When your child needs specialist care, you may come across different paediatric specialists. You might see a neurologist, respiratory paediatrician or neonatologist depending on your child’s condition and age.
The RCPCH currently offers training in 17 paediatric sub-specialties, including neurology, respiratory medicine, gastroenterology, neonatal medicine and several other specialist areas. You do not need to choose the right specialist yourself, as your GP or general paediatrician can assess your child’s needs and arrange appropriate referral.
What Is the Difference Between General Paediatrics and a Paediatric Subspecialty?
A general paediatrician can assess many health problems affecting your child, especially when the cause is unclear. If your child’s symptoms involve several areas, you may find that general paediatrics gives you a broader assessment before a specialist is needed.
A paediatric sub-specialist has additional focused training and expertise in a particular area, such as neurology or kidney disease. You do not always need the narrowest specialist first, as your child’s GP or paediatrician can help you decide which type of care is most appropriate.
Within the UK training pathway, doctors usually move into specialty-level paediatric training after core paediatric training, and those pursuing an RCPCH sub-specialty apply through a competitive recruitment process. Completing an approved sub-specialty programme can result in the sub-specialty being recorded alongside paediatrics on the GMC Specialist Register.
How Do UK Paediatric Specialist Pathways Differ?
| Type of care | Examples | What it means |
| General paediatrics | Broad assessment of children’s health problems | Useful when symptoms are unclear, affect several systems or do not yet point to one specialist |
| RCPCH paediatric sub-specialty | Neurology, respiratory medicine, nephrology, neonatal medicine, oncology | Focused paediatric training within one of the RCPCH’s recognised sub-specialty programmes |
| Other child-focused medical specialty | Paediatric cardiology, dermatology, psychiatry, radiology | Specialist children’s care, but training follows another UK Royal College or specialty pathway |
| Paediatric surgical specialty | Paediatric surgery, paediatric urology | Surgical care for children through surgical specialist training |
What Does a Paediatric Cardiologist Treat?
Paediatric cardiology is a child-focused specialty, but it follows a different UK specialist training pathway from the 17 RCPCH paediatric sub-specialties. A paediatric cardiologist specialises in heart problems affecting your child, from congenital heart defects to heart rhythm problems. If your child has a heart murmur, abnormal rhythm or another concern, your child may be referred for specialist assessment.
You may come across tests such as an ECG, echocardiogram or heart monitor during your child’s assessment. You do not always need a paediatric cardiologist for every heart symptom, as your GP or general paediatrician can decide whether your child needs specialist referral.
What Does Paediatric Gastroenterology, Hepatology and Nutrition Cover?
Paediatric gastroenterology, hepatology and nutrition specialists care for children with conditions affecting the digestive system, liver, feeding and nutrition. If your child has persistent digestive symptoms or complex feeding problems, your child may be referred for specialist assessment.
Your child may need blood tests, imaging or other investigations, while procedures such as an endoscopy or liver biopsy may be considered in selected cases. You do not always need a specialist for abdominal pain, constipation or vomiting, as your GP or paediatrician can first assess what care your child needs.
What Does a Paediatric Neurologist Treat?
A paediatric neurologist specialises in conditions affecting your child’s brain, nerves and muscles. If your child has complex seizures, unusual movements or persistent weakness, your child may be referred to a paediatric neurologist for specialist assessment.
You may see tests such as an EEG, MRI or genetic testing depending on your child’s symptoms. You do not always need a neurologist for headaches, fainting or tics, as your GP or general paediatrician can first assess whether your child needs specialist care.
What Does a Paediatric Respiratory Specialist Treat?
A paediatric respiratory specialist focuses on your child’s lungs and breathing. If your child has difficult-to-control asthma, chronic lung disease or ongoing breathing problems, your child may be referred for specialist assessment.
You may see tests such as spirometry, sleep studies or lung imaging depending on your child’s symptoms. You do not usually need specialist respiratory care for a simple cough or viral infection, but your child may benefit from referral if symptoms remain difficult to control.
UK Guidance Note
The RCPCH currently lists 17 recognised paediatric sub-specialties within the UK paediatric training pathway. However, not every doctor who specialises in children’s healthcare follows this route. Paediatric cardiology, dermatology, surgery, psychiatry, radiology and several other child-focused specialties are trained through other Royal Colleges or specialist pathways. This is why the word “paediatric” in a doctor’s title does not necessarily mean they completed an RCPCH paediatric sub-specialty programme.
