Cheer up! You are not alone in your concern for our specialty: the fall in recruitment to family practice residencies in the USA is sufficient for it to be overtaken by paediatrics and the declining attraction of internal medicine to US medical students was lamented by two American physicians who quoted a Texan saying “when the horse dies, get off”. Is (community) paediatrics dying or dead? If so, is it for resuscitation or the knacker?

What is paediatrics in the UK? It is the specialist medical care of children and young people. The unique responsibility of doctors is in diagnosis and treatment of patients—in our case those of a particular age. We might therefore ask ourselves if there is any sign of the public not wanting our skills? Far from it: an increasingly sophisticated and consumerist society is likely to have a lower threshold for having its children seen by a specialist if colleagues in primary care are not able to deal with their concerns adequately. General practitioners bring the holistic skills of family centred practice to the child and carers, but a physician who has had paediatric training and experience may be needed to shift the focus to the child, especially when assessing symptoms. Furthermore the approach to the sick child has changed: I recently saw a retired GP colleague’s grandchild who was referred to our acute assessment unit. She was amazed: “thirty years ago I would have given an injection of Ampiclox at home and nine times out of ten the child …