CERTIFICATION IN REPRODUCTIVE ENDOCRINOLOGY AND INFERTILITY ...Document Transcript
T H E R O YA L A U S T R A L I A N A N D
NEW ZEALAND COLLEGE OF
OBSTETRICIANS AND GYNAECOLOGISTS
CERT I F I C AT I O N I N R EPRODUCTIVE
ENDO C R I N O LO G Y A N D INFERTILITY TRAINING
PROG R A M H A N DBO O K 2004
The Royal Australian and New Zealand College of
Obstetricians and Gynaecologists
CERTIFICATION IN REPRODUCTIVE
ENDOCRINOLOGY AND INFERTILITY
TRAINING PROGRAM HANDBOOK 2004
ON INFORMATION AND REGULATIONS
IN THIS HANDBOOK
Every effort has been made to ensure that the information and
College regulations in this handbook were correct
at the time it was produced.
A regularly updated version of the handbook is available
on the College website (http://www.ranzcog.edu.au)
Readers are strongly advised to consult the website
version when checking information or regulations.
TABLE OF CONTENTS
Schedule of Fees 6
Reproductive Endocrinology and Infertility (REI) - Deﬁnition 7
Aims of REI Subspecialty 8
Reproductive Endocrinology and Infertility Subspecialty Committee 9
List of current CREI Subspecialists 10
List of current CREI Subspecialists 11
The CREI Training Program 12
Applying for prospective approval to commence the REI Training Program 14
Training Program Assessment Requirements 17
REI Examinations 20
Syllabus for learning in Reproductive Endocrinology and Infertility 24
REI Subspecialty Training Clinical Skills to be Recorded in the
Daily Training Record / Training Assessment Record 30
REI Subspecialty Training Clinical Skills to be Recorded in the
Daily Training Record / Training Assessment Record 31
Standards for ther Accreditation of a CREI Training Unit 32
Currently Accredited Training Units 34
Continuing Certiﬁcation 35
Subspecialties Compendium 36
SCHEDULE OF FEES
Annual Training Fee $AU 780
Late lodgement fee 10% annual fee per month
Re-instatement fee 50% annual fee
COGU In-hospital clinical examination $AU 660
MFM In-hospital clinical examination $AU 660
Subspecialty Written Examination $AU 830
Subspecialty Oral Examination $AU 2080
Overseas-trained Subspecialist Assessment $AU 1275
Subspecialty Certiﬁcation Fee $AU 465
The RANZCOG is committed to the National Principles for the Fair Handling of Personal
Information. A copy of these principles can be obtained at http://www.privacy.gov.au or by
contacting the Privacy Commissioner on +61 2 9284 9600.
All information submitted to the College by or about Trainees will be handled responsibly and in
accordance with these principles.
Only information essential to the legitimate function of the College will be collected. The College
will endeavour to ensure that information collected is correct and current, and that it is kept as
securely as practicable. On request, Trainees will be told how information collected about them
will be used. Trainees may also arrange to view their ﬁles by making written application to the
REPRODUCTIVE relevant clinical services throughout a
INFERTILITY (REI) - • accept a major regional responsibility
DEFINITION for higher training, research and audit in
areas of recognised subspecialisation
Reproductive Endocrinology and Infertility is
• establish, as far as possible,
a subspecialty of obstetrics and gynaecology.
consistency in recruitment, training and
Reproductive Endocrinology and Infertility
assessment across areas of recognised
subspecialists are specialists in Obstetrics and
Gynaecology, awarded the FRANZCOG, who are
trained and assessed as being competent in the
comprehensive management of patients with
reproductive endocrine disorders and infertility.
A CREI subspecialist must spend at least 67%
of his/her clinical time working in the area
of this specialty, the remainder being split
between obstetrics and gynaecology. At least
part of this work must be within a professional
setting that provides a comprehensive service
for patients with infertility or gynaecological
endocrine disorders (this may include private
units as well as public hospitals).
It is not intended that only persons with
the CREI should treat infertile couples. It is
probable, though, that specialists with this
qualiﬁcation will be leaders in this area and
directors of assisted conception units.
The Certiﬁcate of Reproductive Endocrinology
and Infertility (CREI) is a qualiﬁcation only
for individuals who hold the qualiﬁcation of
Fellow of The Royal Australian & New Zealand
College of Obstetricians and Gynaecologists
The College introduced certiﬁcation in the ﬁve
subspecialties in order to:
• improve knowledge, practice, teaching
• promote the concentration of specialised
expertise, special facilities and clinical
material that will be of considerable
beneﬁt to some patients
• improve the recruitment of talented
graduates into areas of recognised
• establish a close understanding
and working relationship with other
• encourage co-ordinated management of
AIMS OF REI SUBSPECIALTY
1. To provide competent management of
patients with reproductive endocrine
disorders and infertility.
2. To provide a comprehensive service for
patients with infertility or gynaecological
REPRODUCTIVE Reproductive Endocrinology
ENDOCRINOLOGY AND and Infertility Subspecialty
INFERTILITY SUBSPECIALTY Committee Correspondence
All correspondence pertaining to the work of
The Reproductive Endocrinology and Infertility the Reproductive Endocrinology and Infertility
Subspecialty Committee is a sub-committee of Committee should be forwarded to the
the RANZCOG Council. Chairman of the Reproductive Endocrinology
And Infertility Subspecialty Committee at
Subspecialty Committees comprise: the address below. The current Chairman is
Professor Geoff Driscoll.
• Two subspecialists nominated by
the Subspecialty Committee and Chairman of RANZCOG
recommended to Council without election Reproductive Endocrinology and Infertility
• Two members who hold the subspecialty Subspecialty Committee
qualiﬁcation, nominated and elected College House, 254-260 Albert Street
by holders of the relevant Subspecialty East Melbourne VIC 3002
• One specialist in obstetrics and
gynaecology, nominated by Council tel +61 3 9417 1699
• A Chairman, appointed by Council on fax +61 3 9419 7817 or +61 3 9419 0672
the recommendation of the Subspecialty email firstname.lastname@example.org
Committee. website http://www.ranzcog.edu.au
The committee is responsible for the
development and maintenance of the College’s
Reproductive Endocrinology and Infertility
subspecialty training program, the approval
of training units and training positions,
approval of the programs and the assessment
of training, development and maintenance
of the syllabus, assessment of Overseas
Trained Specialists, training and assessment
in countries other than Australia and New
Zealand, the appointment, support and ongoing
training of Training Supervisors, and any other
matters relating to the training program as
may be directed by Council from time to time.
Subspecialty Committees report to the Training
and Accreditation Committee, the Examination
Committee, Council, and other Committees
of Council as necessary. Subspecialty
Committees usually meet three times per year
by teleconference or face to face meetings.