What Does Paediatric Diabetes and Endocrinology Cover?
A paediatric endocrinologist specialises in hormone conditions affecting your child’s growth, puberty and metabolism. If your child is growing unusually slowly, starting puberty early or showing signs of hormonal imbalance, your child may be referred to this specialist.
You may also see paediatric endocrinologists involved in your child’s diabetes care, including insulin and glucose monitoring. You do not always need endocrine testing for short stature, as your GP or paediatrician can first assess your child’s growth pattern.
What Does a Neonatologist Do?
A neonatologist specialises in caring for newborn babies, especially if your baby is premature or has serious health problems after birth. If your baby needs help with breathing, feeding, infection or other complications, you may see a neonatologist in a neonatal unit.
Your baby’s care may continue after leaving hospital if your baby was very premature or medically vulnerable. You may therefore have follow-up appointments where your baby’s growth and development are monitored as they continue to grow.
What Does a Paediatric Nephrologist Treat?
A paediatric nephrologist specialises in your child’s kidneys, urinary system, fluid balance and blood pressure. If you notice ongoing urinary problems or your child’s tests show abnormal kidney function, your child may be referred to this specialist for further assessment.
Your child may need specialist care for kidney disease, nephrotic syndrome or congenital kidney problems. You do not usually need a nephrologist for a simple urinary infection, but if your child’s symptoms keep returning or tests suggest an underlying problem, your GP may recommend specialist care.
What Is Paediatric Allergy, Immunology and Infectious Diseases?
The RCPCH paediatric sub-specialty framework covers allergy, immunology and infectious diseases within this specialist area. If your child has a severe allergy, recurrent or unusual infections or a possible immune problem, they may be referred for specialist allergy, immunology or infectious-disease assessment.
Your child may receive specialist support for food or drug allergies, immune deficiencies or complicated infections. Your child’s care may also involve other specialists when their condition affects areas such as the lungs, skin or digestive system.
What Does a Paediatric Oncologist Treat?
A paediatric oncologist specialises in diagnosing and treating cancers that affect children and young people. If your child is diagnosed with or is being investigated for a condition such as leukaemia, a brain tumour or another childhood cancer, they may be referred to a specialist oncology team.
Your child’s treatment may involve oncologists, surgeons, nurses and other specialists working together. You may also receive support from psychologists and education professionals while your child goes through treatment and follow-up.
What Do Child Mental Health and Paediatric Palliative Medicine Cover?
Child mental health is one of the RCPCH paediatric sub-specialties and provides specialist paediatric input in complex cases where mental health may interact with a child’s physical health, development or wider care needs. This is distinct from child and adolescent psychiatry, which follows a different specialist training pathway.
Paediatric palliative medicine supports babies, children and young people with life-limiting or life-threatening conditions and their families. Specialists may help with complex symptom management, advance care planning and coordinated care across hospital, hospice and community settings, with the aim of supporting comfort and quality of life alongside other treatment.
What Does a Paediatric Rheumatologist Treat?
A paediatric rheumatologist specialises in inflammatory and autoimmune conditions affecting your child’s joints, muscles and other parts of the body. If your child has persistent joint swelling, stiffness or unexplained inflammation, your child may be referred for specialist assessment.
Your child’s diagnosis may involve a detailed history, examination and blood tests rather than one definite test. You do not usually need rheumatology care for ordinary growing pains, but if your child’s symptoms persist or worsen, your GP may recommend specialist assessment.
What Do Paediatric Emergency and Intensive Care Specialists Do?
Paediatric emergency medicine and paediatric intensive care medicine are separate paediatric sub-specialties, although both may be involved when a child is seriously unwell. Paediatric emergency medicine looks after your child when they need urgent assessment for illness or injury. If your child becomes seriously unwell, you may see emergency specialists deciding whether your child can go home, needs observation or requires admission.
Paediatric intensive care is for children who need a higher level of support for critical illness or serious injury. If your child needs intensive care, you may see specialists working with other teams to manage breathing, circulation, kidney problems or other complex needs.
What Are Paediatric Neurodisability and Community Child Health?
Paediatric neurodisability and community child health are separate RCPCH sub-specialties, although their work can overlap when children have developmental, disability or complex health needs. Paediatric neurodisability supports children whose long-term conditions affect development, movement or daily life. If your child has cerebral palsy, brain injury or complex motor difficulties, they may be referred for specialist assessment to help understand their wider developmental, physical and everyday needs.
