Obstetrics and Gynaecology

Dr Fiona BachST2 O&G trainee

Contents

1. Being an Obstetrician and Gynaecologist

2. How to become an Obstetrician and a Gynaecologist

Why I love Obstetrics and Gynaecology!

• Very varied

• You can tailor your job to what you want – to an extent!

• Lots of patient contact

Being an Obstetrician and Gynaecologist

• General Obstetrics and Gynaecology– most jobs are for both

• Obstetrics alone • Benign Gynaecology• Oncology• Reproductive Gynaecology• Urogynaecology• Community gynaecology - Sexual and

Reproductive Health

Obstetrics – my point of view

• Starting from the beginning

• Getting involved!

Fetomaternal Medicine

Labour ward managementFetal distressC-sectionPPH

Fetomaternal Medicine

Highs and lowsPre-term deliveryFetal death• Sharing these moments

Fetomaternal MedicineMedical complications of pregnancy

Pre-eclampsiaDiabetes

Any medical problem not related to pregnancyhow pregnancy affects the illness and how the pregnancy affects the illness

Fetomaternal Medicine

ScanningGrowth scans

Monitoring liquor volume

Structural fetal abnormalities

Gynaecology – my point of view

• Again – get involved!

• Varied

• Hysteroscopy

• Laparoscopy

Gynaecology

• 24yr old woman– Right sided abdominal pain started last night, increasing in

intensity. Brown pv discharge. Sexually active.

– PT+ve• Ectopic, Miscarriage, ultrasound

– PT –ve• PID – pelvic abscess• Cyst accident – torsion/rupture• Appendicitis • Constipation• UTI

Reproductive medicine

• Fertility and assisted conception– Clinic– Funding– Success...failure

Urogynaecology

• Urinary symptoms• Prolapse

• “Wet women”– Massive impact on peoples lives– Social exclusion

Gynaecology oncology

• Cancer of the Ovary, Uterus, Cervix, Vulva, Vagina

• Colposcopy – LLETZ– Cervical cancer vaccines

Multidisciplinary• Medics• Anaesthetists• Paediatricians• Surgeons• Midwives– Community and Hospital– Specialist

• Physiotherapists• Physics – scanners more advanced• Geneticists – pre-natal diagnosis• Engineers – fine needles for intrauterine needling

Midwives!

• Independent practitioners

• Experts on normal birth• Excellent source of

knowledge• Instrumental deliveries

and FBS

Did you like what you saw?Becoming an Obstetrician or Gynaecologist

• Pass Medical school!!– “Get Ahead” – series of MCQ/EMQ books based

on the Leeds syllabus

• Pass Foundation Years– Women’s health module– Part 1 exam• Revision course• Busy SpR

Training now

Foundation years

• Acquire generic competences– Manage the acutely ill patient in a variety of settings– Does not matter if you do not do O&G as FY1/2 it is

the generic skills that are important

• Acquire generic skills– Team working– Infection control– Clinical governance– Risk management

Assessments

• Mini CEX – clinical evaluation exercises• CbD – case-based discussions• MSF – multi-source feedback• DOPs/OSATs – objective structured

assessments of technical skill

• ARCP – annual review of competence progression

Training now

Training programme

• E-Portfolio• Structured teachings• ST1/ST2– Generic skills, knowledge, understanding and

competences in O&G– Manage acute obstetric and gynaecological

presentations– Part 1– C-sections, forceps, laparoscopy, hysteroscopy,

Training programme cont...

• ST3 – ST5– Further competences – Part 2– Chance to do academic training– More complicated C-sections, rotational forceps,

laparoscopy, hysteroscopy, hysterectomy, ectopic, oophorectomy, salpingectomy

• ST6/ST7– Further competences– ASTMs – Advanced Training Skills Modules i.e. Specialise

Out of training programme guidance

• Beneficial to a trainee’s educational and professional development– Training can count towards award of CCT– Can be done abroad

How to improve your chances!Undergraduate

• The National Undergraduate Curriculum in Obstetrics and Gynaecology (NUCOG)

• RCOG website – area just for you guys!– Events for students– Free e-mail updates

• Elective!!

How to improve your chances!FY1/FY2

– Women's health module• Obstetric and gynaecology history taking and

examination skills• Basic obstetric problems• Basic gynaecology problems

– Show an interest – audit/presentation– Part 1 Exam– Talk to consultants

• Miss Jackie Tay / Mr Nigel Simpson

Questions?

ConclusionObstetrics and Gynaecology

• Very varied and interesting speciality

• You still can be a generalist or you can super-specialise

• Excellent team working

• Fantastic patient contact

Resources

• Get Ahead! – question books

• http://www.mmc.nhs.uk/

• www.rcog.org.uk

• http://www.foundationprogramme.nhs.uk/pages/home