Meetings tend to be scheduled for the weeks
preceding Council. Council meets in March, July
LIST OF CURRENT CREI SUBSPECIALISTS
New South Wales Dr W Birrell
Dr M Bowman
Professor M Chapman
Dr A Clark
Dr M Costello
Professor G Driscoll
A/ Professor J Eden
Professor I Fraser
Dr N Gayer
Professor P Illingworth
Professor R Jansen
Dr C S James
Dr R Lahoud
Dr M Livingstone
Dr D F Lok
Dr R Lyneham
Dr J W Persson
Dr R Porter
Dr F B Quinn
Professor D Saunders
Dr R Teirney
Dr I Wang
Dr R Woolcott
Victoria Dr L Burmeister
Dr B Downing
Dr L Hale
Professor D Healy
Professor G Kovacs
Dr P J Lutjen
Dr L Rombauts
Dr A Speirs
Dr C Stern
Dr B Vollenhoven
Dr D Wilkinson
ACT Dr Janelle McDonald
Queensland Dr C V Boothroyd
Dr K Forbes
South Australia Professor J Kerin
Professor R Norman
Dr O Petrucco
Continued over page ...
LIST OF CURRENT CREI SUBSPECIALISTS
West Australia Dr J Yovich
Tasmania Dr W Watkins
New Zealand Dr P Benny
Professor C Farquhar
Dr P Fisher
Dr W Gillett
Dr F Graham
Dr G Gudex
Professor J Hutton
Dr Neil Johnson
Dr G Phillipson
Overseas Prof B Dunphy
THE CREI TRAINING PROGRAM
The 3-year Training Program comprises clinical training and assessment requirements as follows:
Clinical training • must be prospectively approved
program • ﬁrst year must be in Australia or New Zealand
• desirable that trainees should not spend all three years in the
same training site
• minimum one year must be spent in Australia or New Zealand
one third of the training period should be spent in active
• minimum number of surgical procedures to be completed over
• completion of an examinable university-based statistics course
Training • trainee reports completed by Training Supervisor and
documentation submitted to the College for each 6-month period
• clinical summaries to be submitted for each 6-month period
• all reports must be submitted within 6-8 weeks of completing
each 6-month period
• Mid –semester assessment to be completed
• Trainee feedback form to be completed
Research project • research topic to be approved in ﬁrst 12 months of training,
with reports at 18 & 24 months
• original research work at a standard to be accepted in a peer-
• case reports and review articles not acceptable
• research paper must be submitted by 30 April in the year of
• must have been ﬁnally approved at least two months prior to
the date of the oral examination
Written • applications close on 30 April each year
examination • usually held in early August (at same time as MRANZCOG
• eligible only if satisfactory Training Assessment Record for 30
months of prospectively approved training
• must be attempted for the ﬁrst time within 2 years of
completion of training
• maximum of four consecutive attempts allowed
• comprises twelve ﬁfteen-minutes short answer questions
Oral Examination • only eligible if written examination is passed and research
paper approved at least two months prior to the examination
• usually held each year within six months of written
• comprises nine ﬁfteen-minute stations (with ﬁfteen-minute
break). Five minutes preparation before each station is allowed
• histological sections, article, videos, laboratory worksheets,
photographs, journal critiques may be included.
Regulations governing the timing of the
attempt at Examinations are included in
the RANZCOG Subspecialty Training and
Assessment Regulations in the Subspecialties
All RANZCOG Trainees must be supervised
by an appointed Training Supervisor/Program
A detailed description of the Appointment
and Duties of Subspecialty Training
Supervisors/Program Directors is located in the
APPLYING FOR PROSPECTIVE Clinical Endocrinology and Metabolism.
APPROVAL TO COMMENCE THE 5. Candidates must be able to monitor and
REI TRAINING PROGRAM manage their own and their institution’s
practices, carry out their own research
Eligibility studies, and analyse the work of others
critically. The candidate must therefore
Prospective Trainees must: have a thorough practical understanding
of the statistical and managerial methods
1. have satisfactorily completed at least used in the ﬁeld, such as:
48 months of the RANZCOG Integrated
Training Program and have passed the • familiarity with hypothesis
Membership Examination, at the time deﬁnition, experimental design,
training is to commence randomisation procedures,
sampling techniques, data
OR acquisition, data storage and
2. hold the FRANZCOG qualiﬁcation.
• scientiﬁc writing and composition
Entry Level Knowledge
• application of parametric tests
1. Candidates are strongly advised to including un-paired and paired
review the following areas: Anatomy ‘t’-test, correlation, linear and
(including male genital anatomy), multiple regression analysis and
Surgical Pathology (excepting neoplasia), analysis of variance; on-parametric
Reproductive Physiology (including male statistics; Chi-squared tests; the
reproductive physiology) and Genetics use of computers for data storage
and Ethics (as applied to reproductive and statistical analysis
medicine). These areas must be known
at the level required for MRANZCOG • computing means, standard
and at the applied subspecialty tertiary deviations and standard errors,
referral level. computing medians and conﬁdence
intervals; comprehension of
2. Candidates must be well acquainted signiﬁcance testing including
with public health and social concerns in understanding of type I and type II
the subspecialty, including the concept errors
of fecundability (monthly probability
of pregnancy), leading to the normal • epidemiological analysis, cohort
expectations of pregnancy in the and case control studies,
community, the medical, ethical, social, assessment of bias, population
and legal aspects of assisted conception, parameters and sampling
donor gametes and embryos, and techniques
• life table analysis
3. Candidates should be familiar with
current literature that concerns the • the techniques of quality control,
subspecialty, especially articles published quality assurance and total quality
in the journals Fertility and Sterility and management in clinical and
Human Reproduction. General medical laboratory practice.
journals, particularly the British Medical
Journal, the Lancet, the Medical Journal
of Australia and the New England
Journal of Medicine also contain articles
that concern the subspecialty and are
therefore also recommended.
4. Candidates should be familiar with
articles on reproduction in the Journal of
National Selection Process Committee, and Program Directors (or their
nominees) from those Training Units which
have a vacancy for training in the next two
Eligibility years. All applicants will be notiﬁed in writing
of the outcome of the interview.
Prospective Trainees must:
3. have satisfactorily completed at least
48 months of the RANZCOG Integrated
Following conﬁrmation of a training post the
Training Program and have passed the
prospective Trainee will need to register as a
Membership Examination, at the time the
RANZCOG Trainee and pay the Annual Training
training is to commence
Trainees who have completed the training
requirements, but not all the assessment
4. hold the FRANZCOG qualiﬁcation.
requirements for certiﬁcation in the
subspecialty, must remain registered as a
Applications RANZCOG Trainee. They must pay half the
Annual Training Fee until the satisfactory
The REI Committee will advertise annually completion of all assessment requirements
(in the March issue of the O&G magazine) for certiﬁcation in the subspecialty, unless
for prospective REI Trainees to apply for a notiﬁcation in writing is received of the
training position in the REI Training Program Trainee’s intent not to proceed with certiﬁcation
which leads to certiﬁcation as a subspecialist in in the Subspecialty.
Reproductive Endocrinology and Infertility.
Trainees who have completed the examination
All prospective Trainees must apply via the but have not yet submitted the thesis are
National Selection Process to commence required to pay the annual Training Fee.
training in the REI Training Program.