Your child’s care may involve neurologists, physiotherapists, occupational therapists and speech and language therapists. You may also work with community paediatricians who coordinate with healthcare, education and community services to support your child’s development, health and everyday needs.
What Are Inherited Metabolic Medicine and Paediatric Clinical Pharmacology?
Paediatric inherited metabolic medicine focuses on rare conditions affecting how your child’s body processes substances. Your child may be referred for specialist metabolic assessment if they have unexplained symptoms or unusual test results that suggest a metabolic condition.
Paediatric clinical pharmacology focuses on the development of medicines and their safe, rational use in children. If your child needs complex treatment, their healthcare team may seek specialist advice to help ensure medicines are appropriately selected, dosed and monitored.
What Other Child-Focused Medical Specialties Are There?
The 17 RCPCH sub-specialties do not cover every area of children’s medicine. If your child needs a cardiologist, surgeon, dermatologist or psychiatrist, you may find that their training follows a different UK pathway.
You may also come across specialists in genetics, urology, anaesthesia and audiology. Your child’s specific condition will help determine which specialist they need and what type of care is most appropriate.
How Do You Know Which Paediatric Specialist Your Child Needs?
You usually do not need to decide which paediatric specialist your child should see on your own. Your GP or general paediatrician can assess your child’s symptoms, consider their medical history and guide you towards the most appropriate specialist care.
- Heart Concerns: Your child may be referred to a paediatric cardiologist if symptoms or tests suggest a heart condition.
- Neurological Symptoms: A paediatric neurologist may be appropriate if your child has complex seizures, persistent weakness or other problems involving the brain, nerves or muscles.
- Digestive Problems: Your child may need a paediatric gastroenterologist when ongoing digestive, feeding or nutritional concerns require specialist assessment.
- Growth or Hormonal Concerns: A paediatric endocrinologist may become involved if your child has problems related to growth, puberty, hormones or diabetes.
- Unclear or Multiple Symptoms: If your child’s symptoms do not clearly fit one specialty, a general paediatrician can assess the wider picture before arranging referral.
The right specialist depends on your child’s symptoms, diagnosis and individual healthcare needs. If several specialists are involved, you can ask which clinician is coordinating your child’s overall care so you have a clear point of contact.
Clinical Tip
Before a specialist appointment, bring relevant clinic letters, test results and an up-to-date medicines list if you have them. It can also help to write down your main concerns and how your child’s symptoms have changed over time, especially when more than one specialist is involved.
Myth vs Fact
| Myth | Fact |
| Every doctor who treats children is trained through an RCPCH paediatric sub-specialty. | No. Some child-focused specialties, including paediatric cardiology and surgery, follow different UK specialist training pathways. |
| Your child should always see the narrowest specialist first. | No. A GP or general paediatrician can often assess the wider picture and decide whether specialist referral is needed. |
| Referral to a paediatric subspecialist means your child definitely has a serious condition. | No. Referral may simply be needed for more focused assessment, investigation or specialist advice. |
| One specialist can always manage every aspect of a complex condition. | No. Children with complex needs may be supported by several specialists and other healthcare professionals. |
| All paediatric sub-specialties deal with one organ system. | No. Areas such as community child health, neurodisability and palliative medicine may consider several aspects of a child’s health and daily life. |
Key Takeaways
- The RCPCH currently lists 17 recognised paediatric sub-specialties within its paediatric training pathway.
- General paediatricians provide broad assessment, while subspecialists have additional focused expertise.
- Not every child-focused specialty is part of the RCPCH sub-specialty pathway; paediatric cardiology and surgery are examples of different UK training routes.
- Your GP or general paediatrician can usually help decide which specialist is most appropriate.
- Children with complex conditions may need care from several specialists working together.
- Child mental health and paediatric palliative medicine are also recognised RCPCH paediatric sub-specialties.
Frequently Asked Questions
1. Which Paediatric Subspecialties Are Recognised Within the RCPCH Pathway?
Within the RCPCH paediatric training pathway, sub-specialties include areas such as neurology, respiratory medicine, gastroenterology, diabetes and endocrinology, nephrology, rheumatology, neonatal medicine and oncology. You may also meet other child-focused specialists, such as paediatric cardiologists or surgeons, whose training follows different UK specialty pathways.
