Welcome, we’re delighted that you’re thinking about paediatric neurodisability as a career
What does a paediatric neurodisability doctor do?
We work with children and young people with developmental problems and disabilities, resulting from both congenital or acquired long-term conditions. This includes, but is not limited to, children with motor disorders (e.g., spinal cord problems, neuromuscular problems, cerebral palsy), learning disabilities, acquired brain injuries, neurodevelopmental disorders (e.g., autism, ADHD), hearing or visual problems, and genetic conditions.
In collaboration with the multi-professional team, we assess and manage these complex medical problems and many co-morbidities that go alongside them (e.g., epilepsy, feeding difficulties, visual impairment, disorders of tone and posture, mental health difficulties, etc.), with an overall focus on promoting the best possible participation and quality of life, as well as support and advocacy for the child and family. Close working with other paediatric sub-specialties is also really important, such as such as neurology, genetics, palliative care, respiratory, gastroenterology, orthopaedics and child psychiatry. We also work closely with the education sector (we often see children in school, and provide advice to the local authority about the needs of our children) and the social care sector (the complex medical needs of our children mean that they often need housing adaptions, short break care, help coordinating services and, sadly, safeguarding problems are even higher in our population than in typically developing children).
The set-up for neurodisability services varies a lot region by region. Some regions have specialist neurodisabilty doctors, whereas some have community paediatricians who fulfil this role. Most neurodisability teams work in community children’s centres or hospital outpatient settings, although some are based in tertiary neuroscience centres, often working closely with neurology. Your regional BACD representative will be able to explain how your local neurodisability service and regional network are set up.
There is a large overlap between the groups of patients we care for between paediatric neurodisability, community child health and paediatric neurology, as well as a number of differences between the different sub-specialties - please see our What is Neurodisability page for more information.
What do people who specialise in paediatric neurodisability say about their careers?
The things that we enjoy about neurodisability as a career are:
- The children and families that we work with are amazing, and it is great to feel that we make a difference to their lives. We get to know them really well and often are involved from when they are an infant or young child to when they are moving to adult services at age 18 years.
- Our workload is generally quite varied – in a day we can see everything from a 3 month old with Down syndrome, to a 4 year old with autism, and a 16 year old with cerebral palsy, all in different settings (clinic, special school, ward etc) and all with particular needs to consider.
- There is the opportunity to work in a variety of settings and develop a range of different interests; some neurodisability paediatricians may work in tertiary setting and have specialist skills, such as tone and postural management and neurorehabilitation, and others may work in a local child development centre and see children with a wide variety of conditions.
- Our colleagues are almost universally really nice people (!!), which makes for a fantastic team environment. It is great to be able to work with such a wide range of people within the multi-disciplinary team and it helps us to provide holistic care for the child and family, as well as being able to continually learn from each other. It can be a challenging job, but is very fulfilling with great support from colleagues.
- As the speciality is largely outpatient based, working hours within specialty are generally 9-5, which makes it more family friendly than many specialities (although some consultant posts will require you to contribute to the child protection on call rota, acute paediatrics on call rota, or sub-specialty out of hours work, such as palliative care).
Visit our member stories to hear more about why some of our colleagues chose neurodisability as a speciality.
How do I become a paediatric neurodisability doctor?
- Most trainees who want to specialise in neurodisability apply for a ‘GRID’ training post in Paediatric Neurodisability or Community Child Health during their ST5 year, (applications typically open in September) to be completed during the final three years of training (ST6-8). The What is Neurodisability page has some further information about the similarities and differences between neurodisability and community child health training, to help you decide which is right for you.
- It is possible to apply for GRID posts at later points in training if you have relevant experience (see RCPCH website for further information).
- Neurodisability GRID training usually consists of 24 months neurodisability (include 3 months CAMHS) and 12 months paediatric neurology; how these placements are run varies across the different deaneries.
- During GRID training, 2/3 of your time will be spent in your speciality and 1/3 in general paediatrics (contributing to the on call rota).
- There is also a SPIN module (over 12-18 months) for trainees who want to develop a special interest in neurodisability, rather than a sub-specialism, alongside general paediatric training at ST6-8. This would be appropriate for a trainee who wanted to become a general paediatrician with special expertise in neurodisability.
- If you are keen to have a greater academic and research focus during training or gain experience of clinical research in paediatric neurodisability, please contact the Strategic Research Group to discuss potential opportunities for this.
See the How do I train in paediatric neurodisability? page for more information.
