Developing a community child health service for the 21st century

A report on a review of the community child health service in Scotland.

Annexe 6

Results of the Paediatric Trainee Questionnaire

1. Background of trainees

Of the 55 who replied:

  • 67% of responders were female (current ST1 entry across the UK is 76% female)
  • 24% were flexible trainees
  • 84% were aged between 25 and 35 (16% 36 and over)
  • 73% attended medical schools in Scotland; 18% outside the UK and 9% trained in England.

2. Training

  • Duration and overall satisfaction

The majority have spent (or expect to spend) 6-9 months in CCH. (11% expected to or had spent 2 or more years in CCH). Responders were almost equally divided across training years 1-7 giving a good spread across the training period. 75% felt that their training was adequate given their choice of career but 24% said no or were uncertain. 7 responders (13%) had either not done any training or were not sure how long they had trained in CCH .

  • Rating of elements of training

In terms of the elements of CCH training there was a high level of satisfaction with some elements of training. Trainees rated their experience highly in child protection; learning disability; motor disorders and communication disorders with more than 40% responders scoring these topics 8 or more on a 10-point scale . Public health topics and research training scored poorly with very few good/excellent ratings. Overall, 80% of trainees rated 10 out of 17 CCH topics listed at >5/10.

Author's Note: Availability of Supervision in CCH Clinics

RCPCH guidance suggests dual consulting (simultaneous presence of consultant at trainee clinic) is available for supervision of trainees. In the Health Board survey 21% (3) HBs in Scotland indicated that all their clinics allow this but 29% (4) indicate less than 50% of their clinics allow dual-consulting. This finding may mean that trainees are not supervised adequately in some areas.

Trainees rating of training by CCH topic (10 point scale)

Chart: Trainees rating of training by CCH topic (10 point scale)

3. Current Duties of Trainees

The vast majority of participants are combining daytime community placement with acute hospital work (82%) and 84% felt this was helpful for their training.

71% are working night "on-call" cover and a further 27% are working both "day and night cover". For those undertaking acute on call, 74% respondents are on the same rota as hospital based trainees. 5% respondents report they are on fixed night work.

20% of participants were undertaking child protection on call but 65% were not.

11% were providing "full cover" and 15% were acting as an "observer only".

Comment: If trainees are actually undertaking " full" child protection cover, then questions need to be asked about their supervision in this very difficult area of work.

4. Study and research

The majority of participants (95%) have access to a PC and the internet at home and at work (96%). 84% felt there were appropriate clinical training facilities in hospitals versus 62% satisfied with training facilities in the community. 84% believed there were adequate library facilities with relevant books and journals but only 62% believed there were adequate library facilities with relevant CCH books.

5. Future career choices

Most trainees (62%) were looking for a consultant post in acute general paediatrics with acute on-call. Several noted other sub-speciality roles eg paediatric emergency medicine; respiratory paediatrics; academic paediatrics; paediatrics with an interest in Diabetes/Endocrinology and paediatric intensive care. When asked if they wished to undertake out of hours/on-call duties as a consultant, 87% answered yes but only 9% of these wished to undertake child protection on call. 40% thought that "social paediatrics" would be an essential ingredient of a future job. 65% thought interagency working/public health/management and planning as essential or desirable in a future job.

Significant numbers rated neonatal on call duties as "undesirable" in a future post with18% stating they wished a job as a general paediatrician with acute and neonatal on-call. 16% wanted a general paediatric post which included child protection on call. 11% wanted to be a community paediatrician with acute on call. 9% wanted to be a community paediatrician with child protection on-call. A majority wished a special interest clinic.


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