Guidelines for Advanced Training in Paediatrics

The Objectives of Advanced Training

During Advanced Training, it is intended that you shall develop the following knowledge and skills.

Medical Knowledge
This is the up-to-date body of knowledge and information required to manage children. It incorporates the synthesis and application of this information to clinical problems. Medical knowledge is continually changing. Paediatricians are required to keep abreast of these changes and to develop the ability to derive relevant evidence-based information and apply it to patient management.

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Clinical Skills
These are the basic tools of a paediatrician and include the skills necessary to take organised, relevant and complete medical histories, to perform thorough physical examinations and to use diagnostic studies and technical procedures appropriately, including understanding, performing and interpreting results. Clinical skills are developed and assessed during Advanced Training. At the end of Advanced Training, you will possess the skills required to practise competently in the chosen area of training.

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Clinical Judgement
This is the process by which diagnostic and therapeutic decisions are made. It requires integration of medical knowledge and clinical skills, consideration of diagnostic alternatives and understanding of the limitations of one's knowledge and experience. Good clinical judgement includes consideration of the risk-benefit ratio for the patient and an awareness of the cost of investigations and treatment. A knowledge of community resources and an understanding of the principles of preventive care are important. The ability to understand scientific and technological changes in medicine and to apply these appropriately to patient care is also a feature of good clinical judgement.

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Understanding of Research Methodology and Quality Assurance
A basic knowledge of research methodology including hypothesis generation and testing and the principles of statistical analysis is essential for a paediatrician. In keeping with trends in continuing education, you will learn how to initiate and evaluate Quality Assurance (QA) programs.

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Humanistic Qualities
The consistent demonstration of integrity, respect and compassion is required in the care of patients and their families. These qualities include the ability to listen, be honest, courteous and responsive to the patient's wishes, to be respectful of the patient's need for information and autonomy, to earn the patient's trust, to provide empathy and to maintain credibility and rapport with the patient and the patient's family. A sympathetic understanding of the interaction between health needs and socio-economic factors is necessary.

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Moral and Ethical Behaviour
The consistent demonstration of high standards of moral and ethical behaviour towards patients, families and co-workers is essential.

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Professional Attitudes and Behaviour
These are the attitudes, behaviour and interpersonal skills defined as essential in relating to patients and educating them, their families and other health care professionals. They include the ability and willingness to accept responsibility, to communicate effectively, to maintain comprehensive, timely medical records, to be available in a consultative role to other paediatricians when needed and to evaluate new medical scientific information relevant to the practice of medicine. Skills and experience in self-assessment and systematic peer-review of quality of care are also expected. A wise paediatrician recognises when fatigue or illness are likely to impair clinical competence and seeks colleagues' help for patient and self management at these times.

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Total Medical Care
The ability to manage patients effectively requires integration of all of the above skills. Excellent medical care results from the consistent ability to apply appropriate comprehensive care of high quality; to be responsive to the patient's needs and wishes; to use therapeutic modalities, laboratory tests and diagnostic procedures efficiently and in the patient's best interest; to provide appropriate and efficient utilisation and coordination of care by consultants and allied health care professionals; and to assure patient advocacy for optimal use of limited resources to maintain or enhance quality of care.

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