Obstetrics and Gynaecology

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Obstetrics and Gynaecology

• Dr Fiona Bach
• ST2 OG trainee

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Contents

1. Being an Obstetrician and Gynaecologist
2. How to become an Obstetrician and a Gynaecologist

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Why I love Obstetrics and Gynaecology!

• Very varied
• You can tailor your job to what you want to an
  extent!
• Lots of patient contact

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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

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Obstetrics my point of view

• Starting from the beginning
• Getting involved!

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Fetomaternal Medicine

• Labour ward management
• Fetal distress
• C-section
• PPH

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Fetomaternal Medicine

• Highs and lows
• Pre-term delivery
• Fetal death
• Sharing these moments

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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

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Fetomaternal Medicine

• Scanning

• Growth scans
• Monitoring liquor volume
• Structural fetal abnormalities

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Gynaecology my point of view

• Again get involved!
• Varied
• Hysteroscopy
• Laparoscopy

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Gynaecology

• 24yr old woman
• Right sided abdominal pain started last night,
  increasing in intensity. Brown pv discharge.
  Sexually active.
• PTve
• Ectopic, Miscarriage, ultrasound
• PT ve
• PID pelvic abscess
• Cyst accident torsion/rupture
• Appendicitis
• Constipation
• UTI

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Reproductive medicine

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

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Urogynaecology

• Urinary symptoms
• Prolapse
• Wet women
• Massive impact on peoples lives
• Social exclusion

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Gynaecology oncology

• Cancer of the Ovary, Uterus, Cervix, Vulva,
  Vagina
• Colposcopy LLETZ
• Cervical cancer vaccines

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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

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Midwives!

• Independent practitioners
• Experts on normal birth
• Excellent source of knowledge
• Instrumental deliveries and FBS

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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
• Womens health module
• Part 1 exam
• Revision course
• Busy SpR

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Training now
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Foundation years

• Acquire generic competences
• Manage the acutely ill patient in a variety of
  settings
• Does not matter if you do not do OG as FY1/2 it
  is the generic skills that are important
• Acquire generic skills
• Team working
• Infection control
• Clinical governance
• Risk management

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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

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Training now
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Training programme

• E-Portfolio
• Structured teachings
• ST1/ST2
• Generic skills, knowledge, understanding and
  competences in OG
• Manage acute obstetric and gynaecological
  presentations
• Part 1
• C-sections, forceps, laparoscopy, hysteroscopy,

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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

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Out of training programme guidance

• Beneficial to a trainees educational and
  professional development
• Training can count towards award of CCT
• Can be done abroad

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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!!

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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

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Questions?
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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

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Resources

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