Paediatric basic training selection is run by networks under the Royal Australasian College of Physicians, in the same formats as adult physician training: a structured panel with a clinical scenario and a situational judgement question in some networks, a multiple mini interview in others. What differs is the content: paediatric scenarios, communication with parents, and child protection. This guide covers the questions that recur and what the panels are listening for.
Motivation and the programme
- Why paediatrics, and why this network?
- What are the qualities of a good paediatric trainee, and which do you have?
- What do you know about RACP paediatric basic training, its rural requirements and its examinations?
- What experience have you had with children and families that shows you are suited to this?
- What will you find hardest about paediatrics?
- What would you do if you were not successful this year?
Panels score evidence: the paediatric and neonatal terms, the sick children you have managed, the audit on a children's ward, the course, the experience with children outside medicine. Know the programme: the length, the written and clinical examinations, the rural and community requirements. Name an honest difficulty: the sick child who deteriorates fast, the distress of families, child protection work, the out of hours load.
The clinical scenarios
At the level of a paediatric registrar who is first to the sick child, usually with reading time:
- The six week old with a fever of 38.5 and poor feeding, who becomes mottled and lethargic.
- The four year old with a fever, a non blanching rash and a capillary refill of four seconds.
- The two year old who has been fitting for ten minutes.
- The twelve year old with type 1 diabetes, vomiting, with a glucose of 30.
- The eight month old wheezy and feeding poorly with a respiratory rate of 70.
- The three day old who is jaundiced and sleepy.
- The five year old with a limp and a low grade fever.
- Anaphylaxis on the ward.
- The newborn not breathing at delivery.
- The child in a remote community with severe dehydration, and when to retrieve.
Structure: systematic assessment, the immediate treatment with the paediatric specifics (weight based doses, fluid calculations, the cerebral oedema risk in DKA, the benzodiazepine pathway), escalation to the consultant and the retrieval service, the conversation with the parents, and what you would do if the first step did not work.
Talking to parents
An assessor plays the parent and stays in role:
- The mother angry that her child has waited four hours.
- Telling parents their baby has a serious congenital condition.
- Explaining why a child with bronchiolitis does not need antibiotics.
- The father who refuses to let you examine his child and wants to leave.
- The teenager who asks you not to tell her parents she is pregnant.
Listen first, acknowledge the feeling before the facts, plain words, small pieces, check understanding, agree the next step and a named contact. Adapt to the parent in front of you.
Child protection and ethics
- A toddler has bruises of different ages and the parents' account does not fit.
- Parents refuse a blood transfusion for their child on religious grounds.
- Parents want to take their child home against advice.
- How do you provide culturally safe care to an Aboriginal child and family, and who can help?
- A colleague appears unwell and is covering the neonatal unit tonight.
The child's welfare is paramount. Gather information without accusing, involve the senior and the child protection team early, document carefully, know your state's mandatory reporting obligations and the legal routes for a refused life saving treatment. For cultural safety, the Aboriginal liaison officer, the family, and flexibility about care.
The situational questions
The difficult supervisor, the error you made, the family refusing treatment for cultural reasons, teamwork and conflict, wellbeing and exam preparation. STAR form with your own actions clear.
What the panels score
Structured and safe clinical reasoning with paediatric specifics and early escalation; communication that listens and adapts; child safety handled with structure and without confrontation; cultural safety in action; evidence of commitment and insight. The common failures are adult doses, confronting the parents in the safeguarding scenario, and explaining before listening.
Preparing
The ten clinical scenarios aloud with the paediatric specifics. The five parent conversations with someone who stays in role. The child protection scenarios with the next step ready. Know your network's format and your state's mandatory reporting rules. Then timed practice, because the parent will not make it easy.