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Obstetrics and Gynaecology

Obstetrics and Gynaecology. Dr Fiona Bach ST2 O&G trainee. Contents. Being an Obstetrician and Gynaecologist 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!

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Obstetrics and Gynaecology

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  1. Obstetrics and Gynaecology Dr Fiona Bach ST2 O&G trainee

  2. Contents • Being an Obstetrician and Gynaecologist • How to become an Obstetrician and a Gynaecologist

  3. Why I love Obstetrics and Gynaecology! • Very varied • You can tailor your job to what you want – to an extent! • Lots of patient contact

  4. 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

  5. Obstetrics – my point of view • Starting from the beginning • Getting involved!

  6. Fetomaternal Medicine Labour ward management Fetal distress C-section PPH

  7. Fetomaternal Medicine Highs and lows Pre-term delivery Fetal death • Sharing these moments

  8. Fetomaternal Medicine Medical complications of pregnancy Pre-eclampsia Diabetes Any medical problem not related to pregnancy how pregnancy affects the illness and how the pregnancy affects the illness

  9. Fetomaternal Medicine Scanning Growth scans Monitoring liquor volume Structural fetal abnormalities

  10. Gynaecology – my point of view • Again – get involved! • Varied • Hysteroscopy • Laparoscopy

  11. 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

  12. Reproductive medicine • Fertility and assisted conception • Clinic • Funding • Success...failure

  13. Urogynaecology • Urinary symptoms • Prolapse • “Wet women” • Massive impact on peoples lives • Social exclusion

  14. Gynaecology oncology • Cancer of the Ovary, Uterus, Cervix, Vulva, Vagina • Colposcopy – LLETZ • Cervical cancer vaccines

  15. 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

  16. Midwives! • Independent practitioners • Experts on normal birth • Excellent source of knowledge • Instrumental deliveries and FBS

  17. 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

  18. Training now

  19. 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

  20. 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

  21. Training now

  22. 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,

  23. 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

  24. 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

  25. 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!!

  26. 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

  27. Questions?

  28. 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

  29. Resources • Get Ahead! – question books • http://www.mmc.nhs.uk/ • www.rcog.org.uk • http://www.foundationprogramme.nhs.uk/pages/home

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