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Programmes for Year 4/5.doc

  1. 1. Oxford Region Specialist Training Programmes in Obstetrics and Gynaecology Job/Programme Description The Oxford Region comprises 1 University Hospital and 9 District Hospitals. The programmes have been designed to give a wide variety of exposure to general Obstetrics and Gynaecology in the first three years, in combination with a full half day study programme in preparation for the Part II MRCOG examination. All posts have educational approval of the RCOG and Postgraduate Dean (Dr Michael Bannon). The Region is committed to fulfilling the requirements of the Junior Doctors Hours Agreement. Progression through the programme is dependent on satisfactory assessment as laid down by the RCOG. Years 4 and 5 of the programme have been carefully designed to give special interest training and allocation to a particular programme will be determined by the interests as developed by the trainee and in open competition with their colleagues. The Year 4/5 programmes are currently under review in line with special interest training as outlined by the RCOG and are therefore subject to change. Applicants must meet the basic entry requirements for the SpR grade i.e. 2 years postgraduate experience, at least 1 year in Obstetrics and Gynaecology and have passed the Part I MRCOG examination. Attention is drawn to the person specification. Applications must be made on the standard form. The Lead Programme Director is currently Miss Felicity Ashworth who is based in Aylesbury Updated June 07 The job descriptions should be read replacing Years 1-3 with ST3-5 and Years 4/5 with ST6/7
  2. 2. Contents PAGE NO. Programme Outline 3 The Training Programmes Years 1-3 4 Year 1 -3 Responsibilities 5 On Call Commitments 6 Weekly Timetables Year 1-3 with Educational objectives 7 Year 4 -5 Programmes 13 Location Details 19 The Hospitals 21 The Educational Programme Years 1-3 34 2
  3. 3. Oxford Region SpR in Obstetrics and Gynaecology Programmes for Year 1-3 NORTH* CENTRAL SOUTH Year Programme 1 Programme 2 Programme 3 Programme 4 Programme 5 Programme 6 1 Milton Keynes Oxford Oxford Reading High Wycombe 2 Milton Keynes Northampton Aylesbury Banbury High Wycombe East Berks 3 Northampton Kettering Banbury Aylesbury East Berks Reading MIXED Year Programme 7 Programme 8 Programme 9 1 East Berks Banbury Aylesbury 2 Oxford Oxford Oxford 3 Aylesbury High Wycombe Milton Keynes Each year 1-3 programme provides the following components for Core Training: - Antenatal Clinic, GOPD, Theatre, Delivery Suite, Emergency Gynaecology, Antenatal and Gynaecological Ward Rounds, a dedicated Teaching Session and appropriate on-call duties. Some posts may offer special interest training but this is more usually offered at year 4/5. Year 1-3 trainees are not encouraged to register for special skills modules. One of the posts at Kettering may be removed and so a 3rd year will be found in another unit.
  4. 4. Programmes for Year 4/5 PROGRAMME A PROGRAMME B PROGRAMME C PROGRAMME D PROGRAMME E PROGRAMME F Special Interest Reproductive Medicine Oncology Urogynaecology Maternal Fetal medicine Maternal Fetal Medicine Obstetrics Year 4 Milton Keynes East Berks Stoke Mandeville Reading Oxford High Wycombe Year 5 Oxford Oxford Oxford Oxford Northampton Reading PROGRAMME G PROGRAMME H PROGRAMME I PROGRAMME J PROGRAMME K Special Interest Minimal Access Surgery Gynaecological Surgery Maternal Fetal Medicine and Risk management Gynaecological Ultrasound and urogynaecology Sub Fertility Year 4 Kettering Reading Banbury Reading Reading Year 5 Northampton Oxford Oxford
  5. 5. Oxford Region SpR in Obstetrics and Gynaecology The Training Programmes: - Year 1-3 In years 1-3 there will be fixed training placements either in North, Central, South or mixed programmes. All programmes rotate through 1 large hospital and 2 smaller hospitals. The training afternoon is under review but will be at least 1 half day per week concentrated on learning for the MRCOG. North Circuit: Programme Directors: - Mr Clive Aldrich and Mr Rob Haughney Hub Unit - NORTHAMPTON Programme 1 Milton Keynes / Northampton (third year elsewhere) Programme 2 Milton Keynes / Northampton / Kettering Central Circuit: Programme Director: - Miss Felicity Ashworth Hub Unit - OXFORD Programme 3 Oxford / Aylesbury/ Banbury Programme 4 Oxford / Banbury / Aylesbury South Circuit: Programme Director: - Miss Jane Siddall Hub Unit - READING Programme 5 Reading / High Wycombe /Wexham Park and Heatherwood Programme 6 High Wycombe / Wexham park and Heatherwood / Reading Mixed Programmes: Programme Director: Felicity Ashworth Hub Unit – OXFORD Programme 7 East Berks / Oxford / Aylesbury Programme 8 Banbury / Oxford / High Wycombe Programme 9 Aylesbury / Oxford / Milton Keynes All posts are resident on call for years 1-3. For details of the hospitals, experience offered and staffing see below. The rotation date has been 1st Wednesday in March each year but likely to move to June then August. Candidates will be asked to rank their choice of rotation at the time of interview. Allocation of posts is by strict rank order on points scored at interview and candidate preference.
  6. 6. Oxford Region SpR in Obstetrics and Gynaecology Year 1-3 Responsibility Trainees will be allocated an educational supervisor at the start of each arm of their rotation, and appraisals will be carried out at regular intervals according to the RCOG structured training programme. The protected teaching time is at present Friday afternoon when all year 1-3 trainees are expected to attend the teaching session which runs concurrently in each circuit to minimise the need for travelling long distances. This is currently under review with local teaching being supplemented by whole day regional sessions. All trainees appointed to Type 1 programmes will be expected to subscribe to STRATOG, distance learning programme organised by the RCOG in preparation for the MRCOG examination. All posts are governed by the General Whitley Council Medical and Dental Terms and Conditions of Service. Annual leave must be arranged at least six weeks in advance according to each hospital’s local protocol. Study leave should be applied for according to local hospital protocols. A] Clinical Work. Duties appropriate to the grade and under the direct supervision of the consultants responsible, including clinics, operating sessions and ward rounds. The daily commitment will vary according to team/consultant responsibilities and the on call commitments. B] Delivery Suite duties as first on call, including active supervision of the SHOs C] Teaching. An active role is expected, including undergraduate and postgraduate teaching on the Delivery Suite. In units where there are medical students weekly tutorials are expected. Attendance at the Friday teaching programme is mandatory. D] Research involvement is encouraged at all levels. E] Audit- all units are actively involved in continuing clinical audit, one term each year is set aside for SpRs to undertake a project which will be presented in the following term and form part of the ongoing assessment. F] Clinical administration, including organisation of waiting lists and admissions relating to consultant supervisor. Smooth running of the team, including GP enquiries, review of pathology etc. Shared responsibility for in-patient care.
