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Paediatrics & Child Health Training Pathway

How to become a paediatrician in Australia — the RACP Basic and Advanced Training pathway, how employment-based entry actually works, and what paediatricians earn.

Paediatrics doesn't have a national selection match — you get onto it by landing an accredited hospital training job and enrolling with the RACP. The real gates are the two Divisional Examinations between Basic and Advanced Training, and competition for advanced-training posts in the popular subspecialties, which sit in a small number of tertiary units.

Why paediatrics & child health

You look after children from newborns to adolescents — acute illness on the ward and in emergency, neonatal care, and a large load of developmental, behavioural and chronic-disease work in clinics. It's a consultation-heavy specialty built around the child and the family, rather than procedures. It suits people who like broad general medicine in children, working with families, and a mix of acute and long-term developmental care — and who are happy with a physician-style exam pathway rather than a procedural one.

  • Draws: Broad scope across acute, neonatal and developmental care, Employment-based entry — no single national match to win, Strong demand and a wide range of subspecialties, Largely clinic-based consultant lifestyle.
  • Trade-offs: Two demanding Divisional Examinations with capped attempts, Lower earning ceiling than procedural specialties, Subspecialty advanced-training posts are scarce and contested, On-call for acute and neonatal work.
  • Subspecialties: Neonatal & perinatal medicine, Paediatric intensive care, Paediatric cardiology, Paediatric oncology, Respiratory & sleep medicine, Neurology, Endocrinology & diabetes, Community & developmental paediatrics.

The training pathway

The same fellowship, two very different timelines. The fast route assumes everything goes right; most people land on the realistic one.

Fastest route
~6 years of RACP training
Three years Basic Training, both Divisional Exams passed first go, then three years Advanced Training. RACP publishes no average time to fellowship, so any PGY here is an estimate.
Internship
PGY1
General registration — the minimum to start Basic Training.
Land an accredited basic-trainee job
from PGY2–3
Get a paediatric training position at an RACP-accredited hospital and enrol with the College.
Basic Training
3 years
General paediatrics, paediatric emergency, neonatology and a specialty term, with work-based assessments.
Divisional Examinations
end of Basic Training
Written and Clinical exams — the gate into Advanced Training.
Advanced Training
3 years
General paediatrics or a subspecialty stream (24 months core + 12 months non-core).
Fellowship — FRACP
Qualified · ~PGY7+ (estimate)
Consultant paediatrician.
Realistic route
7+ years of RACP training (estimate)
Typical — a hospital year or two before a training job, possible exam resits, and competition for the advanced-training post you want. RACP publishes no average, so this is an estimate.
Internship + residency
PGY1–2
General registration and early hospital experience.
Secure a basic-trainee position
PGY2–3
Entry is employer-run — some states coordinate recruitment into paediatric training networks, others hire hospital by hospital.
Basic Training (3 yrs)
with capped exam attempts
Both Divisional Exams must be passed within the time limit (up to four written and three clinical attempts).
Divisional Examinations
the barrier
Written (two papers) and Clinical (long and short cases) — must pass to progress.
Advanced Training (3 yrs)
general or subspecialty
Subspecialty posts (e.g. neonatology, PICU, oncology) sit in a few tertiary units and are the more contested.
Fellowship — FRACP
Qualified (estimate)
Consultant paediatrician.

How competitive is it?

There's no national selection match for paediatrics, and no jurisdiction or college publishes applicant-to-position ratios or fill rates, so a competitiveness number can't be quoted. What is published is the size of the workforce: the RACP's Paediatrics & Child Health Division covers about 5,400 Fellows and trainees, within roughly 9,400 RACP trainees nationally. Entry is employer-run — you compete for an accredited hospital training job rather than a place in a central match — so competitiveness varies by hospital and state. The clearest pinch points are the two Divisional Examinations and, later, the popular subspecialty advanced-training posts, which sit in a small number of tertiary units.

Unaccredited time: No formal unaccredited-registrar grade as in surgery — but because entry is employment-based, the real step is landing an accredited paediatric training job, which can be competitive depending on the hospital and state.

Sources: RACP — Paediatrics & Child Health Division, RACP — Basic Training (Paediatrics & Child Health), RACP — entry into Basic Training (by state).

