obstetrics and gynaecology dr fiona bach st2 o&g trainee
TRANSCRIPT
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Obstetrics and Gynaecology
Dr Fiona BachST2 O&G 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 managementFetal distressC-sectionPPH
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Fetomaternal Medicine
Highs and lowsPre-term deliveryFetal death• Sharing these moments
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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
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Fetomaternal Medicine
ScanningGrowth 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.
– PT+ve• 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– Women’s 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 O&G 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 O&G– 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 trainee’s 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