Trainees who have completed all other
Applicants will be asked to forward a assessment requirements (including the
curriculum vitae with a list of research and research paper) and are waiting to sit the
publications and the names of three referees. examination, are not required to pay the
The interviews will usually be held in June/July; Training Fee IF they are sitting the examination
applicants may be required to travel to College in the following year as the result of a
House for the interview. College decision to postpone a subspecialty
examination until more than one candidate is
Selection criteria for Trainees eligible.]
applying for the REI Training Program
Trainees who discontinue their registration as a
Applicants will be assessed against the registered RANZCOG Trainee and subsequently
following Selection Criteria : decide to obtain subspecialty certiﬁcation will
be required to pay half the Annual Training Fee
1. Previous experience in obstetrics and for the period of time between the last record
gynaecology of registration as a RANZCOG Trainee and
2. Previous surgical experience certiﬁcation as a Subspecialist.
3. Research experience
4. Psychosocial medical experience The RANZCOG registration and prospective
5. Teaching experience approval of training form is distributed in
6. Commitment to Gynaecological Oncology December.
7. Ability to relocate during the Training
8. Referee reports
The interview panel will comprise two
representatives of the REI Subspecialty
Applying for prospective approval to
continue the CREI Training Program
The Reproductive Endocrinology and Infertility
Subspecialty Committee must prospectively
approve all training for EACH year of training,
even though prior overall approval for the
three-year proposal has been gained.
Overseas Trained Subspecialists
Overseas Trained Subspecialists applying for
Certiﬁcation as CREI subspecialists are directed
to consult the Subspecialties Compendium.
TRAINING PROGRAM if they choose to do so, provided they meet
certain requirements (see below). This record
ASSESSMENT REQUIREMENTS of experience, whether in printed or electronic
format, has several functions:
Minimum Surgical Procedures
• It provides you with a personal record of
Certiﬁcation as a CREI Subspecialist requires clinical experience, which can be used to
a minimum number of surgical cases to be plan further training with your Training
performed, assisted at or observed over the 3- Supervisor or other mentors.
year clinical training period as follows:
• It provides you with the basis for the 6
• assistance at 10 microsurgical cases monthly summaries of your experience,
performed by a CREI training centre which you are obliged to prepare for
approved microsurgeon the College. These are used by your
• assistance at one anastomosis/ Training Supervisor, the relevant Program
performance alternate anastomosis to Co-ordinator, and the REI Committee
count as one case when supervised by a to monitor your experience and ensure
CREI accredited training centre approved that it is appropriate for your year of
microsurgeon training. This information is also used
• performance of 10 microsurgical cases by the College to monitor the experience
overall provided for you by the hospital.
• involvement in a CREI Committee
approved laboratory/animal research NOTE: The Logbook is reviewed and signed by
project supervised by a CREI training the Training Supervisor every 3 months.
centre approved microsurgeon (counts
for a maximum of 5 cases overall) • It makes up a component of the formal
• documented microsurgical cases proof of training, which you are obliged
supervised by a CREI training centre to provide to the College when you apply
approved microsurgeon during for Fellowship.
FRANZCOG training to count up to a
maximum of 5 cases. Important note
You are required to use a new Logbook for
Daily Training Record Logbook EACH year of training. You will receive a
- Printed Version new Logbook at the beginning of each year
from the College following registration as a
This is for recording on a daily basis: Trainee for that year. There is no charge for
the Logbook, as its cost is included in your
• clinical experience Annual Training Fee.
• attendance at meetings
• attendance at outpatient clinics The Logbook includes detailed instructions on
• research activities. how to complete it.
The information in the Daily Training Record Daily Training Record Logbook
must be tallied and recorded in the Training
Assessment Record at six-monthly intervals. – Electronic Version
NB It may be necessary for the Chairman of Trainees may maintain an electronic Daily
the Subspecialty Committee, or the Training Training Record Logbook providing the following
Supervisor/Program Director to view the Daily requirements are met.
Case Record for veriﬁcation or clariﬁcation of
details in the Training and Assessment Record. When setting up an electronic Logbook all
the introductory pages of the printed College
The Daily Training Record Logbook is a record Daily Training Record Logbook, including
of selected aspects of your experience during 1 the Certiﬁcate of Accuracy and the Record
year of the Training Program. Trainees will be of Discussion and Agreement by Training
issued with a printed version of this Logbook, Supervisor must be incorporated. In addition,
but they can keep an electronic version instead the headings contained in the Logbook must be
duplicated in any electronic Logbook. the CREI Training Program.
Every 3 months, you must submit a printed The Training and Assessment Record Book
Daily Training Record Logbook for signature must be updated every six months and sighted
and notation by your Training Supervisor. If by your Training Supervisor, who signs the Six-
the data has been maintained electronically, Monthly Training Summary (see below) before
then a print-out of the data must be produced it is forwarded to the College. You should also
at the time of signing. The print-out must forward the Six-monthly Trainee Report (see
also be notated and signed by the Training below).
Supervisor and be speciﬁcally referred to in the
printed Logbook. Completion of Training Assessment
The RANZCOG will only accept the printed
Logbook for assessment purposes. Where • Update as necessary the record
electronic records are maintained and the of training sites and dates for
Training Supervisor has noted print-outs of commencement and completion of
these records, the print-outs must accompany training
• At the end of each six-month period:
Clinical training: Tally the clinical experiences
• electronic Logbooks must be in a recorded in the Logbook and record the results
spreadsheet program, such as Excel on the Six-monthly Clinical Training Summary.
• full headings are required and must be Your Training Supervisor must sign this
shown on any print-out summary.
• annotations used in electronic
Logbooks must be fully explained in an Average weekly timetable: Complete an
accompanying legend average weekly timetable for the six-month
• trainees must regularly back-up any training period. NB If the training program
electronically maintained Logbook. altered signiﬁcantly during the six months,
Claims for recognition of training will use photocopies of the page to indicate the
not be recognised where data cannot be different training experiences.
• training periods must also contain Research report: Complete the Trainee
all relevant information to determine Research Progress Report and have the
the relevant training period (including Training Supervisor complete the Training
training year), the name of the training Supervisor Research Progress Report.
supervisor, location, and type of training.
Training periods should be kept separate Discussion: Discuss your Training Assessment
from each other Record and the accompanying Six-monthly
Trainee Report (see below) with your Training
The privacy of all patients must be protected. Supervisor. Sign the Six-monthly Trainee
The guidelines detailed in the printed College
Logbook apply to electronically maintained NOTE: the Subspecialties Committee assesses
Logbooks and records. all overseas training. Trainees undertaking
overseas training will need to forward their
Training Assessment Record Training Assessment Record to College House
The Training and Assessment Record is Mid-semester assessment
designed to provide the Chairman of the
Subspecialty Committee and the Training The mid-semester assessment is completed by
Supervisor/Program Director with a sequential the trainee and Training Supervisor, each giving
presentation of all training and assessment a brief assessment of the trainee’s progress
achievements. It will enable you to record over the three-month period. The Training
progress made in each of the components of Supervisor must indicate if the assessment is
satisfactory OR that improvement is expected. receives copies of satisfactory Six-monthly
In the latter case a warning is then given that Trainee Reports and Clinical Summaries for that
failure to improve may result in a FAIL in the period.
next six-monthly Trainee Report. The Training
Supervisor and Trainee must both sign and The College will only accept forms where:
date the form before it is forwarded to College
House. • The Training Supervisor has indicated
the Report is either satisfactory or
Six-monthly Trainee Report unsatisfactory
The Six-monthly Trainee Report, which is • The Report has been signed by the
completed by the Training Supervisor, is Training Supervisor
a summary of the ratings and comments
collected from individual consultants with • The Report has been signed by the
whom you work. Each of the relevant Trainee
consultants ﬁlls out a Trainee Assessment
Form. Your Training Supervisor consolidates If any of the above are missing from the form,
the information into the single composite Six- it will be returned for completion.
monthly Trainee Report. This report is used for
two purposes: Trainees who do not submit satisfactory
Six-monthly Trainee Reports and
• it provides you with feedback on your Clinical Summaries will be discussed
performance from the consultants with by the Subspecialties Committee and a
whom you work recommendation will be made to the Federal
Training and Accreditation Committee that no
• it provides the College with feedback on credit is given for the period in question. This
your progress will extend the training time for the Trainee.