  7. 7. Oxford Region SpR in Obstetrics and Gynaecology On Call Commitments NB: These details may change Junior Doctors Hours are constantly under review within the Oxford Region. On call commitments are therefore subject to change. Northampton: - Full shift rota, 1 in 8 (resident on duty prospective cover) Kettering: - Modified shift system shared between 8 middle grade staff (resident on duty, prospective cover). The rota is arranged to maximise training opportunities for the SpRs. Milton Keynes:- Full shift system Oxford :- Full shift system. Banbury:- On call 1 in 4 (first on call, resident on duty)-under review Stoke Mandeville:- Full shift system. 1 in 7 with 1 in 8 weekend days. Resident on duty, prospective cover. Reading:- Shift system. Nights in blocks of 3 and 4, only obstetric cover at night as gynae and second on by staff grades. Seven week cycle, prospective cover. Currently band 2A, 56 hours. High Wycombe:- On call 1 in 5 (first on call, resident on duty) Wexham Park:- On call 1 in 5 resident on duty Pay Banding – Please check with the relevant Trust All posts include prospective cover for annual and study leave of colleague 7
  8. 8. Weekly Time Tables - Years 1-3 With the implementation of the EWTD and additional posts being incorporated into the programme, all weekly timetables are being reviewed, however all programmes are likely to have the same sort of structure. Below are the timetables for the Oxford Year 1-3 trainees. Monday Tuesday Wednesday Thursday Friday Educational Objectives SpR 1 Gynae WR Theatre Theatre GOPD ANC Antenatal WR Delivery Suite Emergency Gynae Teaching Core Training - oncology interest SpR 2 Theatre Theatre Antenatal WR GOPD Emergency Gynae ANC Delivery Suite Teaching Core Training - urogynae interest SpR 3 Delivery Suite Delivery Suite Theatre Theatre GOPD ANC Antenatal WR Core Training -fetal medicine and oncology interest SpR 4 Delivery Suite Delivery Suite ANC Antenatal WR Gynae WR Theatre Theatre GOPD Teaching Core Training –High risk obstetrics + endoscopic surgery interest SpR 5 Emergency Gynae Emergency Gynae Antenatal WR EP Clinic Delivery Suite Delivery Suite ANC Antenatal WR Teaching Core Training – High Risk Obstetrics interest Each trainee will spend 6 months in two of the above posts at the discretion of the College Tutor
  9. 9. Weekly Time Tables - Years 1-3 Most units now operate a full shift pattern, usually with periods of nights Monday to Thursday and a second period Friday to Sunday. Regular evening shifts are included from 1700 – 2100 or 2200. Each team is expected to arrange for all inpatients to be seen on a daily basis. This should be organised within the team. Additional duties will be required to be added to the weekly timetable to cover daytime emergency duties to a maximum working week of 58 hours. In all units it is imperative that the rota is referred to on a regular basis to ensure all duties are covered. It is the trainee’s responsibility to ensure clinics etc. are informed of periods when the trainee will either be on night duty or holiday so that clinical commitments can be cut appropriately. The basic formats of the timetables are subject to alteration Internal rotations are at the discretion of the individual unit and programmes may alter to cover annual and study leave of colleagues. 9
  10. 10. Oxford Region Specialist Training Programme in Obstetrics and Gynaecology ST6 and ST7 Programmes Job Descriptions Allocation of ST6 and ST7 programmes will be in open competition with other trainees within the region. The posts are paired and trainees are expected to rotate after one year (possibly 17 months 2008-09) to the second unit. All trainees are interviewed for their ST6 placements towards the end of ST5 and the ST6 trainees are also seen. There is the possibility that the Wycombe post will be based at Aylesbury and the Banbury post at Oxford by the end of 2007/8. Two ATSMs must be completed to gain CCT. The RCOG recommend that the majority of trainees undertake the advanced labour ward module. All programmes have been designed to give exposure to an ATSM and to provide time for both administration and personal study. Certain units can offer additional ATSMs above those described. It is expected that 2 sessions per week will provide special interest which may be part of weekly rota. General training and on call duties will continue. Whilst the programmes are presented as fixed, there is flexibility within the programmes to provide the training required for completion of the requirements for CCT. If a trainee wishes to consider less than full time training, please inform the training programme director to look at the possibility of job shares. The 2 Lecturer posts and the subspecialty training posts in Maternal Fetal Medicine, Reproductive Medicine, Gynaecological Oncology and Urogynaecology are NOT included in the package and are appointed following national advertisement. Felicity Ashworth Lead Training Programme Director Updated: September 2007
  11. 11. The posts will be paired and the trainees will be expected to rotate, after one year (possibly 17 months 2008-09), to the second Unit. There is flexibility at the Units regarding ATSMs and a trainee may be able to alter the ATSM on discussion with the tutor. ST6 ST7 Preference MIXED ATSM A Milton Keynes: ALWP Oxford: Acute gynae and early pregnancy/benign surgery: Laparoscopy Subfertility & Reproductive Medicine B Oxford: ALWP Banbury: Cervical disease/benign vaginal surgery C Oxford: Hysteroscopic surgery/acute gynae & early pregnancy Reading: ALWP D Wexham: ALWP Reading: Benign abdominal + vaginal surgery E Reading: Urogynaecology Reading: ALWP OBSTETRIC ATSM F Wycombe: ALWP/ Labour ward lead Oxford: Maternal medicine/advanced Antenatal practice G Reading: Maternal Medicine/ALWP Oxford: Maternal medicine/Fetal Medicine/ advanced antenatal practice/ALWP GYNAECOLOGY ATSM H Aylesbury: Urogynaecology Oxford: Benign vaginal surgery/laparoscopy I Wexham: Benign vaginal surgery/cervical disease Oxford: Oncology lead/ Benign abdominal surgery/vulval disease September 2007 O&G SPECIALIST TRAINING PROGRAMME ST6/7 ROTATIONS 11
  12. 12. O&G SPECIALIST TRAINING PROGRAMME Programme Directors for the Oxford Region Miss Felicity Ashworth (Lead) Miss Jane Siddall (South) ST6/7 ROTATIONS Each post will offer general obstetric and gynae training to ensure completion of the advanced parts of the new logbook/curriculum. The ST6/7 trainees will be expected to lead the more junior trainees, organise rotas, lead departmental meetings and join in appropriate management meetings. Involvement in two audit projects per year would be anticipated. The posts have allocated ATSMs which fit in with the development of special interests for future consultant posts. Most trainees should complete advanced labour ward practice unless intending to apply for gynae only consultant posts. The ATSM preceptor will be allocated at each unit by the College Tutor. Application for an ATSM is made on a College registration form which must be signed by the local supervisor as lead preceptor and then by the Deanery ATSM director – currently Miss F Ashworth, TPD. Obstetric and Gynaecology ATSMs Programme A ST6 Milton Keynes The trainee will gain ATSM in ALWP under the supervision of Miss Naomi Whitelaw, Labour Ward and Clinical Governance lead. There will be a minimum of two sessions