What experiences should I seek out if I am interested in a career in neurodisability?
To explore whether neurodisability is right for you, some of the following activities and experiences may be helpful. Additionally, when it comes to applying for a GRID post, being interested and motivated are the most important qualities, as well as showing that you have taken the time to explore neurodisability and have some knowledge of the specialty and current issues.
- While you are going through your general paediatric rotations, seek out children and families with disabilities on the ward and speak to them about their journey so far. Other ideas include (but are not limited to!):
- Attending complex patient/MDT meetings or discharge planning meetings for patients with complex disabilities that you have been involved with during their admission and thinking about what the child and family’s needs are
- Ask if you can observe a physiotherapy session or speech and language assessment when these happen for disabled children on the ward
- Seeing patients admitted following a significant head injury and finding out about what the follow up pathway is like
- Looking at Emergency Health Care Plans of children presenting acutely and consider what some of the important issues are when writing these plans
- Spending time with the Epilepsy Specialist Nurse to gain experience of discussing a new diagnosis of epilepsy or emergency seizure management with families.
- Attending community or neurodisability clinics, or more specialist clinics such as genetics and neurology
- During your neonatal placements some useful experiences to seek out include:
- Attending developmental follow up clinics
- Observing Bayley developmental assessments
- Contributing to a discharge planning meeting for a baby with complex needs and reflecting on the roles of the range of professionals involved
- Being involved with the explanation of cranial USS scan results to parents, and discussing potential neurodevelopmental outcomes of prematurity or HIE with parents as part of counselling before delivery or an update on the unit
- Delivering a teaching session for colleagues on the outcomes of prematurity
- …and many more!
- Most trainees currently do a six-month community rotation at ST4-5 level – useful things to do during this include:
- Spending time with therapists
- Asking a speech and language therapist to show you different types of alternative and augmentative communication a child may use
- Spending time in special school and think about what information may be useful to include in a child’s Education, Health and Care plan – see if you can have a go at writing one of these with your supervisor’s help
- Asking if you can be present for Advanced Care Planning discussions for the children cared for by the team
- Some useful clinics to make sure to try to attend are: tone and postural management, autism diagnostic assessment, feeding clinics and complex disability clinics.
- In future with the Shape of Training changes, it may be that not all trainees will have the opportunity to do a community or neurodisability placement as part of their core training. Speak to your training programme director and let them know you are interested in disability; ask if you can do a placement in this field; if not you may be able to use some study leave to gain some experience as a taster.
- Let your supervisors know that you are interested in disability; they might be able to get you involved in relevant audits or quality improvement projects or help you to link up with your local neurodisability team. Try to do a project on a neurodisability-related topic and consider submitting an abstract for the BACD Annual Scientific meeting or the BACD session at the annual RCPCH conference – it may be selected for a poster or oral presentation!
- Have a look through the current neurodisability and community child health grid curriculums to gain insight into the different areas a trainee will gain experience in and different areas that you can specialise as a consultant; it might also give you some other ideas about the types of experience you can look to gain now to help you understand more about neurodisability and whether it's right for you.
- All of the local BACD regional representatives are happy to be contacted for further information about opportunities to gain neurodisability experience, ways to get involved locally and to find out more about neurodisability as a career.
- Come to the annual BACD trainees’ day which is for all trainees interested in paediatric neurodisability – it’s a great opportunity to chat to trainees about their training so far and learn about some of the current and topical issues in paediatric neurodisability. Previous study days have also offered the option of a one-to-one appointment with members of the CSAC to discuss training, including for trainees interested in neurodisability.
- Other conferences and meetings you may find useful include local/regional neurodisability, epilepsy and palliative care network meetings, BACD annual scientific meeting, BACD regional study days and the BACD session at RCPCH annual conference.
- If you wanted to undertake some more in-depth learning, useful courses may be the free Disability Matters e-learning modules, BPNA Paediatric Epilepsy Training (PET) 1 course and the Paediatric Disability Distance Learning Course ‘An introduction to paediatric disability and clinical assessment’ module.
- Join the BACD – the BACD is the UK’s only multidisciplinary organisation for those working in the field of childhood disability; benefits of joining include regular newsletters and emails to keep up to date, access to resources, discounts on BACD educational meetings and opportunities for meeting others who are passionate about children and young people with disabilities.
Please get in touch!
The BACD has three trainee representatives, Eleanor Yule, Vivien Wong-Spracklen and Catherine Agar, who are very happy to answer your questions about paediatric training and paediatric neurodisability - please email [email protected]