Completion of Six-monthly Trainee Six-monthly Feedback
Report Questionnaire on Training Unit
Your Training Supervisor is responsible for
completing the Report, based on the Trainee All RANZCOG REI Trainees are required to
Assessment Forms which have been ﬁlled out provide a conﬁdential evaluation of their
by the consultants. Your Training Supervisor Training Unit. This questionnaire can be
will discuss the Report with you before you discussed with the Program Director, although
BOTH sign the document. this is not essential, and should be sent to the
Chairman of the Reproductive Endocrinology
Note: in some overseas hospitals, the Training and Infertility Committee via College House.
Supervisor may not be familiar with the forms This report aims to identify strengths and
or this requirement, and you will need to weaknesses within Training Units so that,
provide him/her with copies of the appropriate where appropriate, improvements in a Training
form and explain how it is used. Unit may be encouraged. The Chairman (or
nominee) will contact the Trainee to discuss
Submitting Training any identiﬁed weaknesses and the best
Documentation approach to improve the situation.
It is essential that the College receives the Removal from Training Program
above documentation after the completion
of each six-month period. The Six-monthly A trainee who receives 3 consecutive
Trainee Report MUST be received at College unsatisfactory reports will be removed from
House no later than eight weeks from the END the training program. After 2 unsatisfactory
of each six-month training period. reports, an agreed remedial program should be
enacted (if not already in place).
A period of training CANNOT be credited until
the Subspecialties Section at College House
REI EXAMINATIONS Oral Examination
Number of attempts at the Eligibility
Trainees must have satisfactorily completed
the Written Examination and Research Project.
Subspecialty Trainees have a maximum of four
Candidates will be informed as soon as possible
consecutive attempts at the written and oral
after the results of the Written Examination
examinations. Candidates who believe there
are special circumstances preventing them
from consecutive attempts may apply to the
Subspecialty Committee for consideration of Format
The Oral Examination takes approximately
three hours to complete and will comprise
Written examination nine clinical stations. The candidate will rotate
through each of these stations during the
Applications examination. The Examination will be held
on a date determined by the REI Subspecialty
Applications for both the Written and Oral Committee.
Examinations will close on 30 April each year.
Please contact the Subspecialties Co-ordinator Examination Stations
for application and fee details. The application
form may also be downloaded from the College There will be 9 separate encounters with 5
Website. minutes preparation time for each encounter.
Candidates will pass through each examination
Eligibility station and, before each encounter begins, will
be given the introductory details of a clinical
The Training Assessment Record must have case or cases that will be developed during the
been assessed as satisfactory for a minimum of encounter.
thirty months of prospectively approved clinical
training. This includes the Six-monthly Trainee Stations may consist of two examiners
Reports and Six-monthly Training Assessments. examining concurrently or sequentially, or
one examiner and an observer. There will be
Note: The minimum training period (thirty 9 stations of 15 minutes duration duration.
months) is calculated up to three weeks prior Every attempt will be made to ensure that you
to the date of the Examination. will not be directly examined by an examiner
from your own hospital.
Candidates should ask explicitly for additional
Subspecialty Written Examinations are usually relevant historical and physical details, for
held on the same day as the MRANZCOG the results of investigations, for consultations
Written Examination in August. The three- if needed, and for responses to treatment.
hour Examination comprises 12 short answer Examiners can then formally change these
questions with ﬁfteen-minutes allowed for answers to explore candidates’ ability to deal
each. with expected or unexpected complications or
confounding events, and with simulated late-
The CREI Written Examination covers stage referrals.
ﬁve areas: female reproductive medicine
(gynaecological endocrinology), male Histological sections, videos, laboratory
reproductive medicine (andrology), work sheets and microscopic photographs
reproductive surgery, assisted conception and can be shown. Where a station consists of a
applied reproductive physiology, including critique of a journal article, there will be 30
statistics. minutes’ reading time at the beginning of the
examination with 5 minutes to review the
A selection of past examination questions is article immediately prior to that encounter.
available upon request. Questions will not necessarily be restricted to
those that would apply to the case.
Notes may be made during the encounters be the training supervisor, but the relevant
(and while reading the published paper) but subspecialty committee must approve the
are to be left in the examination room. nomination.
Instructions for Candidates Trainees must submit a research paper which
attempting the Oral Examination should be at a standard which is suitable for
submitting to a peer-reviewed journal, by 30
Candidates who succeed in this examination April in the year of examination. Case reviews
will be expected: and reports will not be acceptable. The project
must be the result of ongoing research. A
• to be clinically competent and doctoral / MD thesis may exempt the trainee
authoritative in each of the areas to from the research project component of the
be examined (female reproductive training program, but will not reduce the
medicine, reproductive surgery, assisted amount of clinical training time. Trainees
conception, male reproductive medicine, will still be expected to demonstrate their
clinical reproductive physiology); involvement in ongoing research.
• to know the principles and limitations of
laboratory practice that affect the making The project must have been assessed
of clinical decisions; as satisfactory 2 months before the oral
• to show skill and sensitivity in informing examination. If the paper is assessed as ‘fail
patients and relatives of options and but suitable for resubmission’ a member of
implications of alternative plans of the relevant subspecialty committee will be
management; assigned to assist the candidate to revise the
• to demonstrate detailed practical paper for re-submission within 6 months. If
knowledge of the legal, regulatory the paper is failed again the full Subspecialties
and ethical framework in which the Committee should review the result with a
subspecialty is practised; and report from the Chairman of the relevant
• to show knowledge of clinical trial subspecialty. The Subspecialties Committee will
methodology and statistics needed both make a recommendation to the Examination
to analyse scientiﬁc data and published Committee about the next course of action.
papers critically and to conduct or
supervise such studies. Trainees will not be eligible for the oral
examination until the Research Project has
The device of simulated clinical encounters, in been passed. Guidelines for assessment of
which examiners can, for example, assume the the Research Project are presented in the
role of colleague, patient, spouse, scientist- Subspecialties Committee Regulations and
technician, nurse, consultant or junior Procedures in the Subspecialties Compendium.
researcher will test these skills.
Research Project 1. Three copies of the research paper must
The Research Project should be prospectively
2. Case reports and review articles are not
approved by the relevant subspecialty
acceptable for the thesis.
committee and the Trainee’s Research and
3. All submissions for assessment must
Ethics Committee, and demonstrate the basic
include the covering page which is
principles of research: original hypothesis
located in the Subspecialties Committee
testing, research methodology, rigorous
Regulations and Procedures.
scientiﬁc method. The paper should be in a
4. The research project must have been
format suitable for submission to a journal.