per week dedicated to the module/work on labour ward. The trainee will also work with Professor B Lynch and will access laparoscopic surgery intermediate level training which could be used to develop the laparoscopic ATSM. There will be two surgical sessions per week. The Department at Milton Keynes is staffed by 7 Consultants, 8 middle grade and 8 junior doctors. There is a full shift rota, 56 hours per week. The number of deliveries in 2006 was 3656. ST7 Oxford The year will be spent working with the Nuffield Department of Obstetrics and Gynaecology (NDOG). Further experience is offered in MAS together with experience in reproductive medicine and surgery. The NDOG is one of 16 departments, which make up the Oxford University Clinical School, a major centre for clinical research in the UK. The Consultant staff involved in the reproductive medicine service are Mr Stephen Kennedy (Clinical Reader and Head of Department), Mr Enda McVeigh, Mr Tim Child, Miss Jane Moore (all Senior Fellows in Reproductive Medicine) and Miss Margaret Rees (Reader). The service provided by NDOG is composed of:- • A weekly infertility clinic, which deals with the investigation and management of sub fertility 12
  13. 13. • A 6 week joint gynaecology/endocrine clinic dealing with polycystic ovarian syndrome • An 8 weekly joint gynaecology/endocrine Turner’s syndrome clinic • A weekly minimal access surgical list, predominantly for fertility and endometriosis As well as this specialised reproductive service the weekly gynaecology clinic is heavily weighted toward reproductive endocrinology and endometriosis. The trainee will also have access (but will not be attached to) the Oxford Fertility Unit, an assisted conception unit performing 1000 cycles of IVF per year as well as intra- uterine insemination and ovulation induction. It is anticipated that trainees in this programme would be able to complete one of the following ATSMs: Acute Gynaecology and Early Pregnancy Benign Gynaecological Surgery: laparoscopy Subfertility and Reproductive Medicine Programme B ST6 Oxford The trainee will be attached to the team which includes Mr Impey, a Fetal Medicine Specialist. Clinical opportunities will include attending the ECV Clinic and ultrasound sessions in either the Prenatal Diagnosis or Fetal medicine Unit. Whilst some experience of scanning and fetal abnormality can be anticipated there will not be sufficient time to gain the necessary scanning skills for the ATSM in Fetal Medicine unless the trainee already has extensive scanning experience. One Delivery Suite session per week is anticipated as a regular commitment plus additional on call commitments as required. The trainee will attend a routine ANC and will be expected to attend the team’s GOPD and some theatre sessions so as to maintain some gynaecological experience. As the team interest is Gynaecological Oncology surgical experience may be limited. The ATSM which will be studied is Advanced Labour Ward Practice. Also available are: Fetal Medicine Advanced Antenatal Practice Labour Ward Lead Please be aware that there are plans for relocation of gynaecological oncology services to the Churchill hospital site, and the possibility of reconfiguration of maternity services from the Horton within the next year. The exact nature of these changes has yet to be decided but may have an impact on this rotation. ST7 Banbury The trainee will be based at the Horton Hospital, Banbury but there will remain a commitment to some obstetric antenatal sessions in Oxford. There is a risk management session and the trainee will be expected to organise and lead the monthly perinatal morbidity and mortality meetings and attend the monthly Oxford Women’s Centre risk management and standards group. 13
  14. 14. There will be general obstetrics and gynaecological training at the Horton. The ATSM in cervical disease management will be supervised by Mr S Canty with the appropriate sessions. ATSM in benign abdominal or vaginal surgery is available. Programme C ST6 Oxford During the year in Oxford the post holder will be predominantly attached to the gynaecological side of the Gillmer/Hurley/Rai team. The experience gained will be mainly in Emergency Gynaecology, including laparoscopic surgery for ectopic pregnancy as well as general gynaecological surgery and endoscopic surgery. A commitment to the obstetric service will continue (Miss Hurley and Labour Ward cover). ATSMs potentially available on this programme include: Benign Gynaecological Surgery: Hysteroscopy Acute Gynaecology and Early Pregnancy Benign Gynaecological Surgery: Laparoscopy Benign Abdominal Surgery Benign Vaginal Surgery ST7 Reading The ATSM in ALWP will be completed under the supervision of an obstetric consultant. The trainee will work 2 sessions per week on delivery suite, attend monthly perinatal meetings, clinical governance (obstetric policy) meetings and participate in outpatient antenatal clinics. Gynaecological training will continue as per new curriculum, with general gynae clinics and theatre lists. Programme D ST6 Wexham ALWP will be supervised by one of the obstetric consultants. There is access to obstetric ultrasound training, maternal medicine and advanced antenatal practice. There is a high risk antenatal population with an obstetric diabetic clinic and HIV clinic. ST7 Reading The trainee will work for either Mr Alan Crystal or Miss Rajee Vijayanand for the gynae ATSM in benign abdominal and vaginal surgery. The syllabus should be referred to, but will include gynae clinic, gynae theatre, monthly clinical governance review and the emergency gynae clinic. There will be general obstetric experience in ANC and labour ward. Programme E ST6 Reading The training in urogynaecology is with Mr Kevin Smith. It may be possible to complete the minimal access surgical modules as an alternative if the trainee has an aptitude for this type of work. The post will include general obstetric duties in ANC and labour ward. ST7 Reading 14
  15. 15. The ATSM in ALWP will be completed under the supervision of an obstetric consultant. The trainee will work 2 sessions per week on delivery suite, attend monthly perinatal meetings, clinical governance (obstetric policy) meetings and participate in outpatient antenatal clinics. Gynaecological training will continue as per new curriculum, with general gynae clinics and theatre lists. Obstetric ATSMs Programme F ST6 Wycombe The ATSM in ALWP will be completed under the supervision of Miss V Miller, labour ward lead. Labour ward lead could be organised if preferred. The trainee will attend labour ward forum and play an active role in department management. General gynae training will continue. ST7 Oxford The year in Oxford will be composed of 6 months working with the Silver Star Service and Fetal Medicine Unit (FMU). The Silver Star Unit provides the high-risk pregnancy service at the Women’s Centre, John Radcliffe Hospital. The Trainee will have the opportunity to gain extensive experience in the antenatal, intrapartum and postnatal management of a wide range of medical disorders, including cardiac, renal and auto-immune disease and thrombophilia. The Unit also cares for women with current antenatal problems such as severe PET and IUGR. The Unit is run by Professor Redman, Professor Of Obstetric Medicine and two Consultant Obstetricians, Miss Greenwood and