RCPI OBE BST Paediatrics Curriculum Final Pilot

BASIC SPECIALIST TRAINING IN
PAEDIATRICS
0
This curriculum of training in Paediatrics w as developed in 2018 through a
systematic review of training, led by Dr Michael B oyle. This rev iewed by
Prof Alf Nichols on, Prof John Murphy and Prof Michael O’N eill National
Specialty Directors, Dr Ann O’Shaug hnessy, Head of Education, I nnovati on
& Researc h and by the Paedi atrics Training Committee.
The curriculum is approved by the Faculty of Paediatric s.
Version Date Published Last Edited By Version Comments

1.0 01/07/2018 Aisling Smith Outcome Based Education (OBE)
pilot curriculum
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Table of Contents
Introduction ......................................................................................................... 3
Overview of Curriculum ................................................................................................. 4

Requirements for Basic Specialist Training in Paediatrics ............................................. 5
Core Professional Skills ........................................................................................12
General Paediatrics Skills .....................................................................................20
History and Physical Examination ................................................................................ 23

Clinical Presentations: Recognition ............................................................................. 27
Diagnostics and Procedures ......................................................................................... 31
Clinical Presentations: Treatment and management .................................................. 35
Professional Development ...................................................................................38
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Introduction
This curriculum outlines the Faculty of Paediatrics' and the Royal College of Physicians of
Ireland’s (RCPI) approach to accreditation and certification of Basic Specialist Training (BST)
in Paediatrics.
Completion of BST is an essential step for a career in Paediatrics and entry into Higher
Specialist Training. This curriculum is aimed at Senior House Officers (SHOs) in training and
their supervising trainers. It outlines the knowledge, skills and attitudes that should be
developed during the period of BST.
Key elements of BST
Clinical experience gained from direct patient care, supervised by senior clinicians and based
on a clinical curriculum. Professionalism and ethical practice learnt through mentorship by
senior clinicians, integrated into the curriculum requirements and supported by RCPI’s
education programmes.
The core curriculum has been updated to ensure that these key elements are completed to
the satisfaction of the Faculty of Paediatrics. Accreditation and certification will focus on
evaluation of trainees’ progress and the educational validity of the posts they occupy. This
will be done by formal registration of all trainees with RCPI and an ePortfolio to ensure that
specific goals and outcomes are achieved and that formal supervision by trainers is
undertaken during each post.
The college recognises that not all trainees will have the same exposure to specialties and
therefore their training experience will differ. As a result the topics and practical skills
obtained during BST will reflect the individual’s rotation programme.
All BST trainees in Paediatrics must pass the MRCPI in Medicine of Childhood examination in
order to successfully complete their BST programme. It should be noted that this curriculum
is not a syllabus for this examination but it will provide guidance for the knowledge required
to take the examination.
Professor Alf Nicholson, National Specialty Director (Paediatrics), Basic Specialist Training
Prof Michael O’Neill, National Specialty Director (Paediatrics), Basic Specialist Training
Prof John Murphy, National Specialty Director (Paediatrics), Basic Specialist Training
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Overview of Curriculum
This curriculum outlines the educational content and expected achievements of the two-year
Basic Specialist Training (BST) Programme. Key training policies, training goals, standards of
professionalism and specific outcomes are detailed.
Trainees will be assessed in the workplace at intervals

throughout the BST programme. These assessments
must be recorded in the BST online ePortfolio.
Trainees are also required to attend an annual review
in RCPI, at which their ePortfolio is reviewed and they
are given the opportunity to provide feedback on
their rotation. The ePortfolio should be kept up to
date throughout the year.
The curriculum for BST outlines the core knowledge, skills and achievements that are
required by the end of the BST Programme to achieve a BST certificate. There will be many
opportunities within the programme for trainees to acquire additional knowledge and skills
over and above the core content and trainees are encouraged to actively seek additional
opportunities to learn.
4
Basic Specialist Training: Requirements and Policies
Overview of Basic Specialist Training in Paediatrics
BST consists of two years of training in approved Senior House Officer posts. Senior House
Officer (SHO) grade is the initial training grade after Internship, and for most doctors the
minimum period spent in this grade will be two years.
BST in Paediatrics is regulated and certified by the Faculty of Paediatrics and RCPI and
completion of this period of training has been a mandatory requirement for entry into most
RCPI-accredited Higher Specialist Training Programmes (Specialist Registrar training) since
1999.
BST must be done in posts that have been approved for training by RCPI.
In addition to your clinical skills and general professional development activities it is

expected that you will gain proficiency in core professional skills including clinical
communication, organisational behaviour and leadership, wellbeing, quality assurance and
improvement etc.
Important rules and procedures relating to the BST programme are listed below.
Requirements for Basic Specialist Training in Paediatrics
To be eligible for a BST Certificate of Completion in Paediatrics trainees are required to:
 Register on the BST programme. Entry to the programme is in July on an annual basis.
 Complete 24 months of training in SHO posts that have been approved for BST.
 A minimum of six months must be spent in posts approved for General Paediatrics
 Six months must be spent in posts approved for pure Neonatology
 Experience in Community Paediatrics, Paediatric Emergency medicine or another
paediatric subspecialty (i.e. Cardiology, Gastroenterology etc.) may be included. Not
more than 6 months may be spent in any one of these specialties.
 Spend no more than six months in any one SHO post.
 Achieve all outcomes as set out in this curriculum.
 Paediatric BST Study Days are held each year, and trainees are required to attend ten
study days over the course of their BST
 Maintain an up-to-date and correctly completed ePortfolio as evidence of satisfactory
completion of training.
 Attend and satisfactorily pass annual reviews
 MRCPI in Medicine of Childhood
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Provisional approval
Trainees who are in their second year of BST and who wish to apply to Higher Specialist
Training are required to submit a letter of provisional approval of BST, which confirms that
the trainee will complete BST before the start date for SpR posts. Trainees in this position
are advised to apply for provisional approval well in advance of the closing date for Higher
Specialist Training applications, due to the large volume of applications received every year.
Applicants should note that provisional approval alone does not count as an application for a
Certificate of Completion; only applications with a full set of supporting documents will be
considered for formal approval. A letter of provisional approval will only stand for a period
of six months after completion of the 24-months in approved training posts.
Entry Requirements
To be eligible for entry to BST, trainees must have:
 Completed their Internship satisfactorily