ﬁnally approved two months before the
The research topic should be submitted to the
relevant subspecialty committee for approval
by the end of the ﬁrst 12 months of training,
and progress reports submitted at 18 and 24
Research supervisors will be appointed on the
nomination of the trainee. The supervisor could
Special Consideration • adversely affected to a substantial
degree by illness or other cause during
Guidelines for RANZCOG the performance of an examination.
In cases where candidates feel their
Preamble examination preparation has been signiﬁcantly
impaired through illness, the College should be
contacted and advice requested.
Special consideration is available to candidates
who believe their examination preparation
and/or performance has been hampered by 2. Consideration
illness or other causes to such a substantial
degree that it is likely to adversely affect their The RANZCOG Examination Committee
performance and, consequently, their result in will consider applications for special
a College examination. consideration relating to MRANZCOG and
DRANZCOG examinations. Applications for
Special consideration is available for all special consideration relating to subspecialty
RANZCOG written and oral examinations, examinations will be considered by the relevant
including the in-hospital clinical examinations subspecialty Board of Examiners, who will
for the subspecialties Maternal Fetal Medicine make recommendations to the RANZCOG
and Obstetrical and Gynaecological Ultrasound. Examination Committee.
All applications for special consideration must Applications for special consideration will
be supported by appropriate documentation, be regarded in the strictest conﬁdence and
except in exceptional circumstances that anonymity of applicants will be maintained
render this impossible or redundant. where possible. Members of the relevant
Appropriate supporting documentation subspecialty Board of Examiners and/or
includes, but is not limited to, certiﬁcates or the RANZCOG Examination Committee
statements from medical professionals licensed will, however, be informed of details of the
to issue such certiﬁcates or statements, police circumstances relating to the application
reports, bereavement notices and statutory in order to make a decision relating to the
declarations. In particular, applications for application.
special consideration that are based on illness
grounds will NOT be considered without Applications for special consideration will only
appropriate supporting documentation from be considered by the relevant College body
medical professionals licensed to issue such where a candidate has submitted an application
certiﬁcates or statements. in accordance with the procedures outlined in
this document, and where the candidate has
1. Grounds for special consideration not gained a grade of ‘Pass’ in the examination
in question under the normal College
The most common reasons for applying for procedures.
special consideration include serious illness
(either yourself or a close family member), 3. Possible outcomes
bereavement, family breakdown and personal
trauma. If you are in any doubt as to whether The outcome of an application for special
particular circumstances warrant special consideration may be any of the following,
consideration, you should seek advice from based on material presented to the relevant
the Assessment Co-ordinator (MRANZCOG College body considering the application.
and DRANZCOG examinations) or the
Subspecialties Co-ordinator (all subspecialty • Candidates may be deemed to have
written and oral examinations) at the College. passed the examination.
• Candidates may be allowed a further
Special consideration is available to candidates attempt at the examination without
who have been: affecting the number of attempts
available to them under relevant College
• prevented by illness or other cause from regulations.
preparing or presenting for all or part of • Given other consideration as deemed
an examination; or appropriate.
• No action may be taken. was not submitted by the due date. It should
be anticipated that any application for special
Where the decision relating to an application consideration in an examination made after the
for special consideration results in a candidate publication of results in that examination will
being granted extra or supplementary attempts not normally be accepted.
at an examination, the decision will include
a recommendation relating to the charging 6. Appeals
of fees or otherwise to the candidate for
presenting at those attempts. Applicants for special consideration will be
advised of the outcome of their application
The remarking of an examination paper is not as soon as is practicable after a decision is
an option available under special consideration reached. Applicants may appeal the decision
provisions, unless the candidate can made in relation to their application through
demonstrate that an error in process or natural the normal College appeals procedure outlined
justice has occurred that warrants such action. in Section 19 of the College Regulations.
4. Application Requirements and Applicant’s Checklist
To assist your application, please ensure that
Candidates should advise the College of you have completed these steps.
circumstances that they feel may warrant
special consideration as soon as they are Have you read the “Special Consideration
aware that such circumstances exist, and Guidelines for RANZCOG Examinations”
communication with the College is possible. information?
Initial notiﬁcation may be verbal or written; Have you notiﬁed / discussed your
however, formal notiﬁcation to the College in application with the College Assessment
writing (via e-mail acceptable) on the ofﬁcial Co-ordinator or Subspecialties Co-
College form MUST occur no later than TWO ordinator as appropriate?
days after the relevant examination was If your application relates to
scheduled or held. Applications relating to circumstances that arose during
MRANZCOG and DRANZCOG examinations an examination, did you advise the
should be directed to the Examinations examination invigilator, local organiser or
Ofﬁcer at the College. Applications relating to examination coordinator as appropriate?
subspecialty examinations should be directed If ‘yes’, you should include this in your
to the Subspecialties Coordinator at the written statement.
College. Have you attached supporting
The fee payable for lodging an application for Have you speciﬁed why you are seeking
special consideration shall be A$150. This fee special consideration?
must be included with the written application Have you written a statement outlining
and shall be refunded in the cases where how the illness / difﬁculty has affected
special consideration is granted. In cases your studies or examination preparation
where applications are lodged via e-mail or and/or performance?
Fax, a written authorisation for debit to the Have you included or authorised
applicant’s credit card is acceptable. payment of the appropriate fee?
5. Late applications
An application made after the relevant date,
or not on the approved form, must be made
to the Chairman of the College Examination
Committee. Such applications will only be
accepted if the Chairman is satisﬁed that it
was not possible for the application to have
been made on the prescribed form or by the
required date. Late applications MUST include
an outline of the reason(s) why the application
SYLLABUS FOR LEARNING structure/function) of hypothalamic/
pituitary secretion including feedback.
IN REPRODUCTIVE The interaction of reproductive steroids
ENDOCRINOLOGY AND with the hypothalamic/pituitary complex.
• The control and functional aspects of
Embryology rhythmic functions (long and short term)
of hypothalamic/pituitary function.
• The embryonic development of the
genital tract in the male and female, • Distribution and cellular characteristics
including factors controlling male and of pituitary hormone secretion with
female gonadal primordia, internal duct particular reference to the gonadotrophe
systems and external genitalia. and the lactotrophe.
• Embryology of the hypothalamic/ • The function of the pineal gland and
pituitary, adrenal and thyroid endocrine melatonin as related to reproduction.
• The site of production, biological action
• The development of the urological and control of secretion of oxytocin,
system. vasopressin and the neurophysins.
• The neuropharmacology of GnRH and
• The development of the breast. its analogues together with a knowledge
of compounds with similar functions in
• The mechanism, diagnosis, and related areas.
management of female patients with
developmental abnormalities of the • The normal (organic and non-organic) of
genital tract including ambiguous hypothalamic pituitary, hypo and excess
genitalia, imperforate hymen, vaginal secretion in the female.
septa, uterine anomalies, Mullerian
agenesis and gonadal dysgenesis. • The mechanisms, investigation, and
management of hyperprolactinaemia.
• The mechanism, diagnosis, and
management of male patients with • The neuroendocrine control of the
developmental abnormalities including male reproductive system. Hypo and
failure of testicular development and / hypergonadotrophic states in the male.
or testicular descent, penile abnormality,
and ambiguous genitalia. • The blood brain barrier.
• Anomalies associated with the urological Hormone Action
system in the male and female.
• The biosynthesis, secretion, production
Nueroendocrine rate, clearance and plasma binding of the
major steroid hormones of reproduction.