Miss Harrington. The Fetal Medicine Unit (FMU) manages mothers who are carrying fetuses with ongoing needs, including those with surgical problems and monochorionic twins. It also cares for women with a history of previous preterm delivery or late miscarriage. The post holder will be involved in the inpatient and intrapartum care of these women. The remaining six months will be spent working in a team (Miss Hurley, Mr Gillmer and M Rai) attending the diabetic pregnancy clinic and Miss Hurley’s ANC. This clinic has a wide spectrum of patients including preterm labour problems, fetal anomalies, HIV, drug addiction problems and teenage pregnancies. Miss Hurley has a prenatal diagnosis session and runs the Oxford Rhesus Therapy Unit (ORTU) and trainees would be welcome to attend some of these sessions. General training in gynaecology will continue and both Mr Gillmer and Mr Rai have a special interest in hysteroscopic surgery, outpatient hysteroscopy and emergency gynaecology. It is anticipated that the trainee would have the opportunity to complete one of the following ATSMs: Maternal Medicine Advanced Antenatal Practice Labour Ward Lead Programme G ST6 Reading 15
  16. 16. The year aims to provide experience in obstetric scanning, including amniocentesis and CVS. The supervising consultant will be Mr Mark Selinger. It is anticipated that the trainee will be working towards Obstetrics ultrasound accreditation. The timetable will include ultrasound sessions, labour ward sessions as well as a high risk pregnancy clinic, gynae outpatients and theatre. Most sessions will be at fixed times, although some sessions such as labour ward and emergency gynae may vary to accommodate holidays and weekends on the rota. The Department will make every effort to protect special interest sessions wherever possible. The Maternal Medicine Module is available with Miss Jane Siddall. The post holder will be expected to complete at least 2 audit projects and to assist in the teaching of SHOs. The trainee will also be expected to attend the Obstetric Risk Management and Obstetric Policy meetings held on alternate Thursdays. ALWP module should be completed between the two units – Reading/Oxford. ST7 Oxford The year in Oxford will be composed of 6 months working with the Silver Star Service which provides the high-risk pregnancy service at the Women’s Centre, Oxford Radcliffe Hospital and the remaining six months will be spent working in the Hurley/Gillmer/Rai team. The details are the same as the description for Programme F, Oxford ST7. It is anticipated that the trainee would complete ALWP and would have the opportunity to study one of the following: Advanced Antenatal Practice Maternal Medicine Fetal Medicine Labour Ward Lead Gynaecology ATSMs Programme H ST6 Aylesbury The trainee will complete the urogynaecology ATSM whilst working for Mr Ian Currie. The timetable includes a session for urodynamics, a dedicated weekly urogynaecology clinic and a theatre list each which, which consists predominantly of incontinence and prolapse surgery. The trainee will continue with general obstetric and gynae duties and lead the junior staff, attending management meetings. ST7 Oxford The trainee will work with Mr Simon Jackson. There is a dedicated continence clinic with input from physiotherapists and continence advisors. There are two urodynamic sessions per week and training available in cystometry and videocystourethrography. Opportunities exist for clinical research in conjunction with other active researchers, including the University Department of Pharmacology. Within the Trust, there are ano-rectal investigative facilities, colorectal surgeons, paediatric and adult urologists who have an interst in anal incontinence, congenital neurological and gynaecological anomalies as well as surgical management of detrusor instability and detrusor hyperreflexia. At both centres continence surgery currently performed includes urethral injections, urethral slings (tension free vaginal tape, trans-obturator tapes) and colpsuspension. Prolapse surgery includes colporrhpahy (with grafts), vaginal hysterectomy, para-vaginal repair, sacrospinous fixation and abdominal sacrocolpopexy (open and laparoscopic). 16
  17. 17. The post at Oxford involves a continuing obstetric commitment with one ANC per week (Mrs R Black) and labour ward cover. ATSMs available include: Benign Vaginal Surgery Benign Gynaecological Surgery: Laparoscopy Urogynaecology Programme I ST6 Wexham The trainee will work with Mr P Reginald for oncology training with dedicated colposcopy sessions providing an opportunity to gain BSCCP accreditation. The trainee will attend the two weekly combined oncology clinic and MDT meetings. There will be access to major gynaecological surgery, including vulval. The ATSM in abdominal surgery or cervical disease management should be achieved. ST7 Oxford The year in Oxford will be spent working with Mr Charnock and Professor Kehoe with further exposure to colposcopy (although please note that currently access to colposcopy is limited), combined oncology clinics and major cancer surgery. A new Cancer Centre is due to open at the Churchill Hospital in 2008. Arrangements for how this will affect trainees have yet to be finalised. It is anticipated that the trainee would be able to complete at least one of the following ATSMs: Gynaecological Oncology Unit Lead Benign Abdominal Surgery Vulval Disease Cervical Disease Management Obstetric commitments will continue during this attachment. Educational activities Appropriate study leave can be taken and the training log book must be completed by the end of ST7. A management course should be attended. ST6/7 can attend relevant all day Friday Deanery teaching if rota commitments allow. There will be an expectation to teach on the ST1-5’s education programme. There is an annual Deanery scientific meeting OXSFOG. Abbreviations ATSM – Advanced Training Skills Module ALWP – Advanced Labour Ward Practitioner Oxford Region SpR in Obstetrics and Gynaecology 17
  18. 18. Location Details The Oxford Deanery is made up of the 4 counties - Oxfordshire, Northamptonshire, Buckinghamshire and Berkshire. This is a mainly agricultural area with much beautiful countryside. Northampton Northampton is a busy market/light industrial town with an expanding population and a considerable influx of new service-based employment as well as the traditional agricultural and rural economy. Post-graduate facilities are excellent with a large sports centre, swimming pool and tennis courts. There is an excellent library and social centre. There is ample local housing for purchase or rent, and a good standard of hospital accommodation both single and married. Kettering Kettering is an expanding market town with a traditional agricultural and rural economy. The improvements in road links mean that this area is developing rapidly and has good facilities. The hospital has 542 beds and is complemented by a modern Multi-disciplinary learning centre with clinical skills lab, extended library and IT suites to fulfil the hospital’s new role as an associated teaching hospital for Leicester Warwick Medical School. A new purpose built treatment centre with fully integrated theatre systems is due to open April 2007 Milton Keynes Milton Keynes lies midway between Northampton and Aylesbury and is along the line of the M1, the London/Glasgow rail link and the Grand Union Canal. London can be reached by road in approximately 1 hour and by rail (Euston) in less than an hour. The city lies in attractive countryside and there are extensive leisure and sports facilities including 2 large leisure complexes. A new 10 screen cinema complex, including restaurants, gaming rooms etc. is located at the city centre. Plans are in hand for a cultural activities and expansion. The Stables theatre run by John Dankworth and Cleo Laine is local. The current population is just over 200,000 (1997). Aylesbury The hospital is situated on the outskirts of Aylesbury, the county town of Buckinghamshire. There is a district general hospital alongside the National Spinal Injuries Centre. Aylesbury has easy access to London, both by road and half hourly train service to Marylebone station. There is beautiful surrounding countryside including the Chiltern hills. 18