 Be eligible for registration on the trainee specialist division of the Medical Council
 Have proof of competency in the English language in line with HSE Specifications
Basic Specialist Training Agreement

Trainees are required to sign a Basic Specialist Training Agreement prior to entering the BST
programme, in which they must formally agree to:
 Fully cooperate in all aspects of the BST programme

 Uphold their commitment to all allocated posts in the structured rotation
programme
 Fulfil their clinical service requirements and work cooperatively with all members of
the service team
 Follow the curriculum and ePortfolio requirements, complete the mandatory
courses and attend assessments as required
 Undertake additional training or assessment if required to do so by RCPI
 Fully commit to and utilise available work time for the BST programme
 Attend to requests/correspondence from RCPI in a timely manner
 Act professionally at all times in their dealings with RCPI.
Training Environment
Training posts require the approval of RCPI. Regular inspection of all posts by RCPI via
hospital inspections is the basis for monitoring the training content of these posts.
Additional monitoring data may derive from questionnaires sent to post-holders. All posts
will be expected to conform to statutory guidelines on hours and conditions of work for
doctors in training.
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Professionalism: Relationships with colleagues and patients are based on mutual respect,
confidentiality, honesty, responsibility and accountability.
The Irish Medical Council outlines 3 pillars of professionalism; partnership, practice and
performance. This RCPI training programme is designed to educate and guide doctors on the
path to advanced clinical expertise in the context of the pillars of professionalism. Trainees
are expected to meet appropriate standards, as outlined in the curriculum, as they continue
to gain clinical skills and expertise. It is expected that trainees learn and demonstrate the
outcomes of professionalism underlying in the performance of all clinical duties.
This includes:
 Showing integrity, compassion and concern for others in day-to-day practice
 Developing and maintaining a sensitive and understanding attitude with patients
 Exercising good judgement and communicating sound clinical advice to patients
 Searching for the best evidence to guide professional practice
 A commitment to continuous improvement and excellence in the provision of health
care whether working alone or as part of a team
Additional detail on professional conduct and expectations in the workplace can be found on
the Medical Council Website.
https://issuu.com/mcirl/docs/guide_to_professional_conduct_and_e?e=12642421/35694606
Supervising Trainer
Every BST post has at least one assigned Supervising Trainer, whose duties include:
 Meeting with the trainee in their first week in the post and agreeing the trainee’s
Personal Goals Plan
 Appraising the trainee’s progress at regular intervals during the post
 Completing the End of Post assessment in ePortfolio
 Supporting the trainee, both personally and in respect of obtaining career advice,
although others may be involved in this
BST ePortfolio
Trainees are required to keep a BST ePortfolio as a record of their progress through BST and
to ensure that their training is valid and appropriate.
The BST ePortfolio is evidence of satisfactory completion of training and is therefore required
for the issue of a BST Certificate of Completion.
The ePortfolio contains all relevant forms for recording information about each aspect of BST.
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Leave
Study leave and annual leave do not affect BST completion dates.
Special Leave (Other than study and annual leave):
Examples of special leave: Sick leave, maternity leave, compassionate leave, Force Majeure
Leave
As the BST programme consists of two years of intensive, supervised clinical training, any
significant period of leave (i.e. greater than 4 weeks) taken over the course of the
programme has the potential to affect the trainee’s opportunities to acquire the core skills
and knowledge required for satisfactory completion of the programme.
In cases where additional leave (including maternity leave) is agreed by the trainee’s
employer, the following conditions apply to all trainees:
≤ 4 weeks over two years: If a trainee takes special leave totalling 4 weeks or less over two
years, his/her BST completion date is not affected.
> 4 weeks over two years: Any leave of greater than 4 weeks must be made up in blocks of 6
months’ extra training.
≤ 7 months: 6 months of training in (an) approved post(s) must be completed in order to

meet the requirements for BST certification. This applies to all trainees who take special
leave totalling more than 4 weeks and less than or equal to 7 months over two years.
> 7 months: 12 months of training in (an) approved post(s) must be completed in order to
meet the requirements for BST certification. This applies to all trainees who take special
leave totalling more than 7 months and less than or equal to 13 months over two years.
> 13 months: 18 months of training in approved posts must be completed in order to meet
the requirements for BST certification.
If an extra 6, 12 or 18 months is required: In cases where, due to leave in excess of 4 weeks,

a trainee is required to complete a further period of training, the College will help to place
the trainee in (a) suitable, approved training post(s).
The post(s) will be approved for BST in the trainee’s specialty and will be counted towards
the clinical training required for certification. However, please note the following:
 RCPI cannot guarantee a post(s) in the trainee’s current hospital or region

 The trainee may need to wait until a suitable post becomes available.
8
Completion of BST: Four-Year Rule
Trainees must complete BST within a four-year period. If a trainee’s expected completion
date is changed to a date greater than four years after their start date, they will be required
to reapply and undertake the full two-year programme again from the beginning.
Withdrawal from Programme
(Withdrawal after commencing BST programme)
Informing the College: If a trainee wishes to leave the programme before their expected BST
completion date, they must notify the BST office in writing at least 4 weeks before they wish
to leave their current post. Emailed notifications will be accepted. The trainee is not required
to outline his/her reasons for leaving the programme, however providing an explanation will
assist future planning and development.
Informing the employer: Notice of resignation by the trainee as an employee of his/her