• Suprahypothalamic structures and neural
systems relevant to the regulation of the • The mechanism of steroid and protein
reproductive processes. hormone action at a cellular level with
particular reference to the reproductive
• The anatomical-functional aspects of hormones.
the peptidergic, catecholaminergic,
and opiode systems in the control of • The response of the reproductive tract to
hypothalamic/pituitary function. cyclical endocrine changes.
• The neurovascular arrangements • The concepts of receptor activity,
between the hypothalamus and the speciﬁcity, and kinetics and their
pituitary. application to receptor assay
• The biochemical basis (including
• The administration, absorption,
distribution, metabolism, and • The physiology, pathophysiology,
excretion of drugs/hormones relevant investigation, and management of
to reproduction including during disordered menstruation, anovulation
pregnancy. Tetrogenecity tolerance, and endometrial hyperplasia.
biological variation, modifying features,
interactions of common drug and • Non-gynaecological causes of abnormal
hormone therapies. uterine bleeding.
• Awareness of Government and • The pathophysiology of amenorrhoeic
pharmaceutical regulations pertaining to states, their investigation and
drugs/hormones and their development management.
together with the design and analysis of
clinical trial methodology. Breast
Gonadal Function • Benign disorders of the breast.
• The development and changes • The breast as an end organ for
throughout life inherent in the ovary and reproductive hormone response.
Thyroid and Adrenal
• The inﬂuence of genetic constitution on
ovarian and testicular development. • The physiology, biosynthesis, control,
and metabolism of normal thyroid and
• Cyclical changes in biochemical functions adrenal hormonal function.
and control mechanisms within the
ovary. • The mechanism, investigation, diagnosis,
and management of disordered thyroid/
• The mechanisms of atresia, selection, adrenal states with particular reference
and maturation of the dominant to reproductive function.
follicle(s). The corpus luteum, its control
in the non-conceptual and conceptual • Thyroid/adrenal changes in pregnancy
cycle. and the newborn.
• The impact of ovulation induction and • The pharmacology and effects of thyroid/
hyperstimulation agents on the ovary. adrenal drug/hormone therapy on the
reproductive system and pregnancy
• The polycystic and related ovarian including the fetus.
• The syndromes of congenital disordered
• The development, maintenance, and adrenal function. The effect of adreno
changes through life of endocrine and cortical hypo and hyper function. The
gametogenetic testicular function. normal and disordered renin-angiotensin
and catecholamine systems.
• The induction and maintenance of normal
spermatogenesis including endocrine, Androgen Disorders
genetic and local environmental effects.
• The production, physiology and
Disorders of the Female Reproductive metabolism of androgens in the normal
Cycle female together with the mechanism of
• The neuroendocrinology of the abnormal
reproductive cycle. • The clinical syndromes, differential
diagnosis, investigation and management
• The physiology of development and of syndromes of androgen excess in the
regression of normal and abnormal female.
endometrial growth and the impact of
exogenous hormones. • The physiology of normal/abnormal hair
growth in the female. Genetics
• The diagnosis, investigation, and • The principles of Mendalian inheritance,
management of late onset adrenal pedigree, and linkage analysis.
• The genetic basis of clinical syndromes
• The pharmacology of antiandrogen including chromosomal abnormalities
therapy. with special reference to syndromes
affecting sexual development and
• The production, physiology, and reproductive function of both the male
metabolism of androgen in the normal and the female.
• Antenatal diagnosis of genetic
• The clinical syndromes of androgen abnormalities. The indications and
deﬁciency in the male. arrangements for specialized service for
genetic diagnosis and counselling.
• Syndromes of receptor and enzyme
abnormality in the male and female. • The relevance of genetics to male and
female infertility, artiﬁcial insemination,
Development and Cessation of Mature and early pregnancy loss.
• Familiarity with the standard laboratory
• The endocrine changes associated procedures associated with chromosomal
with reproduction from conception to preparation, identiﬁcation, and current
the mature development of normal nomenclature.
reproductive function including
gonadotrophin secretion in the male and • The mechanisms of mitosis and meiosis
female fetus and neonate. including the effects of chromosome
• The normal chronology of pubertal
changes in the male and female. Immunology
• The effects of gonadal and adrenal • The mechanism of antibody response
hormones on bone growth and other including the origin and function of IgA,
non-reproductive organs. IgM, IgG and IgE.
• The mechanism, investigation, diagnosis, • The origin and functions of “T”, “B”,
and management of delayed pubertal “helper”, “suppressor”, and “natural
development and the syndromes of killer” cells.
• The effect of active and passive
• Disorders of sexual development. Male immunization on hormonal speciﬁc target
and female pseudo hermaphroditism. tissues.
• The physiology and pathophysiology of • Knowledge of auto-immune disease
the menopause including gynaecological affecting reproduction.
and non-gynaecological clinical
manifestations. • The basic components of the immune
system and their possible role in
• The role of replacement and therapeutic male and female reproductive failure,
regimes associated with the menopause. recurrent abortion, infertility and
• The mechanism, investigation and
management of bone loss. • The place of immunological diagnostic
procedures relating to infertility,
• The effect of old age on testicular fertility, gonadal failure and endocrine
endocrine and gamete function. dysfunction.
Pathology • The physiology of decidual-chorionic
• The normal histological appearance
(together with cyclical changes where • Physiology and pathophysiology of fetal
appropriate) of the vagina, endometrium, phypothalamic pituitary, gonadal, and
the myometrium, fallopian tube and the pancreatic function.
ovary in the female.
• The pathophysiology of altered maternal
• The normal histological appearance of endocrine states, e.g., thyroid, adrenal,
the male reproductive tract and the and pancreatic states during pregnancy.
• The feto placental unit as it relates to
• The normal histology of the pituitary, the the physiology and pathophysiology of
adrenal, and thyroid glands. steroid hormones.
• The normal histological features of early • The physiology of the fetal adrenal gland.
implantation and of early pregnancy loss.
The Control of Fertility
• The normal features of aging on the
reproductive tract. • The pharmacodynamics, metabolic
effects and complications of oral and
• The pathological changes characteristic injectable contraceptive preparations.
of the impact of endometriosis,
antenatal hormone exposure, the action • The mechanism of action and
of abnormal levels of endogenous complications of intrauterine
reproductive hormones, myoﬁbromata contraceptive devices.
• The efﬁcacy of traditional contraceptive
• The histology of physiological, methods.
physiopathological, and speciﬁc
pathological tumours associated with • Surgical techniques associated with male
hormonal production from the ovary and and female sterilization.
• The techniques of interruption of
• The pathological features of gonadal pregnancy.
dysgenesis and intersex.
• The potential of immunology for
• The histological features of tumours contraception.
of the pituitary, changed thyroid and
adrenal function and other tumours • The status of contraceptive research and
associated with reproductive function. its limitations.
• The features of altered testicular Female and Male Fertility
architecture related to reproduction
function. • The normal expectations of fertility in
the community and the evaluation of the
Fetal Medicine infertile couple.
• The maintenance of pregnancy and • The diagnosis, investigation, and
the initiation of parturition including management of non-ovulation including
physiology, pathophysiology, and modes of investigation and the selection
pharmacology of the prostaglandins and of ovulation inducing drugs.