  19. 19. Oxford Region SpR in Obstetrics and Gynaecology Oxford Oxford City lies near the confluence of the Thames (known here as the Isis) and the Cherwell Rivers. It is famous as the seat of the University of Oxford, one of the oldest and best known universities in the world. Oxford is also an industrial centre with printing operations and other manufacturing industries including motor vehicles and steel products. Surrounded by beautiful countryside it is within easy reach of London and Birmingham. Banbury Banbury is a growing market town set in a surrounding agricultural community. It has an important livestock market and is a centre for manufacturing agricultural machinery as well as food processing. It has good road and rail links with both London and Birmingham. Reading Reading is the administrative centre of Berkshire and also the site of the University of Reading. It is an agricultural centre known for its nursery gardens. There are good facilities within the town centre. East Berks East Berkshire has a population of 370,000. It covers the boroughs of Slough, Windsor/Maidenhead and Bracknell, together with an overlap zone in the South Buckinghamshire, south of the M40. The River Thames divides the district population into north and south, with about 60% located in the north and the remainder in the south. The towns of Bracknell, Maidenhead, Slough and Windsor house two thirds of the population, the remainder living in rural areas or small towns. Much of the district lies within designated green belt areas. 19
  20. 20. Oxford Region SpR in Obstetrics and Gynaecology The Hospitals Northampton General Hospital The department comprises:- Consultants - Mr J G Bibby MD FRCOG Mr W A R Davies FRCS(Ed) FRCOG Mr E J Shaxted DM FRCOG Mrs J Anthony FRCOG (Obstetrics only) Mr A Duncan FRCS MRCOG (Gynae Oncology only) Mr C Aldrich MD MRCOG (District College Tutor & Training Programme Director, North Circuit) Mr W McCullough FRCS Ed MRCOG Mr C Von Widekind MD Mr O Cooper MRCOG Miss K Chew MRCOG (Gynae Oncology only) The consultant sub-specialty interests are:- Urogynaecology and colposcopy :- Mr Bibby Infertility Mr Davies Minimally Invasive Surgery Mr Shaxted Fetal Medicine Mrs Anthony/Mr Aldrich Oncology Mr Duncan/Miss Chew Emergency Gynaecology Mr McCullough Obstetrics Risk Management Mr Von Widekind Labour Ward lead Mr O Cooper In addition there are 7 SHOs and 2 Trust Grades 4 SpRs (Oxford), 2 SpRs (LNR) 1 part-time clinical assistants. There are 3 specialist nurse practitioners in Uro- gynaecology, Reproductive Medicine and Minimal Access surgery. Total number of beds on the NGH site is 740. Obstetrics beds 56 plus 9 labour ward 4 HDU Water Birthing Room Gynaecology beds 40 Plus Day Care beds Deliveries per year 3,511 (2002) Gynaecological operations 3,448 (1998) Gynaecological emergencies 1,918 (1998) Neonatal facilities: 23 cots, 4 designated as intensive care 20
  21. 21. Oxford Region SpR in Obstetrics and Gynaecology Facilities:- Labour Ward: Full monitoring facilities, including fetal blood sampling, ultrasound and 24 hour anaesthetic cover at Consultant level. Natural birthing room. Special facilities for stillbirth, fetal abnormality care. Dedicated theatre suite. Four anaesthetic consultants with special responsibility for Obstetric services. There is a new fetal monitoring system involving STAN (ST segment analysis) Theatre:- Twin gynaecological theatres with advanced laparoscopic equipment, video and microsurgery facilities. Day case surgery area. Colposcopy & Hysteroscopy Suite:- Electrocautery treatment. Infertility:- Weekly infertility clinics, daily follicle scanning service (advanced assisted conception available privately). Antenatal Care:- Consultant clinic (mostly shared care), GPU and midwifery led options. Small steady number of home confinements. Serum screening for Down Syndrome. Anomaly scanning. Antenatal assessment unit for day care (mainly hypertension), computerised CTG monitoring, ultrasound and doppler facilities. Joint Obstetric and Diabetic clinic weekly. Fetal medicine clinic. Invasive procedures Urogynaecology:- Services and clinic in the out-patient department. Gynae-Oncology:- Multidisciplinary clinics monthly. There are weekly multi- disciplinary meetings in gynae-oncology. Gynae Cancer Centre. Diagnostic Services:- Pathology results available by computer access in all clinical areas. Imaging services include ultrasound, CT and MRI. Specialist perinatal pathology at consultant level. Medical students from Oxford, Leicester and Warwick University rotate through the department. All SpRs are involved in a robust educational programme that the department operates, including weekly obstetric meetings, a fetal medicine meeting and core training sessions in general obstetrics and gynaecology for the SHOs. A rapid access/early pregnancy clinic runs every day during the week. Research and audit are encouraged and supported by the Department and regular audit presentation days are held. 21
  22. 22. Oxford Region SpR in Obstetrics and Gynaecology Kettering General Hospital. The department comprises :- 6 Consultants;- Mr DJ Wilkin FRCOG Mr M Newman FRCOG (Clinical Lead) Mr P Wood MD FRCOG (Associate Medical Director) Mr R Haughney MRCOG (College Tutor and Training Programme Director North Oxford Circuit) Dr R Iqbal MRCOG (obstetrics only) Mr S Doshi MRCOG All Consultants share the Obstetrics and Gynaecology workload except Dr Iqbal who only covers Obstetrics There will be 4 SpRs; 3 in years 1-3 and 1 in year 4/5 together with 4 staff grades on the middle grade rota. There are 5 SHOs, 4 of which are VTS trainees The Department: The department of Obstetrics and Gynaecology is housed in a single modern building (The Rockingham Wing) with 63 Obstetric beds, 40 Gynaecological beds and 16 special care cots (4 designated for intensive care). 3525 babies were delivered in 2004. There were over 3500 new gynaecological referrals and approximately 3,300 gynaecological procedures were performed, including day cases. Antenatal Care: Comprehensive prenatal screening services incorporating biochemical screening and fetal anomaly scanning. Full time Prenatal diagnosis Co- ordinator. Designated prenatal diagnosis session. Original regional pilot site for biochemical screening for Down’s syndrome. Joint diabetic pregnancy clinic. Antenatal Day and Early Pregnancy Assessment units in operation. These come under the umbrella of the designated Fetal Health Unit which opened in 1997. Biophysical profiles and facilities for Doppler Studies exist. Intrapartum care: Electronic fetal heart rate monitoring and fetal blood sampling for high risk pregnancies. Low risk home-from-home facilities. Separate en-suite bereavement room. Waterbirth facilities. There are plans for a new high dependency area on labour ward and for a separate midwifery-led delivery unit on site. Out Patient Clinics: These are held in the Rockingham Wing and also in Corby, Wellingborough, Rushden, Thrapston and Market Harborough. Theatres: Full range of gynaecological procedures including minimally invasive surgery and cancer surgery. Some day case work will transfer to the fully integrated theatres in the new Diagnostic and Treatment Centre due to open in April 2006. Colposcopy: Upgraded new colposcopy suite. Loop excisions and cold coagulation carried out. 22