Selection criteria & how to apply

Paediatric selection is run by employers, not the College — so the exact process varies by state and hospital, and no published rubric assigns set weightings. The components commonly assessed:

Curriculum vitae & experienceAssessed
Your clinical experience, paediatric terms, and academic record. Some states (e.g. Queensland) also use short written-statement responses.
Referee reportsAssessed
Structured references from supervisors — several states require three consultant-level referees.
InterviewAssessed
A panel interview, or in Victoria an online multiple mini-interview (MMI). Format and number of stations vary by state.
Eligibility & DPE approvalGate
General registration, the required hospital experience, an accredited training position, and sign-off from the site Director of Physician Education.

Key documents: RACP — apply for physician training, RACP — entry into Basic Training (state pages).

How to get a training job, state by state

The part most guides skip. Because there's no national match, getting in means getting an accredited hospital job — and how that's organised differs sharply by state, from coordinated statewide recruitment to hospital-by-hospital hiring. Pick your state below.
NSW

Who runs selection: Entry is through the NSW Health JMO recruitment portal, with HETI coordinating placement into the state's paediatric physician training networks. You typically apply in PGY2 to commence in PGY3.

Where to apply: NSW Health JMO portal (HETI networks) — application portal.

When: JMO applications generally open around July and close in August for the following clinical year.

Interviews: Statewide panel interviews of shortlisted applicants.

Worth knowing: The major children's hospitals are The Children's Hospital at Westmead and Sydney Children's Hospital, Randwick (both part of the Sydney Children's Hospitals Network), plus John Hunter Children's Hospital in Newcastle. Successful applicants get a multi-year training-and-employment position in a network.

Links: NSW Health — JMO recruitment, Sydney Children's Hospitals Network.

VIC

Who runs selection: A statewide program run by the Victorian Basic Paediatric Training Consortium (VBPTC) across about 16 health services, with central recruitment through the two primary sites. Most enter as a junior RMO in PGY2.

Where to apply: VBPTC (Royal Children's / Monash Children's recruitment) — application portal.

Interviews: Shortlisted candidates sit an online multiple mini-interview (MMI).

Worth knowing: Anchored by the Royal Children's Hospital Melbourne and Monash Children's Hospital. The consortium model means one statewide program rather than separate hospital schemes.

Links: Victorian Basic Paediatric Training Consortium, RACP — entry into Basic Training (VIC).

QLD

Who runs selection: Centralised statewide recruitment through the Queensland Health RMO & Registrar Campaign — one application with rotation preferences — into the Queensland Basic Paediatric Network. Trainees commence PGY3 or later.

Where to apply: Queensland Health RMO & Registrar Campaign — application portal.

Interviews: Selection uses referee reports, clinical experience, CV review, short written-statement responses and an interview (no published weightings).

Worth knowing: All trainees spend at least six months at the Queensland Children's Hospital and rotate to an outer-metropolitan or regional hospital. Queensland has a strong rural and regional paediatric footprint.

Links: Queensland Health — basic paediatric training, RACP — entry into Basic Training (QLD).

SA

Who runs selection: Apply online through SA Health careers; selection is coordinated through the Women's and Children's Health Network, with a statewide panel interviewing shortlisted candidates and negotiating site allocation. Trainees commence PGY3 or later.

Where to apply: SA Health careers (Women's and Children's Health Network) — application portal.

Interviews: Statewide panel interview of shortlisted applicants.

Worth knowing: Network sites include the Women's and Children's Hospital (Adelaide), Lyell McEwin Hospital and Flinders Medical Centre.

Links: SA Health — careers, RACP — entry into Basic Training (SA).

WA

Who runs selection: Employment-first, with no single statewide paediatric match. You secure 12 months as an RMO/registrar at Perth Children's Hospital (or a paediatric/neonatal registrar post at Fiona Stanley Hospital), mostly through the WA Health annual intake campaign, after which the basic-training selection process runs.

Where to apply: WA Health annual medical intake (Perth Children's Hospital) — application portal.

Interviews: Selection coordinated by Perth Children's Hospital postgraduate medical education.

Worth knowing: Perth Children's Hospital is the single tertiary children's hospital, so most paediatric training centres on it, with rural and remote rotations across a vast state.

Links: MedCareersWA, RACP — entry into Basic Training (WA).

TAS

Who runs selection: Secure employment as a paediatric SRMO first, then apply for a junior registrar (BT1) post via a single online application requiring a CV, cover letter, a trainee data form and three consultant referees.

Where to apply: Tasmanian Health Service (jobs.tas.gov.au) — application portal.

