The future of paediatric cardiology in the United Kingdom. British Cardiac Society and the Royal College of Physicians of London.

(1) The working party has considered the requirements for the training of paediatric cardiologists and has suggested a flexible curriculum that allows the specialty to benefit from doctors coming into it from both adult cardiological and paediatric disciplines. (2) The working party appreciates that the short term problem with appointment of paediatric cardiologists cannot be solved immediately and recommends that appointing authorities should show patience. They should look to the possibility of identifying suitable candidates, at present in training, and making proleptic appointments to allow appropriate training to be completed. (3) There is a need for an increase in the number of paediatric cardiologists to service the specialty during a period when the patient load will increase because of population trends and changes in work patterns (specifically adults with congenital heart disease and prenatal cardiology). The care of adults with congenital heart disease has to be planned, certainly at regional and probably supraregional levels, and the financial and training implication has to be recognised. (4) The working party therefore recommends that there should be one consultant paediatric cardiologist per million of the population to allow for these changes in the service. (5) The working party considers that this report makes a very strong case for an increase in the number of senior registrar and registrar posts in the specialty. The existing number of junior posts will not fill the increase in agreed new posts and those made vacant by retirements between now and the end of the decade. When the additional posts recommended by the working party are taken into account at least three new senior registrar posts are needed. To make sure that a satisfactory supply of experienced candidates is available to fill the senior registrar posts the working party recommends the provision of two full time middle grade registrar jobs for each senior registrar position.