hospital must be given in accordance with the provisions of their contract of employment.
Leave of absence: If a trainee wishes to take leave of absence, retain credit and return to the
BST programme, this must be agreed with the relevant hospital(s) and the BST office. The
trainee should seek prospective approval of their leave of absence at least 4 weeks in advance.
Approval will be agreed on a case by case basis and credit may not be retained in all cases.
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Training Goals
Throughout the training programme the trainee is working towards continual progression in
training goals. Clinical and professional experience is recorded under these headings. For
each post the trainee and trainer will meet to complete an end of post assessment and
evaluate progress for each goal. The trainer will determine if the trainees progress meets
expectation for that point in training.
Experience will be gained in general paediatric and neonatal posts and on acute unselected
take. For each post a trainee is expected to develop their skills against these goals and
record outcomes appropriately. Assessments of these skills incorporate core professional
skills.
 Partnership
o Communication and interpersonal skills
o Collaboration
o Health Promotion
o Caring for the patient
 Practice
o Patient safety and ethical practice
o Organisational behaviour and leadership
o Wellbeing
 Performance
o Continuing competence and lifelong learning
o Reflective practice and self-awareness
o Quality assurance and improvement
 History and Physical Examination
o History Taking
o Physical Examination
o Clinical Assessment Tasks
 Clinical Presentations: Recognition
o Recognition of clinical presentations
o Recognition of emergencies
 Diagnostics and Procedures
o Identification of underlying pathology and risk factors
o Diagnostic Tasks
o Independent Performance of Procedures
o Observation of Procedures
 Clinical Presentations: Treatment and management
o Treatment and management
o Emergency Management
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Outcomes
Specific outcomes are defined under each goal. By the end of BST a trainee should
demonstrate an ability to meet that outcome. Evidence of experiences, expected case mix
and details of knowledge required are outlined.
A matrix of the key information for each outcome in provided at the start of each section.
Details of assessment
A record of experience is kept for each outcome.
Outcomes recorded per post
Outcomes that require continuous progress and where experience is required in multiple
clinical settings are recorded per post. At end of post assessment, the trainer will evaluate if
progress has been made on this outcome.
Outcomes that are recorded formatively
Skills that are expected to develop over time. During an assessment a trainee is evaluated
against the expected standard for their level of experience. An observed skill may be
recorded as a formative assessment once specific feedback has been given and areas for
improvement identified. Once an outcome has been successfully attained a trainee is not
required to record formative assessments unless the trainer identifies a need to repeat the
assessment or a significant amount of time has lapsed since the trainee successfully
completed the outcome.
Record cases and a case mix
Examples of cases that are reflective of clinical experience gained are required to be
recorded in ePortfolio. For some outcomes a mix of cases may be required to demonstrate a
variety of experience.
Workplace Interactions
Many outcomes are recorded in ePortfolio as self-assessments that are then discussed with
the trainer on completion of each training post. The trainee should review the expected
knowledge and complete the self-assessment when they are confident they could answer
questions on the knowledge points covered.
Other outcomes will be assessed through informal observations, case based discussion or
formal observation by a trainer who has delivered appropriate feedback to the trainee.
Sign off
When an outcome is successfully signed off it is eligible to count towards progress against
training goals. The assigned trainer will determine if the submitted records of experience are
acceptable. The trainer may wish to discuss the records in more detail with the trainee and
the trainee should be prepared to discuss any self-assessments submitted or observations.
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Core Professional Skills
Goals, Outcomes and Assessment Details
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Partnership
Communication and interpersonal skills
Take a focused and accurate history   
Effectively communicate information to clinical staff   
Effectively communicate information to patients and families   
Engage in open disclosure   
Provide an appropriate patient handover in line with local and national
handover policy  
Collaboration
Work as part of a team    
Cooperatively solve problems with colleagues and patients  
Maintain clear clinical records   
Perform procedures within the WHO safe surgery guidelines   
Health Promotion
Caring for patients
Discuss the pathophysiological basis of the investigation    
Choose appropriate investigations    
Take an informed consent   
Write problem-orientated discharge notes, letters, more detailed case
reports, concise out-patient reports and focused reviews  
Deal with end of life issues and symptom control   
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Practice
Patient safety and ethical practice
Practice aseptic techniques and hand hygiene   
Encourage others to observe infection control principles   
Actively participate in and understand incident reporting   
Organisational behaviour and leadership
Plan schedule and arrive on time   
Respond to colleagues in a timely manner   
Manage time appropriately in the clinical setting   
Set appropriate personal goals  
Communicate leave and off duty appropriately with all members of team  
Wellbeing
Recognise potential stressors  
Effectively deploy stress reduction strategies and wellness improvement  
Effectively manage your physical and mental health e.g . have own GP  
Direct patients and colleagues to appropriate mental health support  
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Performance
Continuing competence and lifelong learning
Teach junior healthcare professionals   
Engage in peer to peer teaching   
Deliver a presentation   
Seek opportunities to learn   
Engage in self-directed learning  
Maintain a record of professional achievements  
Reflective practice and self-awareness
Identify gaps in own knowledge  
Work within their own ability and call for help when appropriate   
Quality assurance and improvement
Engage with audit and quality improvement projects  
Critically evaluate a research paper   
Contribute research evidence to a group discussion   
Understand the core concepts of data protection   
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Partnership
“Good care depends on doctors working together with patients and colleagues towards
shared aims and with mutual respect. Partnership relies on trust . . . , patient-centred care . .
., working together . . ., good communication . . . and advocacy . . . .”
Chapter 2, P10
The training goals for partnership are:

 Communication and interpersonal skills
 Collaboration
 Health Promotion
 Caring for the patient
Communication and interpersonal skills
Facilitate the exchange of information, be considerate of the interpersonal and group

dynamics, have a respectful and honest approach.
 Engage with patients and colleagues in a respectful manner
 Actively listen to the thoughts, concerns and opinions of others
 Maintain good working relationships with colleagues
Outcomes
By the end of BST the trainee will demonstrate an ability to:

1. Take a focused and accurate history
2. Effectively communicate information to clinical staff
3. Effectively communicate information to patients and families
4. Engage in open disclosure
5. Provide an appropriate patient handover in line with local and national handover
policy
Record of experience: Recorded with a clinical case example

