Overview
Paediatrics mirrors the physician pathway: three years of basic training (increasingly in accredited networks anchored by the children's hospitals), the Divisional Written and Clinical exams in their paediatric versions, then advanced training in general paediatrics or a subspecialty (neonatology, paediatric emergency, cardiology, oncology, community/developmental and more).
The workforce story of the 2020s is developmental-behavioural demand: ADHD, autism and school-functioning assessments have created year-plus waitlists and transformed community paediatrics into one of the busiest (and, privately, best-remunerated) corners of the field.
The pathway
- PGY1Internship; paediatric terms help but aren't mandatory everywhere. Apply via state recruitment for paeds BPT.
- Basic training (3 years)General paeds, neonates, community and subspecialty rotations across a network (children's hospital + metro/regional partners).
- Divisional exams (paediatric)Written then Clinical, same structure and seriousness as adult medicine.
- Advanced training (3 years)General paediatrics or subspecialty programs, competitive job applications, with neonatology/PEM/cardiology the tightest.
- FRACP → consultantGeneral paediatrician (hospital, community, private) or subspecialist (usually children's-hospital based).
Formal requirements
- General registration + PGY1; appointment to an accredited paediatric basic training position (state recruitment processes).
- RACP registration, work-based assessments, required rotations (incl. neonates, community).
- Both Divisional exams passed to enter advanced training.
Selection and points
How selection works
| Component | What it involves |
|---|---|
| Network/hospital job application | CV, referees, interview, children's hospital networks (SCHN, RCH/VIC, QCH, WCH, PCH) run coordinated intakes in most states. |
Points & scoring
- No formal points matrix; demonstrated commitment (paeds terms, child-health research, NETS/volunteering) and referee strength decide shortlists at the big networks.
The unofficial view
- The children's hospitals are oversubscribed; mixed metro/regional programs are a genuinely good and less contested way in; you can converge on the children's hospital for advanced training.
- Paediatric referees who have seen you with children and families are the core signal, one strong paeds term outperforms a long generic CV.
- NICU resus courses, immunisation volunteering, and child-protection or school-health projects mark genuine commitment more convincingly than a personal statement.
Competition & demographics
Competitiveness
- Basic training entry at children's hospitals ~2–4:1 (indicative); regional/mixed programs near 1:1.
- Advanced training: neonatology, PEM and paediatric cardiology are the competitive gates; general paediatrics absorbs most applicants.
Who's in the program
- ≈ 75% of trainees are women; strong part-time training culture (among the best of the acute specialties).
Exams
| Exam | When | Format | Cost | Pass rate |
|---|---|---|---|---|
| Divisional Written Examination (Paediatrics) | End of basic training year 2–3 | MCQ papers, paediatric curriculum | ≈ $3,000–3,500 | ≈ 65–75% (indicative) |
| Divisional Clinical Examination (Paediatrics) | Following year | Long + short cases with real children and families | ≈ $4,000–4,600 | ≈ 60–75% (indicative) |
Fees and pass rates are indicative; check the college's current fee schedule and exam reports.
What training costs
- RACP annual training fees ≈ $2,700–3,300; exam fees as above; courses (APLS ≈ $2,000) additional.
How to improve your chances at each stage
StageMedical student
- Do a children's hospital elective and a rural paeds term, breadth reads well and tests the vocation.
- Child-health research (bronchiolitis, immunisation, developmental screening) is accessible and publishable.
StageIntern (PGY1)
- Take paediatric or neonatal terms if available; do APLS early.
- Apply through your state's paeds BPT process; ask current trainees which networks genuinely support exam preparation and part-time training.
StageResident (PGY2–3)
- In basic training, bank neonates/community rotations early and join a written study group a year out.
- Pick your advanced-training target by mid-basic-training and start research/referee building there, neonatology and PEM shortlists reward early, visible commitment.
StageRegistrar years & applications
- For competitive ATs: a research year or higher degree attached to the children's hospital department is the standard differentiator.
- General paediatrics + a special interest (developmental, respiratory, diabetes) is the most employable configuration in the country.
StageIf you don't get on (or change your mind)
- Adjacent: GP with child-health focus (shorter, huge demand), paediatric emergency via ACEM, community/developmental roles, or adult medicine dual pathways early in training.
See also the general strategy guide: universal CV, referee and interview advice that applies across specialties.
Job market & workforce outlook
Outlook: General paediatricians in demand regionally and in community/developmental practice (huge ADHD/autism assessment waitlists); some metro subspecialty consultant markets are tight
- Regional general paediatricians are in chronic shortage; community/developmental demand (ADHD/autism assessment) far exceeds supply everywhere.
- Subspecialty consultant posts concentrate in children's hospitals and can be tight (small units, slow turnover); plan fellowships and geography accordingly.
Income
- Public packages $280,000–430,000; private community/developmental paediatrics with efficient assessment models indicatively $300,000–500,000+.
- Neonatology and PICU are salaried hospital careers with shift loadings.
Pre-tax, indicative, and highly variable with hours, setting and billing model. ATO figures are averages of taxable income by reported occupation.
Subspecialties & special interests
| Area | Notes |
|---|---|
| General paediatrics | Hospital + community, most employable |
| Neonatology | NICU shift-based; competitive AT |
| Paediatric emergency | Via RACP or ACEM |
| Community & developmental | ADHD/autism, enormous demand |
| Cardiology, oncology, neurology… | Children's-hospital subspecialty ATs |
International medical graduates
- General paediatrics (UK/Ireland qualifications) is on the expedited specialist pathway as of January 2026 (verified), relevant to overseas-trained paediatricians.
- Standard route otherwise: RACP SIMG comparability assessment.
Official links
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