  23. 23. Oxford Region SpR in Obstetrics and Gynaecology Hysteroscopy: Out patient hysteroscopy clinic including one stop clinic for post menopausal bleeding. Infertility: Weekly fertility clinics. Infertility nurse practitioner. Ovarian Follicle Scanning. On going discussions with PCT regarding the provision of assisted fertility techniques. Urogynaecology: A urodynamic service is available Paediatric Gynaecology: A regional Paediatric and Adolescent Gynaecology service has been established. Oncology : Full multi-disciplinary service with regular meetings. Clinical nurse specialist. The Gynaecology department also has a medical termination facility with dedicated staff nurse practitioner. There is a robust in house training programme. Both research and audit are encouraged and supported by the Department. Access to Medline and Cochrane databases and internet is available throughout the department. Medical Students: - Leicester Warwick University. The hospital is designated an associate teaching hospital. This has led to a large expansion in the library and IT facilities plus a new clinical skills lab. Milton Keynes General Hospital. Departmental Staff: Five Consultants Mr Christopher Balogun-Lynch FRCS FRCOG Mr Anthony Stock MRCOG Miss Naomi Whitelaw MRCOG District Tutor Miss Meghana Pandit MRCOG Associate Specialist Mr Ghaly Hanna MRCOG Miss Nandini Gupta MRCOG Mr Agboola MRCOG Miss Naomi Whitelaw is the current Clinical Director. All consultants share the general workload of the department. Mr B-Lynch, Mr Stock and Miss Whitelaw all do colposcopy clinics. Mr B-Lynch takes a special interest in gynae oncology and minimal access surgery. Mr Stock and Hr Hanna both take a special interest in fetal medicine. Mr B-Lynch has special recognition for his world renowned Brace Suture and his training skills in minimal access surgery. Miss Whitelaw is labour ward lead with Miss Pandit taking special interest in urogynaecology and is the College Tutor. Miss Gupta takes a special interest in early pregnancy assessment and problems. 23
  24. 24. Oxford Region SpR in Obstetrics and Gynaecology Trainees: At present there are seven SHO and four SpR posts (three in year 1 to 3 and one year 4). There are also three non-career grade doctors on the middle-grade rota. Gynaecology: About 3,000 operations per year (1999). Twenty-five + beds. The department also has access to about five day unit beds on a daily basis. Each week there are three colposcopy clinics, one combined medical and ante-natal clinic and one urogynaecology clinic under the supervision of Miss Pandit. There is also a out-patient hysteroscopy clinic and a urogynaecology clinic. Progress is being made towards a specialised urodynamics clinic. The use of pre-assessment clinics staffed by nurses is steadily increasing. Pregnancy related services: An Early Pregnancy Assessment Unit is currently located on the outpatient clinic area. Antenatal Care: Virtually all initial assessments and serum screenings are done by midwives in the community. There are six hospital-based antenatal clinics per week. Some hospital-staffed ante-natal clinics are held in different community health centres or surgeries. Day Assessment Unit: This is run by Midwives with medical input where necessary. Labour Ward Beds: Ten Maternity Beds: Fifty-six Births: About 3,300 per year Medical Students: from University of Oxford. OXFORD – The Women’s Centre, John Radcliffe Hospital The Nuffield Department of Obstetrics and Gynaecology (NDOG) is the academic unit of the University of Oxford.:- Prof. Christopher Redman is Professor of Obstetric Medicine. Prof. Sean Kehoe is Professor of Gynaecological Oncology. Readers: Mr Ian Mackenzie (Oncology, Undergraduate Training) Mr Stephen Kennedy (Endometriosis and Pelvic Pain) Senior Lecturer: Dr Paul Chamberlain (PND and Obstetric Ultrasound) Oxford Region SpR in Obstetrics and Gynaecology 24
  25. 25. Oxford Fertility Unit Mr Enda McVeigh Director Mr Tim Child Consultant Miss Jane Moore Consultant There are 2 clinical lecturer posts (0.6WTE) employed by the University The NHS consultant staff, giving their main interests comprise:- Mr Mark Charnock (Oncology) Mr Michael Gillmer (Diabetic Pregnancy and MAS) Miss Pauline Hurley (Deanery Advisor, Subspecialist in Fetal Medicine) Mr Simon Jackson (Urogynaecology ) Mr Lawrence Impey (Maternal Fetal Medicine) Miss Catherine Greenwood (Maternal Fetal Medicine) Mr Vic Rai (Emergency Gynaecology, Urogynaecology) Miss Kirsten Duckitt (Maternal Medicine) Miss Margaret Rees (Medical Gynaecology) There are 3 subspecialty trainees, 1 in Fetal Maternal Medicine, 1 in Reproductive Medicine and 1 in Gynaecological Oncology. It is anticipated that there will also be a sub-speciality trainee in Urogynaecology. There will be are 13 SpR grade posts at the John Radcliffe by the end of 2005, five in years 1-3, eight in years 4/5. There are, in addition, flexible trainees at SpR grade, 10 SHOs and 2 Associate Specialists, one in Clinical Genetics / PND and one in Fetal Cardiac Scanning. The pattern of emergency duties is a full shift with periods of night duty. Prospective cover is included and annual leave booked for periods of night duty will not be allowed. All trainees will be expected to do 1st SpR on-call for the Delivery Suite as part of the rota. All services are located within the Women’s Centre. Deliveries per year: 6,063 (2003), Caesarean Section Rate 19% CNST: Level 1 achieved in 2004, with plans for Level 2 in 2005 Obstetric beds:- 81+ 16 Delivery Suite beds 9 Observation area beds 2 natural birthing rooms including 1 pool within the 16 delivery rooms 25
  26. 26. Oxford Region SpR in Obstetrics and Gynaecology Obstetric Ultrasound; Total Scans – 8,982 (2003) Gynaecology beds: 32 + 14 Day Care beds Gynaecological referrals: New patients -10,698 (2003) Colposcopy - 1,007 Gynaecological operations: Inpatient –2,552, Day Case – 2,484 (2003) Neonatal Facilities: 21 with 7 designated intensive care. There are plans to increase the number of intensive care cots as the Thames Valley Neonatal Network is developed. Facilities:- All the major subspecialty interests are represented within the Women’s Centre. Delivery Suite:- There are 2 dedicated obstetric theatres and modern monitoring facilities, including an Axis central monitoring, ultrasound and fetal blood sampling Gynaecology Facilities:- There is a single gynaecological ward plus a day case unit and 2 dedicated theatres with laser facilities. The Outpatient Department, housed within the centre is solely for the use of the Women’s Centre and neonatal unit. Feto-Maternal Medicine Unit incorporates the Fetal Medicine Unit, the Silver Star High Risk Pregnancy Unit, the Oxford Rhesus Therapy unit , Prenatal Diagnosis and the Obstetric Diabetic Clinic. Alongside these services are the Day Assessment Unit and Ultrasound - anomaly scanning is offered as a routine. The department is recognised for the RCR/RCOG Diploma in Obstetric ultrasound. The Oxford Fertility Unit provides a comprehensive infertility service integrating the work of the general Fertility Clinic, Andrology Clinic and the Assisted Reproduction unit. (The Andrology and Assisted Reproductive Units are patient funded). 26