Workplace interactions: Handover is observed in the workplace and a trainer will record
feedback. An example of engagement in the open disclosure or incident reporting process is
recorded. All other outcomes are informally observed.
Sign off: Signed off once during training upon successful evaluation by the observing trainer
Collaboration
Collaborate with patients, their families and your colleagues to work in the best interest of
the patient, for improved services and to create a positive working environment.
 Work cooperatively with team members to deliver an excellent standard of care

 Seek to build trust and mutual respect with patients
 Freely share knowledge and information
 Take on-board available, relevant feedback
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Outcomes

1. Work as part of a team
2. Cooperatively solve problems with colleagues and patients
3. Maintain clear clinical records
4. Perform procedures within the WHO safe surgery guidelines
Health Promotion
Communicate and facilitate discussion around the effect of lifestyle factors on health and
promote the ethical practice of evidence based medicine.
 Seek up to date evidence on lifestyle factors that:
o negatively impact health outcomes
o increase risk of illness
o positively impact health and decrease risk factors
 Actively promote good health practices with patients individually and collectively
Caring for patients
Take into consideration patient’s individuality, personal preferences, goals and the need to
provide compassionate and dignified care.
 Be familiar with
o Ethical guidelines
o Local and national clinical care guidelines
 Act in the patients best interest
 Engage in shared decision making and discuss consent
Outcomes

1. Discuss the pathophysiological basis of the investigation
2. Choose appropriate investigations
3. Take an informed consent
4. Write problem-orientated discharge notes, letters, more detailed case reports,
concise out-patient reports and focused reviews
5. Deal with end of life issues and symptom control

Workplace interactions: A case based discussion is recorded where the trainer has seen
example of discharge notes, reports etc.
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Practice
“…behaviour and values that support good care. [Practice] relies on putting the interests and
well-being of patients first. The main elements of good practice are: caring when treating
patients . . . , confidentiality . . ., promoting patient safety . . ., integrity . . ., self-care . . .,
practice management . . ., use of resources . . ., and conflicts of interest . . . .”
Chapter 2, P11
The training goals for practice are:
 Patient safety and ethical practice

 Organisational behaviour and leadership
 Wellbeing
Patient safety and ethical practice
Put the interest of the patient first in decisions and actions.

 React in a timely manner to issues identified that may negatively impact the patients
outcome
 Follow safe working practices that impact patients safety
 Understand ethical practice and the medical council guidelines
 Support a culture of open disclosure and risk reporting
Outcomes

1. Practice aseptic techniques and hand hygiene
2. Encourage others to observe infection control principles
3. Actively participate in and understand incident reporting
Organisational behaviour and leadership
The activities, personnel and resources that impact the functioning of the team, hospital and
health care system.
 Understand and work within management systems
 Know the impacts of resources and necessary management
 Demonstrate proficient self-management
Outcomes

1. Plan schedule and arrive on time
2. Respond to colleagues in a timely manner
3. Manage time appropriately in the clinical setting
4. Set appropriate personal goals
5. Communicate leave and off duty appropriately with all members of team
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Wellbeing
Be responsible for own well-being and health and its potential impact on the provision of
clinical care and patient outcomes.
 Be aware of signs of poor health and well-being
 Be cognisant of the risk to patient safety related to poor health and well-being of
self and colleagues
 Manage and sustain your own physical and mental well-being
Outcomes

1. Recognise potential stressors
2. Effectively deploy stress reduction strategies and wellness improvement
3. Effectively manage your physical and mental health e.g. have own GP
4. Direct patients and colleagues to appropriate mental health support
Record of experience: Engagement in wellbeing strategies is self-assessed

Workplace interactions: Trainees are encouraged to take a proactive approach to wellbeing
Sign off: Once during training upon successful submission of self-assessment
Performance
“…describes the behaviours and processes that provide the foundation for good care.
[Performance] requires . . . competence . . ., reflective practice . . ., acting as a role model . .
., teaching and training medical students and doctors new to practice . . . .”
Chapter 2, P12
The training goals for performance are:
 Continuing competence and lifelong learning

 Reflective practice and self-awareness
 Quality assurance and improvement
Continuing competence and lifelong learning
Continually seek to learn, to improve clinical skills and to understand established and
emerging theories in the practice of medicine.
 Meet career requirements including those of the medical council, your employer
and your training body
 Be able to identify and optimise teaching opportunities in the workplace and other
professional environments
 Develop and deliver teaching using appropriate methods for the environment and
target audience
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Outcomes

1. Teach junior healthcare professionals
2. Engage in peer to peer teaching
3. Deliver a presentation
4. Seek opportunities to learn
5. Engage in self-directed learning
6. Maintain a record of professional achievements
Reflective practice and self-awareness

Bring awareness to your actions and decisions and engage in critical appraisal of own work
to drive lifelong learning and improve practice.
 Pay critical attention to the practical values and theories which inform every day
practice
 Be aware of your own level of practice and learning needs
 Evaluate and appraise your decisions and actions with consideration as to what you
would change in the future
 Seek to role model good professional practice within the health service
Outcomes

1. Identify gaps in their knowledge
2. Work within their own ability and call for help when appropriate
Quality assurance and improvement
Seek opportunities to promote excellence and improvements in clinical care through the
audit of practice, active engagement in and the application of clinical research and the
dissemination of knowledge at all levels and across teams.
 Gain knowledge of quality improvement methodology
 Follow best practice in patient safety
 Conduct ethical and reproducible research
Outcomes

