Alex Field Southend Hospital How to Succeed in Obstetrics & Gynaecology and learn to love midwives…. Alex Field Southend Hospital

Obstetrics and Gynaecology

Obstetricians…

What is expected of you The training matrix. No seriously just the training matrix. If it is on the training matrix, you need to do it. If it is on the training matrix and you have done it, you will succeed at ARCP

https://www.rcog.org.uk/globalassets/documents/careers-and-training/assessment-and-progression-through-training/training_matrix.pdf

How many assessments? Check the training matrix BUT Aim for 2/week Midwives, sonographers and nurses can complete if appropriate You will need to get consultants to do at least some of the OSATs (check the training matrix for details) Do not leave them all to the last minute Do those which have been requested of you Every significant event needs a reflective practice event

Problems Find a senior trainee to talk to: we have all been in your situation. We can help with e-portfolio, ARCP preparation, exam prep etc Raise them with your educational supervisor, college tutor or let me know Raise concerns early whilst there is still time to do something

Run-through training Do not take your eye off of your CV Training is like 1 protracted job interview Keep your eyes open for opportunities 7 years will pass faster than you think

The Exam MRCOG part 1 to progress to ST3 Just get it done This one of the biggest reasons for non-progression

Audit This is compulsory Do not fail your ARCP because you haven’t done it Organise and get it done early Aim to do something you can get presented or published There is a presentation day (in deanery teaching timetable): an opportunity to present research/audit organised by the academic team at Cambridge

Procedures Ask to do things Senior trainees should be capable of training you, it is our/their job If you are paired with someone who is not training you, raise it with the college tutor Staff grades should also teach Be realistic about what you ask for Be realistic about who you ask (be nice to the new ST3) Negotiate: opening and closing, half hysterectomies etc Negotiate with GP trainees etc to swap sessions

Assessments Try to pin people down straight away to do them Agree at the start of clinic etc that you will do an assessment Chase them up promptly but politely: they will disappear from your e- portfolio if not completed If people are regularly not completing assessments they have agreed to do then raise it with college tutor

Ultrasound Be realistic about what you need to achieve: The compulsory basic modules are very basic Do the required courses Be a pain Ask your college tutor/educational supervisor what their plan for your ultrasound training is ‘Organise your own training’ is not acceptable as is being asked to come in in your own time You can take study leave

Ultrasound Be aware that some of ATSMs need intermediate modules signed off before hand If doing the intermediate modules then check out the sign-off process first and discuss with your educational supervisor Ask around your colleagues to find out where is good for ultrasound training: there are some very good units out there If signed off as competent but you are not allowed to scan then raise this as an issue Please scan cautiously and within your competencies: even the best sonographers at tertiary units ask for second opinions

Band 7 Midwife

Midwives vs nurses Midwives are not nurses They will often refuse to do ECGs, NG tubes etc, give medications they do not understand, do things they do not agree with etc They are independent practitioners They will often also be held responsible for your mistakes Respect the midwives, value their opinions and if you disagree, explain why If they do not believe you are right, they will escalate it above your head

However… If you feel you are being bullied by midwives, escalate this either through the senior midwifery staff or medical staff Midwives should be capable of venepuncture, cannulation and suturing If an individual midwife is incapable of doing these things it ought to be escalated to their band 7 before you are called (except in an emergency) Midwives hate suturing and this is something you need for ST1. Take advantage of this

What to do next Really look at the training matrix Spend some time looking at the eportfolio especially log book Book courses, deanery teaching and study leave Come up with a plan for exams Start thinking about where you want to go for ST2/3 Pair up with a senior trainee Start doing assessments now.

Future rotations Things to consider Level of cover: junior registrar/senior registrar cover Number of trainees Number of deliveries Ultrasound scanning Gynae surgery Rota Commuting distance Depends what kind of person you are and what you need to achieve

Who’s who? Educational supervisor: responsible for ensuring that your individual educational needs are met and for pastoral care. Will do the educational supervisors report which forms the basis of your ARCP. College tutor: responsible for the education of all the RCOG trainees within the unit, sits on the specialty trainee committee Training program director: responsible for managing O&G training across the deanery and most importantly, allocations (Jo Nieto) Assessment training program director: responsible for assessments and most importantly ARCPs (Charlotte Patient)

Who’s who? Teaching training program director: organises the deanery teaching program (Malini Prasad) ATSM training program director: in charge of ATSM provision (Helen Johnson) Head of School: responsible for everything O&G (Jane MacDougall) Postgraduate dean: responsible for training in Health Education East of England RCOG Trainee Rep for the deanery: me

Trainee Representation Each unit has a registrar and SHO rep. There should be regular meetings locally to discuss issues and take them back to the college tutor These reps also attend 3x a year local meetings chaired by me to take any issues back to the school board, the specialty training committee and ultimately the RCOG Each deanery rep also sits on other RCOG committees to ensure trainees views are heard across the college

My Job Elected post for 3 years My term ends approximately in May Need at least 2 years left of training Nominated by 2 colleagues Email voting by fellow trainees I will not/cannot stand again

Responsibilities Attend RCOG Trainees’ Committee Meetings 3x a year Sit on another RCOG Committee and attend their meetings Chair local deanery trainees’ committee meetings 3x a year Sit on either school board or specialty training committee meeting 3x a year Amend website

Good things Meeting people Networking Looks good on CV Can make a difference Nice lunch at the college (top rate cheeseboard) Get all the latest gossip

Bad things Sooooo many meetings Bureacracy More emails than you can reply to/people not reading the ones that you send Significant time commitment

Volunteers Please consider volunteering to help Help with the training committee (we really need a secretary) Help with the website

The Website Previously was very out of date Now much more up to date BUT: only me able to update it currently Up to date teaching program, ARCP guide, contact details, job opportunities and courses https://heeoe.hee.nhs.uk/og_home

The Website If you want more content then please feel free to suggest I want to make it as useful to trainees as possible Twitter: @OGEoETrainees, makes it very easy to share info quickly