responsibility and project management. PEM subspeciality training is a fantastic opportunity for those interested in the management of children and young people in our emergency departments to develop their skills and further their passion.
“Paediatric Emergency Medicine training within Wales is based at Cardiff – a bustling capital city with lots to offer, as well as both beaches and mountains nearby. The Children’s Emergency Department there has an enthusiastic and supportive team. More so than virtually any other place I have worked, they strive to work as a single multi-disciplinary team and would regularly organise staff social events. The nearby children’s hospital is also an excellent facility and working there for six months provides a welcome fresh perspective to practicing paediatric medicine, away from an Emergency Department setting.”
“Fantastic opportunity to fine tune paediatric resus, majors and minors skills in a paediatric major trauma centre. Supported along the way by a dynamic team of consultants from both paediatric and Emergency Medicine providing a wealth of knowledge and enthusiasm for teaching.”