1. Engage with audit and quality improvement projects
2. Critically evaluate a research paper
3. Contribute research evidence to a group discussion
4. Understand the core concepts of data protection
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General Paediatrics Skills
Goals, Outcomes and Assessment Details
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History and Physical Examination
History Taking
Take a comprehensive, targeted and adaptable history   
Take an allergy-focused history   
Take a history and assess common acute neonatal presentations   
Physical Examination
Perform a detailed physical examination      
Perform an appropriate and thorough newborn examination    
Perform a 6 week examination   
Clinical Assessment Tasks
Assess pubertal status    
Assess nutritional status    
Assess blood pressure    
Assess developmental status    
Assess hepatic synthetic dysfunction or failure   
Perform the assessment of the child with reduced consciousness or coma   
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Record of Workplace
Clinical Presentations: Recognition
Recognition of clinical presentations
Assess common paediatric conditions      
Recognise acute gastroenteritis   
Recognise dehydration  
Recognise constipation  
Recognise and assess the level of severity of asthma  
Recognise prematurity and low birth weight sequelae    
Recognise infections in the neonate  
Recognise common diseases and neonatal issues  
Recognition of emergencies
Recognise the deteriorating child or infant       
Recognise and take the initial steps in the management of potential child protection issues    
Recognise organ failure    
Recognise serious life threatening illnesses in the newborn    
21
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Record of Workplace
Diagnostics and Procedures
Identification of underlying pathology and risk factors
Discuss the safe, effective and necessary role immunisations play in child health   
Discuss the use of Vitamin K with parents including the indications for use   
Screen for common congenital heart disease   
Interpret blood gas analysis and oximetry    
Investigate common neonatal disorders   
Diagnostic Tasks
Record and interpret electrocardiograms  
Interpret biochemical tests  
Interpret commonly encountered X-rays  
Demonstrate knowledge of the indications for common neuro-imaging abnormalities by CT, MRI or
ultrasound  
Perform peak flow rates  
Perform a Mantoux test  
Independent Performance of Procedures
Arterial puncture for blood gas analysis   
Blood cultures with aseptic technique   
Blood sampling   
Height measurement using a stadiometer    
Intravenous cannulation    
Lumbar puncture    
Observation of Procedures
Intraosseous needle insertion 
Umbilical artery or vein catheterisation 
Tracheal intubation 
nt
l
ing
i sa
me
ser d
ord
al d ppra
ve
ved
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lop
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Cas Ca se
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ly
ix R
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cor
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nti
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Per
F or
On
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Record of Workplace
Clinical Presentations: Treatment and management
Treatment and management
Manage common paediatric presentations       
Explain the management of eczema (primary)   
Clinically manage an asthma admission   
Manage dehydration   
Plan fluid therapy   
Manage acute gastroenteritis    
Manage constipation  
Provide all relevant information when making a surgical or orthopaedic referral  
Manage the neonate with an infection  
Take the initial steps in the management of the sick neonate, including phototherapy   
Emergency Management
Identify and take the initial steps to manage the deteriorating child or infant       
Manage acute seizures and status epilepticus   
Manage common metabolic crisis   
Stabilise the neonate   
Perform neonatal resuscitation   
22
History and Physical Examination
The training goals for history and physical examination are:
 History Taking
 Physical Examination
 Clinical Assessment Tasks
History Taking

1. Take a comprehensive, targeted and adaptable history
2. Take an allergy focused history
3. Take a history and assess common acute neonatal presentations
General Paediatrics
Take a comprehensive, targeted and adaptable history

Workplace interactions: Assessment of this outcome is formally observed by a registered
trainer who will provide real time feedback. This is completed once, or formatively if
additional refinement of approach is required.
Focus of Feedback - Communication and appropriateness

The trainer evaluates if the trainee:
asked relevant questions
was fluid, focused and practiced in approach
obtained the appropriate consent for the people who are present
communicated with empathy
ensured those present understood the terms and language used
ensured the patients dignity and privacy
appropriately summarised their findings
understood the diagnostic significance of patterns of symptoms
23
Take an allergy focused history
Record of experience: Self-assessed by the trainee for a specified clinical case

Workplace interactions: Progress may be discussed with the trainer
Focus of Feedback – Knowledge of allergy and appropriate follow up

The trainee evaluates their ability to:
understand the pathophysiology of allergy
differentiate between IgE and non IgE allergy
recognise the risk of anaphylaxis
confidently determine when allergy testing is indicated
recognise common food allergies
appropriately refer children requiring specialist care
Neonatal Medicine
Take a history and assess common acute neonatal presentations

Workplace interactions: Informally observed in the workplace by senior staff members
specific real time feedback given. Progress may be discussed with a trainer during end of
post assessment based on workplace feedback and submitted self-assessments.
Sign off: Once during training upon successful evaluation of self-assessment by trainer
Focus of Feedback – Key concepts in assessing a neonate and taking a history

take a history of pregnancy
take a familial history
understand the relevance of scans in neonatal history
identify the key concerns of the parent
24
Physical Examination

1. Perform a detailed physical examination
2. Perform an appropriate and thorough newborn examination
3. Perform a 6 week examination
General Paediatrics
Perform a detailed physical examination
Record of experience: A case mix is recorded including a range of examination types,

Examples to include head to toe, abdominal, ENT, Respiratory, Neurological, and pGALS.
Workplace interactions: Informally observed in the workplace by senior staff members who
provide recorded feedback on performance. Progress is discussed with a trainer during end
of post assessment based on workplace feedback and submitted assessments.
Sign off: Evaluated per post with an emphasis on progression of skills with experience
Focus of Feedback – Skill in physical examination, management of the child and follow up
Perform an accurate, organised and appropriate physical examination
Manage the environment
Minimise disturbance to the child
Document findings
Appropriately plan for next steps
Neonatal Medicine
Perform an appropriate and thorough newborn examination
Record of experience: Recorded formatively as a directly observed procedure

Workplace interactions: Formally observed in the workplace, in real time, by a senior team
member who is appropriate to provide feedback on performance as determined by the
trainer. Progress is discussed with a trainer and observations are repeated until the expected
level of proficiency is reached.
Sign off: On successful completion of a directly observed procedure in line with the trainers
expectations.
demonstrated an understanding of the expected behaviour of a new born
performed a smooth and minimally invasive examination
discussed routine and complex follow up
25
Perform a 6 week examination

expectations
performed the examination
managed the neonate
communicated with the primary care givers
Clinical Assessment Tasks

