Paediatrics: Specialty Training Interview Questions

The paediatrics questions that sit on top of the specialty training core: clinical scenarios, the system and governance questions specific to the specialty, and presentation titles.

Updated 24 October 2026

The structures these questions are marked on

ETHICS Establish the facts and capacity, Think through the four pillars and name the tension, Hear the other side fairly, Identify two or three options, Choose a patient centred action with the next step, Safeguard and document. Full guide →
SAFER See the patient, Assess systematically with ABCDE, Fix what you can and decide, Escalate with a clear request in SBAR or ISBAR, Review: the patient told, the handover, the documentation and what you would do if the first plan failed. Full guide →
The What it is in a sentence, Why it matters with a fact, What it means for this organisation and specialty, What I would do at my level and how I would measure it. Full guide →

Motivation

Point to things you have done rather than feelings you have: tasters, audits, courses, exams, conferences. Name what you will find hard, honestly. Know the curriculum, the stages and the exams, and have an answer for what you would do if unsuccessful this year.

Asked in most interviewsUsually asked by the consultant colleague in the specialty
Why paediatrics, and what have you done to show you are committed to it?
Why children and families, with evidence: the paediatric rotation and what it taught you, a taster in neonates or community paediatrics, a child health audit, a course, a role with children outside medicine. Say what each taught you.
Asked in most interviewsUsually asked by the clinical director or clinical lead
What makes you suited to working with children and families, and what will you find hardest?
Qualities with evidence: the frightened child you calmed, the parent you reassured, the sick infant you managed. Then the honest difficulty: the child who deteriorates fast, the distress of families, safeguarding, the out of hours load.
Often askedUsually asked by the consultant colleague in the specialty
What do you know about the RCPCH Progress curriculum, the MRCPCH exams and the length of training?
The Progress curriculum's levels, the MRCPCH exams and when they fall, the length of training, and the subspecialty options. Two accurate sentences, then how you would fit the exams around work.
Often askedUsually asked by the clinical director or clinical lead
Tell us about an audit, QI project or teaching activity relevant to child health.
The problem, the measure, what changed, the result, and your part. If it was on a children's ward or in child health, say why that mattered.

Communication

Describe one real conversation and step through it. Practise a handover in SBAR until it is automatic: situation, background, assessment, recommendation, with what you want the senior to do stated plainly.

Asked in most interviewsUsually asked by the consultant colleague in the specialtySPIKES
You need to tell a parent that their baby has been found to have a heart murmur and needs an echo. Have that conversation with me.
Find out what they have heard, explain that most murmurs in babies are innocent and the echo is to make sure, say what the echo involves and when, and give them something to do while they wait. Do not promise it is nothing.
Asked in most interviewsUsually asked by the clinical director or clinical leadSPIKES
A mother is angry that her child has waited four hours in the emergency department. Speak to her.
Acknowledge first and genuinely. Then explain briefly what has happened and what will happen now, without defending the department. Offer what you can: a time, a plan, an update. De escalation is the mark, not winning the argument.
Often askedUsually asked by the consultant colleague in the specialtySPIKES
A father refuses to let you examine his child and wants to leave. What do you say?
Find out why before you persuade: a previous bad experience, a cultural concern, fear of what you will find. Address it, explain what the examination is for and what happens if it is not done, offer alternatives, and if he still refuses, involve the senior and consider the child's safety.
Often askedUsually asked by the clinical director or clinical leadSPIKES
Explain to a parent why their child with bronchiolitis does not need antibiotics.
Acknowledge that they want the best for their child, explain plainly that this is a virus and antibiotics do not help and can harm, say what does help and what to watch for, and give clear return advice. Check they feel able to manage.
Often askedUsually asked by the consultant colleague in the specialtySPIKES
You have to tell a parent that their child's blood test suggests leukaemia and the oncology team are coming. Begin that conversation.
SPIKES: the setting, what they already know, a warning shot, the information in small pieces, silence while they absorb it, and the plan with the oncology team's name and when they will arrive. Do not fill the silence.

Ethics and professionalism

Patient safety first, then gather information, then escalate through the right route, then support the people involved. Name the obligations that apply, including the duty of candour. Say what you would do, not what should be done.