• The role of microsurgery for tubal
• The neuroendocrine and general corrective procedures in the male
endocrine changes in the mother during and female and the inﬂuences on the
pregnancy and the puerperium. expectation of results.
• The evaluation of uterine and cervical • The role of endogenous and exogenous
factors in infertility including the androgens to infertility in the male.
indications for corrective procedures.
• The usefulness of diagnostic procedures
• The mechanism, diagnosis, investigation, in the infertile male.
and management of endometriosis.
• The mechanisms, investigation, and
• Artiﬁcial Insemination (husband) - management of azoospermia and
indications, methods applicable, results, oligospermia.
Early Pregnancy Loss
• Donor Insemination - indications for
therapy, selection of donors, methods • The mechanism of implantation and
of therapy, results, medical, legal, and the physiology of early pregnancy
ethical aspects. recognition.
• Adoption - medical, legal aspects, areas • The mechanisms investigation, diagnosis,
of counselling, adoption agencies, local and management of patients with
regulations, outcome of procedures. multiple early pregnancy loss.
• IVF/GIFT and related procedures - the • The immunology of early pregnancy loss
choice of hyperstimulation regimes, and the role of therapy.
normal and abnormal responses, decision
making, methods of oocyte collection, • The genetics of early pregnancy loss.
oocyte recognition, inﬂuences on the
rates of fertilization, methods of gamete Sexual ASpects of Reproduction
and embryo transfer, the expectation
of results, medical and ethical aspects • Physiodynamics of normal psychosexual
of this technology. Federal and State development and the establishment
legislation relating to the above of the gender role through childhood,
procedures including the constraints on puberty, and adulthood.
• Normal and abnormal psychosexual
• Sperm-oocyte interaction, fertilization function and gender disturbance.
and early embryonic development.
• Psychological factors in disordered male
• The practical approaches to ovum and female reproductive function.
and embryo donation and recipient
preparation. • Psychological changes associated with
infertility and the impact on the family.
• Scientiﬁc methods used for infertility
programs including life table analysis. • The psychological and endocrine changes
associated with premenstrual syndrome,
• The formation, composition, and analysis the menopause and the impact of
of seminal ﬂuid. Tests of spermatozoa hormonal therapy.
function. • The principles of sexual counselling and
modes of therapy.
• The physiology and pathophysiology of
ejaculation and sexual function including Clinical Diagnostic Techniques /
hormonal and non-hormonal inﬂuences.
• The male reproductive tract and
• Be able to interpret ﬁndings, and perform
conditions relevant to infertility, sperm
competently when appropriate: operative
transport, and accessory duct function.
biopsy of the lower reproductive tract,
cytology, endoscopy, laparoscopy,
• The medical and surgical approaches to
hysteroscopy with assorted techniques,
therapy of male infertility.
reversal of sterilization, infertility surgery
including reconstruction of bicornuate Research Methods
or septate uterus, myomata, uterine
synechiae, cervical incompetence, • Familiarity with hypothesis deﬁnition,
reparative techniques for tubal and/or experimental design, sampling
adhesive pelvic disease, wedge resection techniques, data acquisition, data
of the ovaries, ovarian cystectomy, the storage, selection of appropriate
staging of endometriosis and surgical statistical analysis and scientiﬁc writing.
management. The place of laser surgery.
• Knowledge of the appropriate
• Radiographic/imaging associated with application of statistical parametric
reproduction, hysterosalpingography, tests including unpaired and paired, “T”
pituitary radiology, arteriography, test, correlation, linear, and multiple
arterial catheterisation, urography, regression analysis, and analysis of
isotope imaging and ultrasound, nuclear variance. Non-parametric statistics. The
magnetic resonance and thermography. use of computers for data storage and
• Dynamic endocrine testing. Visual ﬁeld
examination. • Computing means, standard deviations
and standard errors. Comprehensions of
• The surgery of development disorders signiﬁcance, conﬁdence interval, type I
including neovaginal, vulva construction, and type II errors.
imperforate hymen, vaginal septate, • Epidemiological analysis, cohort and
mullerian anomalies with obstruction of case control studies, assessment of bias,
drainage. population parameters and sampling
• Surgical techniques for the management
of ambiguous genitalia. • Familiarity with the techniques of quality
control in laboratory procedures.
• The indications and techniques for
gonadectomy in the female. Molecular Biology
Laboratory Prcedures • A general appreciation of recombinant
technology and its potential impact in
• The methods and kinetics associated medicine through the availability of
with the production, distribution, and puriﬁed proteins and improved diagnostic
metabolism of reproductive hormones. techniques.
• Immuno and bioassay methodology for • A general understanding of the basic
common reproductive steroid and protein techniques of gene manipulation
hormones. including the use of restriction
endonucleases and speciﬁc hybridization
• Receptor identiﬁcation, function, and probes to isolate genes, the use of
analysis. cloning vectors in gene propagation,
the techniques of DNA sequencing and
• The culture and maintenance of oocytes, synthesis.
fertilization, and preparation for embryo
transfer. • An appreciation of the potential
application of rDNA technology in biology
• The role of the micromanipulator in and medicine with particular reference to
gamete handling. rDNA probes for the diagnosis of genetic
disease in adult and fetal medicine.
• The techniques of sperm analysis and the
procedures associated with the isolation • The engineering of transgenic
of motile spermatozoa. organisms and their use as a source of
human proteins and other reagents of
• Cryobiology associated with gamete and pharmaceutical interest.
REI SUBSPECIALTY TRAINING CLINICAL SKILLS TO BE
RECORDED IN THE DAILY TRAINING RECORD / TRAINING
It is appreciated that as the subspecialty evolves there will be Trainees who will be at the
forefront of its evolution and who do not intend to practise clinically in every area of the
subspecialty. Nevertheless they must, in their training, acquire a working knowledge of these
skills in order to place themselves properly in the context of any given situation and the enquiries
of their non-subspecialist colleagues.
The skills required are listed as follows, together with their abbreviations (which can be used in
trainees’ Daily Case Record and Training Assessment Record):
Female Reproductive Medicine
OI-C Ovulation induction with clomiphene
OI-FSH Ovulation induction with follicle stimulating hormone
OI-GrRH Ovulation induction with pulsatile GnRH
Ovarian suppression with Oral contraceptives or other steroid
OS-GnRHA Ovarian suppression with GnRH agonists or antagonists
HRT Hormone replacement therapy
AAT Anti-androgen therapy
GEC General Endocrinology cases
PAG Puberty/adolescent gynaecology
FPC Family Planning (contraceptive) cases
NEC Neuro-endocrinology cases
Female reproductive surgery
TMS Tubal micro-surgery
TR Tubal reversal (microsurgical anastomosis)
BAS Benign adnexal surgery (ovarian cystectomies etc)
MM Myomectomy (laparotomy)
MP Metroplasty (laparotomy)
HABL Hysteroscopic endometrial ablation
HPP Hysteroscopic Polypectomy
HMM Hysteroscopic Myomectomy
HDA Hysteroscopic division of adhesions
HMP Hysteroscopic matroplasty (septoplasty)
LAH Laparoscopic assisted hysterectomy
LAS Laparoscopic excision adnexal tissue
LEE Laparoscopic excision extensive endometriosis
TAH/BSO Total abdominal Hysterectomy/bilateral salpingo-oopherectomy
Andrology and male reproductive surgery
MFC Male factor (male infertility ) cases
DAC Diagnostic andrology cases (non-infertility)
DUC Diagnostic Urology cases
MHRT Male Hormone replacement therapy
VR Vasectomy reversal
MESA Microsurgical epididymal sperm aspiration
TESE Testicular sperm or spermatid extraction
TB Testicular Biopsy
Continued over page ...