1. Assess pubertal status
2. Assess nutritional status
3. Assess blood pressure
4. Assess developmental status
5. Assess hepatic synthetic dysfunction or failure
6. Perform the assessment of the child with reduced consciousness or coma
General Paediatrics
Assess pubertal status
Assess nutritional status
Assess blood pressure
Assess developmental status
Assess hepatic synthetic dysfunction or failure
Record of experience: Each task should be assigned to at least one case during training.
Workplace interactions: Informally observed in the workplace and the trainee should seek
feedback where appropriate. These tasks may be discussed with the trainer at end of post
assessment.
Sign off: On the trainers approval of submitted case examples.
Focus of Feedback – Performance of task and follow up
Perform the assessment of the child with reduced consciousness or coma
Record of experience: One case example and completion of APLS training.

feedback where appropriate. This task may be discussed with the trainer.
26
Clinical Presentations: Recognition
The training goals for the recognition of clinical presentations are:
 Recognition of clinical presentations

 Recognition of emergencies
Recognition of clinical presentations

1. Assess common paediatric conditions
2. Recognise dehydration
3. Recognise acute gastroenteritis
4. Recognise constipation
5. Recognise and assess the level of severity of asthma
6. Recognise prematurity and low birth weight sequelae
7. Recognise infections in the neonate
8. Recognise common diseases and neonatal issues
General Paediatrics
Assess common paediatric conditions
Record of experience: A case mix reflective of experience is recorded.

feedback on performance. Progress is discussed with a trainer during end of post
assessment based on workplace feedback and submitted cases.
Sign off: Evaluated per post with an emphasis on progression of skills with experience.
Focus of Feedback – Ability or recognise key signs and symptoms

understand the pathophysiology of the presentation
recognise the clinically significant signs and symptoms
differentiate breath sounds e.g. wheeze, stridor and grunting
select appropriate investigation and procedures to avoid unnecessary discomfort
Recognise acute gastroenteritis
Record of experience: A case based discussion. Case examples may also be recorded.
Workplace interactions: The trainee is expected to initiate and record a case based
discussion on the recognition and management of acute gastroenteritis. Core professional
skills are evaluated as part of this discussion and case notes should be available for the
trainer to review.
Sign off: On successful completion of case based discussion.
27
Focus of Feedback – Knowledge of gastroenteritis, record keeping and follow up
During discussion the trainee should be able to:
identify signs and symptoms of dehydration
discuss the adjustment of management plan based on the childs age
plan fluid therapy
explain the embryology of the gastrointestinal tract and its relationship to
disease, e.g. malrotation
explain the physiology of the GI tract, including the liver and pancreas
describe the principles of absorption and malabsorption
Recognise dehydration
Recognise constipation
Recognise and assess the level of severity of asthma
Record of experience: At least one case recorded per outcome

Workplace interactions: These presentations may be discussed with the trainer
Sign off: On the trainers approval of submitted case examples
Focus of Feedback – Recognition of signs and symptoms and follow up
Neonatal Medicine
Recognise prematurity and low birth weight sequelae
Record of experience: A case based discussion (CBD). Case examples may also be recorded.
Workplace interactions: The trainee is expected to initiate and record a CBD
Sign off: On successful completion of CBD
Focus of Feedback – Recognition and understanding of sequelae

describe prematurity sequelae
describe low birth weight sequelae
Recognise infections
Recognise common diseases and neonatal issues
Recognise serious life threatening illnesses in the newborn
Record of experience: Each presentation should be assigned to at least one case during the
neonatal rotation. These can also be recorded in other posts where appropriate.
appropriate feedback. These outcomes will be discussed at the neonatal end of post
assessment.
Sign off: On approval of submitted case examples.
Focus of Feedback – Recognition and understanding of signs and symptoms
28
Recognition of Emergency

1. Recognise the deteriorating child or infant
2. Recognise organ failure
3. Recognise serious life threatening illnesses in the newborn
4.
General Paediatrics
Recognise the deteriorating child or infant
Record of experience: Self-assessed by the trainee for a case mix including all ages. Examples
of experience to include:
Acute life threatening illness
Acute asthma
Acute croup
Acid-base and electrolyte homeostasis
Bronchiolitis
Cardiopulmonary arrest
Cardiac and respiratory emergencies
Coma and convulsions
Shock
Meningococcal septicaemia
Severe trauma
Suspected sepsis
Poisonings
Workplace interactions: The trainee should seek feedback in the workplace on the ability to
recognise paediatric emergencies. Progress will be discussed with trainer during end of post
assessment.
Focus of Feedback – Progress in the recognition of emergencies

understand the pathophysiology of the presentation
recognise the clinically significant signs and symptoms
select appropriate investigation and procedures to avoid unnecessary discomfort
29
Recognise and take the initial steps in the management of potential child protection issues
discussion with their trainer.
Sign off: On successful completion of case based discussion
Focus of Feedback – Recognition of child protection as an emergency

recognise a potential child protection issue
discuss the initial steps in management of a child protection issue
explain the Children First guidelines
Recognise organ failure

Workplace interactions: Informal feedback in the workplace. Progress may be discussed with
trainer.
Neonatal Medicine
Recognise serious life threatening illnesses in the newborn

Workplace interactions: Informal feedback in the workplace, during the neonatal rotation in
particular. Progress may be discussed with trainer.
30
Diagnostics and Procedures
The training goals for diagnostics and procedures are:
 Identification of underlying pathology and risk factors

 Diagnostic tasks
 Independent performance of procedures
 Observation of procedures
Identification of underlying pathology and risk factors

1. Discuss the safe, effective and necessary role immunisations play in child health
2. Recognise and take the initial steps in the management of potential child
protection issues
3. Discuss the use of Vitamin K with parents including the indications for use
4. Screen for common congenital heart disease
5. Interpret blood gas analysis and oximetry
6. Investigate common neonatal disorders
General Paediatrics
Discuss the safe, effective and necessary role immunisations play in child health
Record of experience: Discussion is self-assessed with a case example