  27. 27. Oxford Region SpR in Obstetrics and Gynaecology Specialist Clinics covering all aspects of the specialty are provided including, colposcopy, out-patient hysteroscopy, urodynamics, infertility, the menopause, gynaecological oncology, recurrent miscarriage and pre-conception counselling. An Early Pregnancy/rapid access gynaecology clinic runs every morning during the week, with a dedicated emergency gynaecology list 3 days per week. The aim is that there will be no out of hours surgery. Special Skills Modules in Gynaecological Ultrasound, Maternal Medicine, and Urodynamics, are available but linked to the Year 4/5 programmes. Year 4/5 Programmes are offered in: - Urogynaecology, Subfertility, Oncology, Maternal Fetal Medicine (3 posts), Gynaecological Ultrasound and Gynaecological operating including Minimal access surgery. Medical Students:- Oxford and Cambridge Universities plus Midwifery Undergraduates from Oxford Brookes University. Stoke Mandeville (Aylesbury) The department comprises:- Six Consultants ;- Miss Felicity Ashworth (Training Programme Director & Assistant Clinical Director) Mr Ian Currie Miss Jacqueline Hall Mr Gavin Kemball (College Tutor) Mr Tunde Dada Miss Geraldine Tasker (Locum, Oncology) Middle Grade Rota (8) 5 NTN’s, 2 Trust Doctors, 1 Staff Grade SHO rota (8) - 5 Vocational Training Scheme Doctors 1 Trust Doctor SHO 2 F2 SHOs The middle grade rota is a full shift pattern (band 2b) with blocks of nights split ¾. Travel time from Oxford is approximately 30-40 minutes. Stoke Mandeville is renowned for its spinal injuries unit and therefore has a large radiology department with MRI and CT scan facilities. The unit has combined obstetrics and gynaecology facilities. There are 38 obstetric beds, 15 gynaecological beds and approximately 2700 deliveries per year. Neonatal facilities include 12 cots and one with designated intensive care cot. The labour ward has a dedicated theatre and water birth facilities. The caesarean section rate is 24% (2005). 27
  28. 28. Oxford Region SpR in Obstetrics and Gynaecology Specialist interests within the department include colposcopy, infertility, menopause, outpatient hysteroscopy, minimal access surgery, fetal medicine and urogynaecology. The current year 4 SpR specialises in urogynaecology and has protected sessions. Special skills modules in urodynamics and gynaecological scanning are offered and have been completed. One consultant is a preceptor in minimal access surgery. Local teaching within the department is arranged on a Friday afternoon combining, where appropriate, with Oxford, Banbury and High Wycombe. Monthly consultant led teaching has been planned. The department has recently purchased several modules of StratOG to enhance teaching. Teleconferencing links are available and are currently being developed into the teaching programme. There are several multidisciplinary meetings within the department. (Obstetric ultrasound, gynaecological pathology, risk management, perinatal morbidity/mortality, clinical audit) Four Oxford medical students have their attachments at the unit and their teaching is encouraged. The Trust is combined with Wycombe Hospital and eventually all deliveries will be on one site. Horton General (Banbury) The department comprises :- 4 Consultants :- Mr Stuart Canty Mr Jonathan Nichols (District College Tutor) Mr H Naoum Mr E Akrong (Locum) Dr S Doshi (Staff Grade) All consultants share the general obstetric and gynaecological workload of the department. There are 4 SpR posts at the Horton. 3 Year 1-3, 1 Year 4/5 In addition there are 3 Year 3 SHOs and 2 Community VTS SHOs The Horton General provides a total of 275 beds for in-patient care Obstetric Beds: 26 Plus 6 Labour ward Gynaecological beds: 12 Plus Day Care beds Deliveries per year: 1369 (1994) Gynaecological operations: 1136 (1994) Neonatal facilities: 3 special care cots Oxford Region SpR in Obstetrics and Gynaecology 28
  29. 29. Facilities:- There are urodynamic and colposcopy clinics under consultant supervision. Facilities exist for endometrial resection and minimal access surgery. Trainees will be expected to contribute significantly to the tuition of GP trainees whilst in this post. Research is actively encouraged. The Royal Berkshire (Reading) The Royal Berkshire Hospital in Reading serves a catchment population of approximately 500,000. In 2001 there were 4700 deliveries and 4060 gynaecological outpatient episodes, in addition there were 867 Colposcopy sessions. There are about 300 hysterectomies performed annually, and 700 laparoscopic procedures. The medical staffing establishment at 2002 was Mr John Greenhalf, FRCS, FRCOG Consultant Gynaecologist Mr Roger Williams, FRCS, FRCOG Consultant Gynaecologist Mr Alan Crystal, FRCS, FRCOG Consultant Gynaecologist Mr Mark Selinger, MD, FRCOG Consultant in Feto-Maternal Medicine Miss Helen Allott, MA, MRCOG Consultant in Feto-Maternal Medicine Miss Patricia Street, FRCOG Consultant in Feto-Maternal Medicine Miss Jane Siddall, FRCOG Consultant in Feto-Maternal Medicine Miss Jill Ablett Consultant in Feto-Maternal Medicine Mr Kevin Smith, MRCOG Consultant Gynaecologist Dr. Janet Clayton Associate Specialist in O&G Ultrasound There are seven posts recognised for Specialist Registrar training, two at years 1-3 (junior trainees, rotations 5 & 6) and five at years 4-5 (senior trainees) (Rotations D, F & H (2 years) and J & K (1 year)). Seven staff grades are also in post. Currently three SHO posts are part of the Reading VTS, and four are open to ‘career’ SHOs. There are three Trust Doctors working at SHO level. All trainees will receive training and provide service in both obstetrics and gynaecology. The senior trainees on rotations D, F, H, J and K will have proportionately more day time duties in Obstetrics or Gynaecology depending on special interest. 29
