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1. What makes a paediatric clinical pharmacologist?

A paediatric clinical pharmacologist is a clinician who has expertise in all aspects of the development of medicines and their safe, rational use. This includes research (from early-phase clinical trials to translational), ethics, clinical practice, drug regulation and education.

In clinical practice, they provide advice and support locally and nationally regarding the introduction of new medicines, adverse drug reactions, poisoning and toxicity, and prescribing policies. They contribute to the ethical review of research, plus the safe and effective conduct and delivery of drug trials. Additional research skills developed during training include those in drug development, medicine safety and the rational use of medicines in children.

Clinical pharmacologists play a vital role in many areas that complement the use of medicines in children. Roles within drug regulation include developing local guidelines, advising on pharmacovigilance and serving on national committees. They contribute to the education of undergraduate and postgraduate healthcare professionals on drug metabolism, formulations and prescribing.

2. A day in the life of a paediatric clinical pharmacologist

By Dr James Moss, Consultant Paediatrician and Clinical Pharmacologist in Liverpool

"There is no ‘standard’ day in the life of a paediatric clinical pharmacologist because the role is so varied. Most have a hybrid role working as general paediatricians with expertise in clinical pharmacology. They use this expertise in different sectors. Examples include; an academic in paediatric clinical pharmacology, advising the national poisons information service or medicines and healthcare products regulatory agency or working within the pharmaceutical industry.

"My typical working ‘week’ (instead of the day) starts with my acute shift on Monday (11 am-7 pm), reviewing children in our paediatric assessment unit. Tuesdays and Wednesdays usually involve reviewing participants in clinical studies on our clinical research facility, working with companies to help design their paediatric clinical studies (including protocol development/participant information leaflets), advising on committees such as the medicines management and advanced therapy of medical products committee and providing general support to the research division. On Thursdays and Fridays, I work for a pharmaceutical company whose focus is on paediatric medicines.

"Balancing the two roles whilst having a young family can be challenging, but I am fairly disciplined and only answer work-related emails when at work. This allows me to strike the right balance not only between my two roles but also allows me to enjoy time with family and friends outside of working hours."

3. How and where to experience paediatric clinical pharmacology in your early medical career

Exposure to paediatric clinical pharmacology will depend to some extent on where trainees are based. The larger, tertiary paediatric centres will most likely have early-phase units where first-in-children studies are conducted. Speaking to the clinical lead for the unit is a good way to gain exposure to paediatric clinical trials. If based in a district general hospital, speak to the paediatric research lead. District general hospitals often have a portfolio of later-phase clinical studies. Try and observe the assent/consent process and the assessment of any adverse events.

As so much of paediatric clinical pharmacology involves research, completing good clinical practice (free via National Institute for Health and Care Research (NIHR) learn) will give some insight into clinical trials. There is also a module on “informed consent with children” which is also recommended.

Another way to gain exposure to the role of a clinical pharmacologist is to join or shadow the hospital’s drugs and therapeutics/ medicines management committees. With expertise in paediatric medicines, paediatric clinical pharmacologists are often members of these committees and advise accordingly.

4. Applying to a paediatric clinical pharmacology programme

There are two sub-specialty posts available in paediatric clinical pharmacology at any one time. Currently, Liverpool (Alder Hey Children’s Hospital) is the only centre offering sub-specialty training. As most paediatric clinical pharmacologists also work as general paediatricians a portfolio that reflects this is important.

For pharmacology specifically, a portfolio that shows that the trainee has an interest in the efficacy, safety, and administration of medicines to children is essential. Audits and quality improvement projects that reflect this are beneficial. Being a sub-investigator in research studies and being up to date with good clinical practice is encouraged. Further educational achievements such as an undergraduate degree/master's/PhD in pharmacology is desirable.

5. Information for paediatric clinical pharmacology trainees

Currently, it is rare for a consultant post in paediatric clinical pharmacology to be advertised. However, all those who have completed their training in clinical pharmacology either have substantive posts within the NHS, are employed as academics with honorary contracts within the NHS or have found careers within the pharmaceutical industry. 

For further advice please contact the following: 

• Dr Dan Hawcutt (CSAC Chair) - d.hawcutt@liverpool.ac.uk. Speak to Dan about: combining clinical pharmacology sub-specialty with a clinical academic training pathway. 
• Dr Steve McWilliam  (CSAC Assessment Advisor) – stephen.mcwilliam@alderhey.nhs.uk. Speak to Steve about: combining clinical pharmacology sub-specialty with a clinical academic training pathway.
• Dr James Moss (CSAC Training Advisor) – james.moss@alderhey.nhs.uk. Speak to James about: combining a role in the NHS and the pharmaceutical industry.
• Dr Christopher Parry (CSAC Trainee Representative) - christopher.parry@nhs.net. Speak to Chris about: the experience of being a trainee in clinical pharmacology. 

External links

To find out more about paediatric clinical pharmacology, the CSAC recommend the following websites as useful resources:

• - information for parents and carers