Workplace interactions: Case may be informally discussed with trainer
Focus of Feedback – Understanding of immunisation and communication

explain the mechanism of action of common vaccinations
discuss vaccination schedules
critically evaluate the evidence base for common vaccinations
engage appropriately and cooperatively with parents, guardians or caregivers
Discuss the use of Vitamin K with parents including the indications for use
Record of experience: Discussion is self-assessed with a case example

Focus of Feedback – Understanding of vitamin K and communication

discuss the indications for use of vitamin K
respond to parents or guardians concerns
discuss the evidence base for use
engage appropriately and cooperatively with parents, guardians or caregivers
31
Screen for common congenital heart disease
Record of experience: Self-assessed task with a case example

Focus of Feedback – Understanding congenital heart disease

screen for common congenital heart disease
discuss the anatomy and physiology of congenital heart disease
understand the role of genetics in congenital heart disease
recognise the clinical manifestations of congenital and acquired heart disease
discuss screening appropriately and cooperatively with parents, guardians or
caregivers
Interpret blood gas analysis and oximetry
Record of experience: A case based discussion with a case examples

discussion with their trainer.
Sign off: On successful completion of the case based discussion
Focus of Feedback – The interpretation of blood gas analysis and oximetry

recognise the indication for gas analysis and oximetry
explain the impact to the child of invasive investigations
Neonatal Medicine
Investigate common neonatal disorders
Record of experience: A case mix reflective of experience is recorded

choose and carry out appropriate investigations. Progress will be discussed with trainer
during end of post assessment.
Sign off: Evaluated at end of post for the neonatal medicine rotation with an emphasis on
progression of skills with experience
Focus of Feedback – Appropriate selection and performance of investigations
32
Diagnostic Tasks
1. Record and interpret electrocardiograms
2. Interpret biochemical tests
3. Interpret commonly encountered X-rays
4. Demonstrate knowledge of the indications for common neuro-imaging
abnormalities by CT, MRI or ultrasound
5. Perform peak flow rates
6. Perform a Mantoux test
All diagnostic task outcomes
Record of experience: Each task should be assigned to at least one case during training
feedback where appropriate. Performance of these tasks may be discussed with the trainer.
Sign off: On the trainers approval of submitted case examples
Focus of Feedback – Performance of task and follow up
Independent Performance of Procedures
By the end of BST the trainee will demonstrate an ability to perform:

1. Arterial puncture for blood gas analysis
2. Blood cultures with aseptic technique
3. Blood sampling
4. Height measurement using a stadiometer
5. Intravenous cannulation
6. Lumbar puncture
Arterial puncture for blood gas analysis

Blood cultures with aseptic technique
Blood sampling

Workplace interactions: The trainee should seek feedback from informal observations in the
workplace. Progress may be discussed with trainer.
Sign off: On successful submission of self-assessment
Focus of Feedback – The indications for, and risks associated with, this procedure
33
Height measurement using a stadiometer
Intravenous cannulation

Workplace interactions: Assessment of this outcome is formally observed by a registered
trainer who will provide real time feedback. This is completed once, or formatively if
additional refinement of approach is required.
Sign off: Once during training upon successful evaluation by the observing trainer
Focus of Feedback – The indications for, and risks associated with, this procedure
Lumbar puncture

expectations
Focus of Feedback – Performance of lumbar puncture, management of the child and

follow up
prepared appropriately
performed the procedure to the expected standard
was able to discuss indications for when consent is not required for lumbar
puncture
was able to discuss the interpretation of test results
Observation of Procedures
By the end of BST the trainee will demonstrate an understanding of:

1. Intraosseous needle insertion
2. Umbilical artery or vein catheterisation
3. Tracheal intubation
Record of experience: The trainee records a self-assessment of their understanding of the

procedure
Workplace interactions: The trainee should seek opportunities to observe procedures in the
workplace or as part of a simulation and ensure they understand all key concepts.
Sign off: On successful submission of self-assessment
34
Clinical Presentations: Treatment and management
The training goals for the treatment and management of clinical presentations are:
 Treatment and management

 Emergency management
Treatment and management
By the end of BST the trainee will demonstrate and ability to:
1. Manage common paediatric presentations
2. Clinically manage an asthma admission
3. Manage dehydration
4. Plan fluid therapy
5. Manage acute gastroenteritis
6. Manage constipation
7. Provide all relevant information when making a surgical or orthopaedic referral
8. Manage the neonate with an infection
9. Explain the management of eczema (primary)
10. Take the initial steps in the management of the sick neonate, including
phototherapy
General Paediatrics
Manage common paediatric presentations
Record of experience: A case mix reflective of experience is recorded.
feedback on performance. Progress is discussed with during end of post assessment based
on workplace feedback and submitted cases.
Focus of Feedback – Ability to manage common presentations

manage the causes of respiratory distress including age-related drug therapy and
emerging treatment strategies
manage common presentations appropriate to the age of the child
describe the pharmacology and pharmacodynamics of common treatment
options
explain the risk factors, and potential complications associated with common
treatments
advise parents, guardians or care givers on post care
appropriately refer children requiring specialist care
35
Explain the management of eczema (primary)
Workplace interactions: The trainee is expected to initiate and record the discussion
Sign off: On successful completion
Focus of Feedback – Understanding how to manage eczema

explain the links between eczema and allergy
discuss appropriate treatment options
Clinically manage an asthma admission