Asked in most interviewsUsually asked by the clinical director or clinical leadETHICS
A two year old has bruises of different ages and the parents' account does not fit. What do you do?
The child first. A full history from each parent, a full examination with a body map, no confrontation. The senior and the safeguarding team before the family leaves, the investigations the assessment needs, and honest communication: the injuries need to be looked into. Document everything.
Asked in most interviewsUsually asked by the consultant colleague in the specialtyETHICS
Parents refuse a blood transfusion for their child on religious grounds. What do you do?
The child's interests first. Explore the refusal, explain the risks, offer alternatives, involve the consultant and the hospital's legal team early, and know that where the transfusion is life saving the court can authorise it and in an emergency the doctors act. Respect the parents throughout.
Often askedUsually asked by the clinical director or clinical leadETHICS
A 15 year old wants contraception and does not want her parents told. How do you approach it?
Gillick competence and the Fraser guidelines: does she understand, can she be persuaded to involve her parents, will she continue the relationship, will she suffer without treatment, is it in her interests. Explain confidentiality and its limits, encourage a trusted adult, and involve safeguarding if there is any concern about the relationship.
Often askedUsually asked by the consultant colleague in the specialtyETHICS
A colleague appears unwell at work and is responsible for the neonatal unit tonight. What do you do?
Patient safety first: the colleague must not care for babies tonight. Say so kindly, keep them from the clinical area, tell the consultant, and support the colleague afterwards. The cover is the senior's to arrange.

Clinical scenario

Go to see the patient, assess with ABCDE, treat what can be treated, escalate early and clearly, and say what you would do afterwards. Assessors are scoring judgement, prioritisation and escalation rather than knowledge; a safe answer that asks for help early beats a clever one that does not.

Asked in most interviewsUsually asked by the clinical director or clinical leadSAFER
A six week old is brought in with a fever of 38.5 and is feeding poorly. Talk us through your assessment and management.
- Follow-up: The infant becomes mottled and lethargic. What now, and who do you call?
Under three months, fever is sepsis until proven otherwise: the full septic screen including lumbar puncture, intravenous antibiotics now at the weight based dose, fluids by weight, and the consultant called. When the infant is mottled and lethargic, a fluid bolus, reassessment, and the retrieval service if not in a tertiary centre. Say you would not wait for results.
Asked in most interviewsUsually asked by the clinical director or clinical leadSAFER
A four year old presents with a fever, a non blanching rash and a capillary refill of four seconds. What do you do?
Meningococcal sepsis: antibiotics immediately, fluid boluses by weight with reassessment after each, the consultant and the retrieval service, and the public health notification. Say the dose per kilogram and the volume per kilogram.
Asked in most interviewsUsually asked by the consultant colleague in the specialtySAFER
A two year old has been fitting for ten minutes when they arrive. What do you do?
ABCDE, oxygen, the glucose, then the status pathway: a benzodiazepine, repeated once, then the second line agent, with the consultant called and anaesthetics or retrieval involved if it continues. Know your hospital's pathway and the doses by weight. Say what you would tell the parents.
Often askedUsually asked by the clinical director or clinical leadSAFER
A twelve year old with type 1 diabetes presents with vomiting, abdominal pain and a glucose of 30. Walk us through your management and its specific risks in children.
Cautious fluids, insulin after the fluids rather than with them, slow correction, potassium replacement, and the risk of cerebral oedema with its warning signs and its treatment. Use the paediatric DKA guideline and involve the consultant and the paediatric intensive care service early.
Often askedUsually asked by the consultant colleague in the specialtySAFER
An eight month old is wheezy, feeding poorly and has a respiratory rate of 70. What do you do?
Bronchiolitis: supportive care, oxygen if hypoxic, feeding support, minimal handling. Know the escalation signs: apnoeas, rising work of breathing, falling saturations, poor feeding, and the role of high flow and the intensive care service. Then the conversation with the parents about antibiotics.
Often askedUsually asked by the clinical director or clinical leadSAFER
A three day old baby is jaundiced and sleepy. What is your approach?
The bilirubin against the hour specific chart, the risk factors, the feeding assessment, the possibility of sepsis or haemolysis, phototherapy or exchange transfusion by the threshold, and the consultant. Sleepy is a warning sign.
Often askedUsually asked by the consultant colleague in the specialtySAFER
A five year old has a limp and a low grade fever. What are you worried about, and what do you do?
Septic arthritis until proven otherwise: the criteria, the bloods, the imaging, urgent orthopaedic involvement, and the differential including transient synovitis and the serious diagnoses that must not be missed.
Often askedUsually asked by the clinical director or clinical leadSAFER
A child develops anaphylaxis on the ward after a new antibiotic. What do you do?
Intramuscular adrenaline at the weight based dose immediately, repeated if needed, then oxygen, fluids and the rest. Stop the antibiotic, record the allergy, and tell the parents. Say the dose.

System knowledge

Name three current pressures and link each to your specialty and your own experience. Know how your training is governed: the ARCP, the curriculum, the college and the GMC.

Often askedUsually asked by the clinical director or clinical leadSYSTEM
What are the biggest challenges facing paediatric services in the NHS?
Three pressures linked to what you have seen: winter respiratory surges, children's mental health presentations, safeguarding caseloads, health inequalities, workforce. Say what a trainee can do about one.
Often askedUsually asked by the consultant colleague in the specialtySYSTEM
What is the role of the RCPCH in your training?
The college sets the curriculum and the exams, runs the e portfolio, and sets the standards of practice. For you it is the Progress curriculum, the MRCPCH and the assessments you are measured against.

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