Interviews: Selection based on application, references and interview.

Worth knowing: Based at the Royal Hobart Hospital with rotations to Launceston General and the North West Regional Hospital; third-year registrars may rotate interstate to Melbourne or Adelaide for breadth.

Links: Tasmanian Health Service — careers, RACP — entry into Basic Training (TAS).

ACT

Who runs selection: Paediatric physician training runs through the Canberra Physician Training Network, based at The Canberra Hospital and the Centenary Hospital for Women and Children, with regional secondments.

Where to apply: Canberra Health Services / Canberra Physician Training Network — application portal.

Interviews: Selection through Canberra Health Services recruitment.

Worth knowing: A single-network territory anchored on the Centenary Hospital for Women and Children, with secondments to regional centres for breadth.

Links: Canberra Physician Training Network, Canberra Health Services — careers.

NT

Who runs selection: The Northern Territory has no standalone basic paediatric training posts — positions are secondment rotations to Royal Darwin Hospital from interstate parent hospitals. Entry is effectively via the parent hospital's recruitment.

Where to apply: NT Health (secondment placements) — application portal.

Worth knowing: Distinctive remote and Aboriginal child-health exposure delivered through secondments rather than a local training program — strong appeal if that's your interest.

Links: NT Health — careers, RACP — entry into Basic Training (NT).

How to optimise your application

The honest read: There's no CV-scoring meeting to game — the levers are landing an accredited training job, passing the two Divisional Exams within their capped attempts, and (if you want to subspecialise) positioning for a scarce advanced-training post early.
  • Get paediatric terms early (tied to Getting the job, start PGY1–2) — Paediatric and neonatal rotations build the experience and references that employer selection looks for.
  • Apply where recruitment is coordinated (tied to Getting the job, start PGY2) — States like NSW, VIC, QLD and SA run statewide recruitment into training networks — one application covers multiple sites.
  • Respect the exam attempt caps (tied to Divisional Exams, start Basic Training) — Written and Clinical exams are capped (up to four and three attempts) and must be passed within the Basic Training time limit — prepare properly the first time.
  • Position for subspecialty early (tied to Advanced Training, start late Basic Training) — Popular subspecialties sit in a few tertiary units — research, networking and the right rotations help you land the scarce posts.

Key documents & official links

FAQ

Is paediatrics hard to get into?
There's no national selection match — you get in by landing an accredited hospital training job and enrolling with the RACP. No applicant-to-position ratios are published, so it's hard to quantify; competitiveness varies by hospital and state. The bigger gates are the two Divisional Exams and later competition for subspecialty advanced-training posts.
How long does it take?
A minimum of about six years of RACP training — three years Basic Training, then three years Advanced Training — on top of internship and any hospital years first. RACP doesn't publish an average time to fellowship, so any total PGY is an estimate.
What exams are there?
Two Divisional Examinations at the end of Basic Training: a written exam (two papers) and a clinical exam (long and short cases). Both must be passed within capped attempts to progress to Advanced Training. The clinical exam's delivery is being reformed, but the long/short-case format is current.
How do I get a training job?
It's employer-run. Several states coordinate statewide recruitment into paediatric training networks — NSW (HETI/JMO portal), Victoria (VBPTC), Queensland (RMO & Registrar Campaign) and SA (Women's and Children's Health Network) — while WA, Tasmania, the ACT and NT are more hospital-based or secondment-based.
Do paediatricians earn less than other specialists?
Generally yes — it's a consultation-heavy, non-procedural specialty with a large public component. The ATO put the average taxable income for paediatricians at $271,518 in 2022–23, below surgeons, anaesthetists and psychiatrists. Some subspecialists earn more.

Trained overseas? (IMG pathway)

How overseas-trained paediatrics & child health doctors get recognised

Overseas-trained paediatricians are assessed by the RACP through a comparability assessment against the Australian training standard, rated substantially, partially or not comparable. Those found substantially or partially comparable typically complete a period of supervised practice (commonly 6–24 months) on the way to fellowship, via the Standard or Accelerated Specialist pathways.

See the RACP pathways for overseas-trained physicians and our IMG internship guide.

Last reviewed 2026-06-01.

AussieClinicians is an independent Australian pay calculator built by Jacob Stretton (RN; final-year medical student). Estimates only — verify with your payslip, payroll, and the linked award/EBA + ATO sources. Not financial or tax advice.