Manage dehydration*
Plan fluid therapy*
Manage acute gastroenteritis*
Manage constipation
Provide all relevant information when making a surgical or orthopaedic referral
Neonatal Medicine
Manage a neonate with an infection
Record of experience: Management of each presentation should be assigned to at least one

case during training. Outcomes marked with an asterisk (*) are covered in the case based
discussion in the clinical recognition section.
feedback where appropriate. Management of these presentations may be discussed with
the trainer at end of post assessment.
Focus of Feedback – Appropriate management and follow up
Take the initial steps in the management of the sick neonate, including phototherapy
discussion.
Sign off: On successful completion
Focus of Feedback – Managing the sick neonate

identify the indications for phototherapy
36
Emergency management

1. Identify and take the initial steps to manage the deteriorating child or infant
2. Manage acute seizures and status epilepticus
3. Manage common metabolic crisis
4. Stabilise the neonate
5. Perform neonatal resuscitation
General Paediatrics
Identify and take the initial steps to manage the deteriorating child or infant
Record of experience: Self-assessed by the trainee for a case mix including all ages.
manage paediatric emergencies. Progress will be discussed with trainer during end of post
assessment.
Focus of Feedback – Progress in the management of emergencies

stablise the patient and manage symptoms
choose age appropriate management options
engage appropriately and cooperatively with family members present
General Paediatrics
Manage acute seizures and status epilepticus
Manage common metabolic crisis
Neonatal Medicine
Stabilise the neonate
Perform neonatal resuscitation
Record of experience: Management of each presentation should be recorded as part of at

least one case during training.
feedback where appropriate. Management of these presentations may be discussed with
the trainer at end of post assessment.
Focus of Feedback – Appropriate management and follow up
37
Professional Development
Clinical Activity
Record frequency of attendance at:

Outpatient Clinics
Ward rounds
Post-call ward rounds
Attendance will be discussed at the end of each post and experience evaluated
Record frequency of call for the post.
Where appropriate record:

Additional Clinical Experience
Subspecialty and special interest experience
Academic and Professional Development activities
Record attendance at hospital based learning including Grand Rounds, Journal Clubs and
Multidisciplinary team meetings
Record attendance at a minimum of 10 approved Study Days during your training

programme.
Record examination attempts in ePortfolio for each part of the MRCPI examination
Record attendance at mandatory courses
 APLS
 BST Leadership in Clinical Practice
 Child Protection
 Ethics, Safe Prescribing Skills and Blood Transfusion for Paediatrics
 Infection control (can be part of hospital induction day)
 NRP
 STABLE
A summary of attendance will be visible at the end of post assessment
Progress Evaluations
Complete the personal goals form for each post
Review progress and complete the End of post assessment
Formally Record the outcome of annual evaluations
38
ency
pl es
Fre qu
E xam
sed
rd
rd
Asse s
Re co
Re co
Professional Development
Clinical Activity
Outpatient Clinics  
Ward rounds  
Post-call Ward rounds  
On call requirements  
Additional Clinical Experience 
Subspecialty and special interest experience 
l
spita
te
e
Onli n
Of f S i
In Ho
Academic and Professional Development activities
Attendance at hospital based learning 
Study Day Attendance 
Course Attendance 
Examinations 
Mandatory Courses   
APLS 
BST Leadership in Clinical Practice 
Child Protection 
Ethics, Safe Prescribing Skills and Blood Transfusion for Paediatrics  
Infection control 
NRP 
STABLE 
Progress Assessments
Personal Goal Plan 
End of post assessment 
Annual assessment 
39

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BASIC SPECIALIST TRAINING IN

Version Date Published Last Edited By Version Comments

Overview of Curriculum ................................................................................................. 4

Core Professional Skills ........................................................................................12

General Paediatrics Skills .....................................................................................20

History and Physical Examination ................................................................................ 23

Professional Development ...................................................................................38

Key elements of BST

Trainees will be assessed in the workplace at intervals

In addition to your clinical skills and general professional development activities it is

Requirements for Basic Specialist Training in Paediatrics

 Completed their Internship satisfactorily

Basic Specialist Training Agreement

 Fully cooperate in all aspects of the BST programme

Special Leave (Other than study and annual leave):

≤ 7 months: 6 months of training in (an) approved post(s) must be completed in order to

If an extra 6, 12 or 18 months is required: In cases where, due to leave in excess of 4 weeks,

 RCPI cannot guarantee a post(s) in the trainee’s current hospital or region

Informing the employer: Notice of resignation by the trainee as an employee of his/her

The training goals for partnership are:

Communication and interpersonal skills

Facilitate the exchange of information, be considerate of the interpersonal and group

By the end of BST the trainee will demonstrate an ability to:

Record of experience: Recorded with a clinical case example

 Work cooperatively with team members to deliver an excellent standard of care

By the end of BST the trainee will demonstrate an ability to:

Caring for patients

By the end of BST the trainee will demonstrate an ability to:

Record of experience: Recorded with a clinical case example

The training goals for practice are:

 Patient safety and ethical practice

Patient safety and ethical practice

Put the interest of the patient first in decisions and actions.

By the end of BST the trainee will demonstrate an ability to:

Organisational behaviour and leadership

By the end of BST the trainee will demonstrate an ability to:

By the end of BST the trainee will demonstrate an ability to:

Record of experience: Engagement in wellbeing strategies is self-assessed

The training goals for performance are:

 Continuing competence and lifelong learning

Continuing competence and lifelong learning

By the end of BST the trainee will demonstrate an ability to:

Reflective practice and self-awareness

By the end of BST the trainee will demonstrate an ability to:

Quality assurance and improvement

By the end of BST the trainee will demonstrate an ability to:

The training goals for history and physical examination are:

By the end of BST the trainee will demonstrate an ability to:

Record of experience: Recorded with a clinical case example

Focus of Feedback - Communication and appropriateness

Record of experience: Self-assessed by the trainee for a specified clinical case

Focus of Feedback – Knowledge of allergy and appropriate follow up

Record of experience: Self-assessed by the trainee for a specified clinical case

Focus of Feedback – Key concepts in assessing a neonate and taking a history

By the end of BST the trainee will demonstrate an ability to:

Record of experience: A case mix is recorded including a range of examination types,

Record of experience: Recorded formatively as a directly observed procedure

Record of experience: Recorded formatively as a directly observed procedure

Clinical Assessment Tasks