2. When Might Your Child Need a Subspecialist Rather Than a General Paediatrician?
Your general paediatrician is often a good starting point when your child’s symptoms are unclear or affect several areas. A subspecialist may become involved when symptoms, test results or a diagnosis point towards a particular field, such as neurology, respiratory medicine or gastroenterology.
3. When might your child need a paediatric cardiologist?
Your child may be referred to a paediatric cardiologist if they have a heart murmur, abnormal heart rhythm, congenital heart problem or another suspected heart condition. Your child may have tests such as an ECG, echocardiogram or heart monitoring during their assessment.
4. When might your child need a paediatric neurologist?
Your child may be referred to a paediatric neurologist if they have complex seizures, unusual movements, persistent weakness or another problem affecting their brain, nerves or muscles. Depending on your child’s symptoms, assessment may include an EEG, MRI or genetic testing.
5. When might your child need a paediatric gastroenterologist?
Your child may need a paediatric gastroenterologist if they have persistent digestive symptoms, complex feeding problems or conditions affecting their stomach, bowel or nutrition. Depending on your child’s symptoms, specialist assessment may include tests such as an endoscopy.
6. When might your child need a paediatric respiratory specialist?
Your child may be referred to a paediatric respiratory specialist if they have difficult-to-control asthma, chronic lung disease or ongoing breathing problems. Your child may need tests such as spirometry, sleep studies or lung imaging depending on their symptoms.
7. When might your child need a paediatric endocrinologist?
Your child may be referred to a paediatric endocrinologist if they have concerns involving growth, puberty, hormones or diabetes. Your specialist can assess your child’s growth pattern and, where needed, support diabetes care such as insulin and glucose monitoring.
8. When might your child need a paediatric nephrologist?
Your child may need assessment by a paediatric nephrologist if they have ongoing urinary problems, abnormal kidney-function tests or a kidney condition. Your child may need specialist care for conditions such as nephrotic syndrome or congenital kidney problems.
9. Who Can Help You Decide Which Paediatric Specialist Is Right for Your Child?
You usually do not need to choose the specialist yourself. Your GP or general paediatrician can assess your child, arrange initial tests and decide which specialist is appropriate based on your child’s symptoms and healthcare needs.
10. What if your child needs more than one paediatric specialist?
If your child has complex healthcare needs, you may see several specialists who each focus on a different part of their care. You can ask your healthcare team who is coordinating your child’s overall care so you do not have to manage separate appointments and advice alone.
Final Thoughts: Finding the Right Paediatric Specialist
Different paediatric subspecialists provide expertise for specific conditions, but you do not usually need to choose the right specialist yourself. Your paediatrician can assess your child’s needs, arrange appropriate tests and refer you to the right specialist when needed.
If you’re considering a paediatrician in London, you can get in touch with us at London Paediatric Clinic.
References:
- Royal College of Paediatrics and Child Health (RCPCH) (no date) Paediatric sub-specialties. Available at: https://www.rcpch.ac.uk/education-careers/apply-paediatrics/sub-specialties
- Royal College of Paediatrics and Child Health (RCPCH) (no date) General paediatrics – specialty level training. Available at: https://www.rcpch.ac.uk/education-careers/apply-paediatrics/sub-specialties/general-paediatrics
- Royal College of Paediatrics and Child Health (RCPCH) (no date) Paediatric neurology – sub-specialty. Available at: https://www.rcpch.ac.uk/education-careers/apply-paediatrics/sub-specialties/neurology
- Royal College of Paediatrics and Child Health (RCPCH) (no date) Paediatric gastroenterology, hepatology and nutrition – sub-specialty. Available at: https://www.rcpch.ac.uk/education-careers/apply-paediatrics/sub-specialties/PGHAN
- Royal College of Paediatrics and Child Health (RCPCH) (no date) Paediatric respiratory medicine – sub-specialty. Available at: https://www.rcpch.ac.uk/resources/paediatric-respiratory-medicine-sub-specialty
- Royal College of Paediatrics and Child Health (RCPCH) (no date) Paediatric diabetes and endocrinology – sub-specialty. Available at: https://www.rcpch.ac.uk/education-careers/apply-paediatrics/sub-specialties/diabetes-endocrinology
- Royal College of Paediatrics and Child Health (RCPCH) (no date) Neonatal medicine – sub-specialty. Available at: https://www.rcpch.ac.uk/education-careers/apply-paediatrics/sub-specialties/neonatal-medicine