REI SUBSPECIALTY TRAINING CLINICAL SKILLS TO BE
RECORDED IN THE DAILY TRAINING RECORD / TRAINING
LAP-OPU laporoscopic egg pick-up (do not code in addition to LAP-GIFT)
LAP-GIFT Laparoscopic Gamete Intrafallopian Transfer
LAP-ZIFT Laporoscopic zygote (or pre-embryo) intrafallopian transfer
TV-OPU Transvaginal egg pick-up (do not include in addition to LAP-GIFT)
TV-GIFT Transvaginal gamete intrafallopian transfer
TV-ZIFT Transvaginal zygote (or pre-embryo) intrafallopian transfer
UET Uterine embryo transfer
LAP Diagnostic Laparoscopy (+/- minor intervention)
HYST Diagnostic Hysteroscopy
US Diagnostic Ultrasound
UFT Ultrasound follicle tracking
CT CT Scan (interpretation with radiologist)
MRI MRI scan (interpretation with radiologist)
IA Sessions in an immuno-assay laboratory
SA Semen analysis
SP Sperm preparation procedures
IVF IVF procedures
IVF-FERT IVF fertilisation checks
ICSI ICSI procedures
CYRO Embryo freezing procedures
PCR Polymeras chain reaction procedures
FISH Fluorescent in-situ hybridisation procedures
TEM Transmission electron microscopy examinations
SEM Scanning electron microscopy examinations
RES Half days spent on research projects
STANDARDS FOR THER complications
ACCREDITATION OF A CREI adolescent and paediatric
TRAINING UNIT gynaecology
NB: Departments need not necessarily 2. Female reproductive surgery
carry out every possible subspecialty endoscopic (minimally invasive)
activity to be involved in the training surgery
of specialists for the qualiﬁcation of pelvic microsurgery
CREI. In applying for accreditation,
prospective training units can submit
joint applications in which activities in 3. Endometriosis
more than one institution complement endocrine management
each other. operative management
The application documents must include: 4. Assisted conception
in vitro fertilization
A. Evidence of activities: general gamete intrafallopian transfer
artiﬁcial insemination (donor or
Names and subspecialty time-commitment of husband)
subspecialists cryopreservation facility for
gametes and embryos
List of those practitioners who have obtained
the CREI will be needed, with an account of 5. Andrology
past responsibility for CREI trainees semenology and laboratory
Letter from the Head of Department stating medical andrology
explicitly the Trainee’s involvement with the surgical andrology, including
CREI Training Program microsurgery
sperm antibody laboratory facilities
B. Evidence of activities: publications
6. Fetal Medicine
The last 5 years’ publications from the Unit clinical genetics and genetic
should be listed under the following headings counselling
(or the publications can be set out with the recurrent abortion management
information required for requirement C,
below): 7. Pathology
Reproductive endocrinology referral) reproductive
Female reproductive surgery histopathology
Endometriosis cytogenetics and molecular biology
Andrology / urology 8. Diagnostic imaging
Fetal medicine laparoscopy
C. Areas of activity: qualitative ultrasound, including facilities for
A qualitative description of subspecialty tertiary referral neuroradiology
activities of the Unit under each of the
following headings and subheadings. 9. Psychosocial
subspecialty level counselling by
1. Endocrinology medical social workers or qualiﬁed
menopause 10. Ethical and Administrative
early pregnancy and its institutional ethics committee
that has considered reproductive
research and is properly application in advance by a trainee registered
composed to satisfy NH&MRC with the College. Ultimately, responsibility
criteria for the trainee receiving suitable training will
computerised data analysis and continue to rest with the Trainee.
formal quality assurance program The advantage in being an accredited Unit
is that prospective trainees will know in
B and C can be combined to give a full advance that the Unit has the capacity to offer
qualitative account of activity, and would them the training they need. The fact of the
usefully also include contributions by past and appointment will then ordinarily be accepted as
present trainees where appropriate. evidence that their position is a suitable one.
D. Evidence of activities: quantitative
List the number of “procedures” performed (or
expected to be performed) at subspecialty level
in a 12-month period. The procedures should
be restricted to those which will either be
performed by trainees or at which trainees will
act as ﬁrst assistant.
The numbers of procedures submitted will be
compared with subspecialty trainees’ past and
future Training Assessment Records where
E. Evidence that activities are
1 Timetable of regular educational,
peer-review and clinical management
meetings at the subspecialist level.
2 Details of clinical and research
activities of all trainees attached to
the subspecialist Units (this can be
incorporated with requirement C, above).
3. Detailed formulation of training programs
incorporating the acquisition of practical
a copy of the relevant departmental policy
and procedures manual in which the manner
of, and criteria for, credentialling of trainees is
Unit accreditation and re-accreditation for
REI subspecialty training will depend on
demonstrating the capacity to develop trainees
across the whole subspecialty.
Training can take place in non-accredited
training units, but such positions would be
approved (for 12 months at a time) only after
Royal Prince Alfred Hospital + Sydney IVF,
Monash Medical Centre, Melbourne
Royal North Shore Hospital, Sydney
Queen Elizabeth Hospital + Wakeﬁeld
Royal Women’s Hospital + Melbourne IVF,
Royal Hospital for Women + Prince of Wales
Westmead Hospital, Sydney
Pivet Medical Centre, Perth
Christchurch Women’s Hospital
Fertility Plus & National Women’s Hospital,
Royal Brisbane, Royal Women’s, Mater &
Princess Alexandra Hospital, Monash IVF Qld,
National Women’s Hospital, Auckland
Please refer to the Subspecialties Committee
Regulations and Procedures for information
about Log Book, Cognate Point requirements
for recertiﬁcation, and the process for dealing
with Specialists who default, which is relevant
to all Subspecialties.
Log Book requirements for REI
Applicants for continuing certiﬁcation
will be required to forward the following
documentation for assessment:
1. A list of patients seen (no names
to be recorded) for the ﬁrst time,
their diagnosis and treatment, for a
consecutive six week period.
2. A list of surgical procedures performed
which includes the date, diagnosis and
procedure, for the same six-week period
as for 1 above.
3. Record on the Clinical Skills list the
number of procedures performed for the
same six week period. The Clinical Skills
list is on page 4/5 of the Logbook.
4. Present a weekly timetable for each of
the six weeks.
Please note, if the Subspecialist is absent for
more than one week then additional weeks will
need to be added to total six working weeks.
The documents will be assessed in accordance
with the requirement that 67% of professional
activity is in the Subspecialty.
The Subspecialties Compendium is a separate
publication to this handbook. Please refer to
the Compendium for the following information:
• RANZCOG Subspecialty Training and
• Appointment and Duties of Training
• RANZCOG Subspecialty Diploma
• RANZCOG Emeritus qualiﬁcation
• Continuing Certiﬁcation
• Defaulting Subspecialists
• Procedures for the Assessment of
Overseas Trained Subspecialists
• Assessment of Dissertations and Theses