  30. 30. Oxford Region SpR in Obstetrics and Gynaecology All consultant gynaecologists offer a wide training in gynaecological surgery, including minimal access work, and conduct both general and PMB out patient services. In addition, Mr. Greenhalf is responsible for the surgical family planning services, Mr. Williams has a special interest in sub-fertility, with designated clinic facilities, Mr. Crystal undertakes gynaecological cancer cases and Mr. Smith has subspecialty expertise in urogynaecological services. Training in all of these areas is available; trainees will normally access two of these firms during the year. The trainee on rotation H will work for Mr. Smith for six months and one other gynaecologist according to training needs for the other six months. The Special Skills Module in Gynae Scanning, in conjunction with High Wycombe, is offered to the senior trainee rotating between Reading and High Wycombe (F). There is an Early Pregnancy Assessment Service. All obstetricians offer a broad training in the management of medium to high risk pregnancy, with five on-site and two satellite outpatient clinics. In addition, Miss Street runs a diabetic ANC in conjunction with the consultant endocrinologists. We have a Day Assessment Unit for monitoring hypertensive disease etc. Mr Selinger offers training in invasive prenatal diagnostic techniques and imaging to senior trainees. Miss Siddall trains junior obstetrician and gynaecologists with Dr Clayton in the skills described in the new core logbook Module 8. Miss Allott runs a clinic for bereaved parents and also one for women with previous traumatic birth experiences. Access to these clinics is for the senior trainee who is pursuing training in F-M medicine (Rotation F) The Delivery Suite has a designated consultant for 40 hours each week, who will supervise ward rounds and teach obstetric skills as necessary to any trainee. All trainees are required to participate in the perinatal morbidity and mortality meetings, and the gynae pathology meetings, each held monthly. Junior trainees are expected to attend specialty teaching and training every Friday afternoon, and to undertake an audit project whilst in post. Senior trainees are invited to attend policy and clinical governance meetings, and are encouraged to help draft guidelines, care pathways etc. Audit projects should also be undertaken. Wycombe General (High Wycombe) The department comprises:- Consultants:- Miss D Sumner General gynaecology, colposcopy, urogynaecology Mr D Eustace (Clinical Director) General gynaecology, oncology, colposcopy, MAS, ultrasound Mr Y Akinsola (College Tutor) General gynaecology, high risk obstetrics, ultrasound Mr C Wayne General gynaecology, MAS, high risk obstetrics Miss V Miller Labour Ward lead, general gynaecology 30
  31. 31. Oxford Region SpR in Obstetrics and Gynaecology There are 4 SpRs, 3 in years 1-3 and 1 in year 4. In addition there are 6 SHOs and 3 Staff Grade Specialists (at the moment) Total number of beds on the Wycombe site is 391. Obstetric beds 46, plus 9 labour ward Gynaecology beds In-patient beds: 23 Day case beds: 10 Deliveries per year 2774 (2002) Gynaecological admissions 3300 (August 2002 – August 2003) Facilities:- Gynaecology:- 2 dedicated gynae operating theatres with facilities for endoscopic surgery. General gynaecology and colposcopy clinics are held at High Wycombe. In addition peripheral clinics are held at Marlow and Amersham. Early Pregnancy Assessment Unit has recently been established. Labour Ward:- Fully equipped with ultrasound and fetal blood sampling facilities with a dedicated obstetric theatre and SCBU on site. Clinics:- Antenatal clinics (including Joint Diabetic Clinic) are held at High Wycombe with CVS Amniocentesis on site. Medical Students from Oxford Medical School and University of the Caribbean. East Berks - Wexham Park and Heatherwood Hospitals. The department comprises 7 consultants, with a further Consultant to join the team in the latter part of 2006. The current team comprises of: Mr P W Reginald MD FRCOG Mr J Fairbank MD MRCOG Mr E S Dimitry FRCOG MPhil Miss S Kalla MRCOG Miss P Sarker FRCOG Specialty Tutor Mr A Pilsniak MD, PhD Miss F Husain MRCOG Obstetric beds: 69 plus 12 delivery rooms Gynaecology beds: 49 Deliveries per year (3,600 in the High Risk Unit & 800 in the Low Risk Unit) Gynaecological admissions: 5000 31
  32. 32. Oxford Region SpR in Obstetrics and Gynaecology Specialty services: Besides general obstetrics and gynaecology specialty services are provided in gynaecological oncology, infertility, prenatal diagnosis, endoscopic surgery and urogynaecology. Gynaecological surgery is carried out regularly. There are 3 colposcopy clinics each week and facilities for various treatment modalities are available including laser and diathermy loop. Colposcopy records are computerised and 8 years database stored. There is opportunity to undertake accreditation for BSCCP. There are regular urodynamic clinics with urogynaecology surgery, with opportunities to undertake Special Skills Module in Urodynamics. There are specialised fertility clinics with complete baseline investigations and treatment up to ovulation with follicle monitoring.. Early pregnancy clinic runs daily on both sites. The department offers universal nuchal translucency screening for Down’s syndrome, prenatal diagnosis using high resolution, non-routine ultrasound, amniocentesis and chorionic villus sampling. The Prenatal Diagnostic Centre is recognised as a training centre for the RCR/RCOG Diploma in Obstetric ultrasound for 2 trainees. The lead trainer is Miss Pampa Sarkar. The unit offers Special Skills Modules in Fetal Medicine and in Maternal Medicine. Laser facilities are used for laparoscopic laser surgery. Endometrial resection is performed regularly, as are the current second generation endometrial ablative techniques. The department offers Special Skills Module in Advanced Hysteroscopy. Combined oncology clinics are held on alternate weeks. Mr Philip Reginald has a special interest in the management of vulval cancer in conjunction with plastic surgeon. The unit offers undergraduate training to medical students from Southampton University and American University of the Caribbean. Training opportunities available: • Extensive experience in high risk obstetrics, both antenatal and intrapartum. • Opportunities in major gynaecological surgery. • Accreditation with BSCCP. • Training for Diploma in Advances Obstetric Ultrasound conducted by RCOG/RCR. • Special Skills Modules in ° Fetal Medicine ° Maternal Medicine ° Investigations for an infertile couple ° Advanced Hysteroscopy ° Gynaecological Ultrasound ° Urodynamics ° Labour Ward Management 32
  33. 33. The SpR will also act as a mentor to an SHO, usually a GP trainee. Year 4/5 SpRs will also undertake teaching of juniors and participate in induction of SHOs 33
  34. 34. 34
  35. 35. The Educational Programme Years 1-3 (currently under review) Friday afternoon has been set aside in all units for SpR teaching. Attendance is mandatory and registers are kept which are collated prior to any assessments. A minimum attendance of 60% is required for progression through the programme. A three year rolling lecture programme has been designed to take the trainee to the Part II MRCOG. Trainees entering at any stage will receive all lectures by the end of three years. All new trainees in Years 1-3 are expected to subscribe to STRATOG, which will form the basis of local teaching sessions Practical sessions in communication and critical analysis are also included. Each year is divided into 4 terms of twelve weeks with one set aside for assessment and personal development. It is expected that every year a trainee will complete a project which will then be presented to the other trainees. The lecture programme is run in three centres to minimise travelling with one central meeting each term. OXSFOG (Oxford Scientific Forum in O&G) takes place one a year where all those working within the region are invited to attend for a whole day’s presentation with prizes presented for the best and an educational afternoon with invited speakers.