»Ê¼Ò»ªÈË

A PEM person is composed under pressure and decisive, who likes to work in teams, with the ability to multi-task and manage several things simultaneously all at once.

Dr Simon Li, Consultant in Paediatric Emergency Medicine in Derby

1. What makes an emergency medicine paediatrician?

A paediatric emergency doctor specialises in the initial management of children presenting with a wide range of undifferentiated conditions. They need to make pragmatic and rapid decisions using a wide breadth of knowledge across a vast range of paediatric presentations.

They are competent in dealing with minor and major trauma and illness presentations. They are adaptable, switching immediately from managing minor conditions to leading the resuscitation of children.

Paediatric emergency doctors must also acquire a wide range of non-clinical skills and abilities, internally and externally. These may revolve around process management in the emergency department, the hospital as a whole, or the wider community and interfaces of care. They must also learn to take care of themselves and the emergency team, developing skills to counteract the high-pressure nature of the work through communication, debriefing, and resilience training.

They gain their skills by working in busy paediatric emergency departments (PEDs), paediatric intensive care units (PICUs), and alongside colleagues from other specialties including emergency medicine, paediatrics, general paediatric surgery and other surgical specialties, mastering both the diagnostic challenges and the practical skills required to treat this diverse population. As consultants, paediatric emergency doctors may work in designated PEDs or alongside adult colleagues, taking on the care of children in mixed EDs.

2. A day in the life of a paediatric emergency doctor

By Dr Simon Li, Consultant in Paediatric Emergency Medicine in Derby

"My day starts by fuelling up with a cup of coffee before taking handover from the night team. I'll be overseeing the functioning of the PED initially concentrating on those patients that have already been seen so that they have definitive plans in place as well as providing advice to and reviews for my team who are assessing and treating children who are newly attending.

"Lunchtime provides an opportunity to catch up with emails and communications I need to respond to. As well as being a PEM consultant I have a couple of other roles too – regionally I am a TPD for ST1-3 paediatric doctors in training within the East Midlands region whilst, nationally, I am a Training Advisor for the PEM ISAC. In the afternoon it’s time for me to teach my group of medical students – being able to engage with and enthuse the next generation of doctors, as well as impart of little bit of knowledge is one of my educational passions. 

"This combination of work keeps me busy – far too busy in fact as there aren’t enough hours in the day. It is therefore very important for my own wellbeing and rest that I enjoy some down time through my love of cooking, walking and spending time with my family to help keep me grounded!"

3. How and where to experience paediatric emergency medicine in your early medical career

As a medical student you should undertake paediatrics and the emergency department as formal placements. Specifically seeking out special study modules or electives in paediatric emergency departments are another great way of experiencing the specialty. You could consider registering as an affiliate member of the RCPCH and/or RCEM. Approach a PEM consultant and we are a happy bunch to enthuse the next generation. 

During Foundation training try to select rotations in paediatrics and/or emergency medicine either as an F1 or F2. Failing this utilise your taster weeks to experience the specialty. 

As a core trainee you might have rotations or be able to request PEM as a placement. Spending time on paediatric assessment units and acute admission wards is also really useful for developing acute skills. During your core paediatric training you can utilise out of programme opportunities within a PED either in the UK or abroad. 

4. Applying to a paediatric emergency medicine programme

The ISAC appreciates that not all regions offer formal rotations in a PED. However you do need to be able to get across your understanding, motivation and commitment to the specialty. It's worthwhile thinking about what specific skills a PEM doctor possesses and needs to utilise in their day-to-day work as you will need to get these across. 

Think about what transferable skills you have within the broad domains of leadership, management, teaching, education and research. You need to demonstrate your personal understanding and completion of a quality improvement or audit project - again it doesn't have to be PEM related but you do need to demonstrate a wider understanding of the process. Look at the sub-specialty scoring criteria early and try and structure your CV on this. It is generally best to try and spread achievements over the various domains rather than one area.

5. Information for paediatric emergency medicine trainees

For those already in PEM training where you have queries about your training it would be useful to address these with your educational supervisor (ES) in the first instance. Beyond that speaking to a wide range of PEM doctors and contact your nominated ISAC link, whilst any members of the ISAC would be happy to assist. 

Towards the end of your training, it would be worthwhile having a think about what kind of consultant post you envisage working and of course where you'd like to work. Your own ES will be a valuable source of information and experience to help guide you.

External links

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