Community child health training.

his leading article aims to highlight the main training issues in community child health (CCH) and, in light of work done so far, discuss provision of appropriate numbers of well trained paediatricians to meet the needs of the nation's children. Community child health is a subspe-cialty of paediatric medicine that has undergone much change in structure and service provision in recent years, and this is likely to continue in the future. Given that a large proportion of advertised consultant posts are in community child health, numbers of specialist registrar (SpR) training rotations should reflect this. This appears not to be the case however, although the actual number of specialist registrars seeking or undertaking subspecialty training in community child health is unknown. Similarly, there is little information available as to what training is actually being provided in this subspecialty, both in terms of quality and quantity. A postal questionnaire of all known CCH trainees was undertaken in 2000. 4 One hundred and six higher specialist trainees were identified through paediatric regional advisers and postgraduate deans nationally and by word of mouth through what trainee network there is. Two thirds replied. Subsequently all trainees were invited to two national study days, and a further questionnaire was completed by the 39 who attended. 4 5 WORKFORCE ISSUES Currently there are approximately 2000 consultant paediatricians in the UK, with around one fifth in tertiary specialties. By 2010 it is predicted that there will be a need for 4000 whole time equivalent paediatricians (3400 in England). A significant proportion of these jobs will be in community child health. This sub-specialty, however, currently has a high number of flexible trainees (around half). Twenty six per cent of CCH trainees studied wished for a part time consultant post. This would decrease considerably the number of whole time equivalent consultants available to fill posts at the end of their training. Also, with the increasing number of females entering medical school (up to 70% in some areas) and the increasing acceptance of part time consultant contracts, one would assume the proportion of consultants working part time will only increase. Estimated numbers of whole time equivalent consultants available in the future, therefore, may well be significantly lower than predicted requirements. Current CCH trainees have strong views about on-call commitments they wish to provide as consultants in the future. Seventy five per cent of CCH trainees felt neonatal on-call would be …