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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 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! • 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 management Fetal distress C-section PPH
Fetomaternal Medicine Highs and lows Pre-term delivery Fetal death • Sharing these moments
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
Fetomaternal Medicine Scanning Growth 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
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 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
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