A new core curriculum for obstetrics & gynaecology Dr Alastair Campbell, Chair of the Core Curriculum Committee Hello! My name is Dr Alastair Campbell and I am a Consultant Obstetrician and Gynaecologist at the Royal Infirmary of Edinburgh and the Chair of the RCOG Core Curriculum Committee. I am pleased to share with you the work of the last three years and talk to you about the new Core Curriculum in Obstetrics and Gynaecology.

The drivers for change which led to the new curriculum being developed, go back a number of years to the RCOG Working Party Report Tomorrow’s Specialist published in 2012 and Professor David Greenaway’s Shape of Training report published in 2013 which many of you will be familiar with.

As a result of these two documents in 2015, Professor Clare McKenzie, previous Vice President for Education, led a curriculum review which was subsequently ratified by council. This review included a detailed review of the structure and the content of our current curriculum and gained information through focus groups and interviews with trainers and trainees around the UK.

Current 2013 core curriculum This pie chart is one of the graphs produced in the Curriculum Review document and it looks at the current competencies in our current curriculum and you will see over 80% of them focus on technical skills. However, we are aware in the importance in modern healthcare, non-technical skills and this is another driver for a change in our curriculum so that non-technical skills are equally represented.

Definition of a consultant “A highly skilled obstetrician and gynaecologist with the appropriate knowledge and attitudes to lead and deliver high quality care; taking account of patient’s needs and advocating for women’s healthcare. This will involve a questioning approach to research and quality improvement. Working well in teams is essential for safe, effective patient care; obstetricians and gynaecologists must be good communicators, supporters of staff and happy to share their expertise and experience as well as being open to the views of others. On completing training the individual will be prepared for lifelong learning, which will allow them to be adaptable and flexible for a modern NHS.” Final report of the Curriculum Review Group, 2015 One of the jobs of the Curriculum Review Group was to come up with the definition of a consultant and a long time was spent discussing and debating the definition of a consultant in the 21st century and you will see this definition outlines the complex and challenging role that a consultant in modern healthcare provides. They have clinical skills, they’re a leader, educator and must ensure a high quality of patient safety.

GMC GPCs Since the publication of the curriculum review document in 2015, the GMC has published their Generic Professional Capability Framework and all colleges are required to ensure that these are incorporated into their curricula by 2020.

Professional identities Healthcare professional Researcher/educator/scholar Clinical expert Champion for women’s health Our new curriculum will be organised in a very different way. There will no longer be the 19 modules. The curriculum will be divided into four professional identities representing those skills which are fundamental to being an effective consultant in the 21st century healthcare system. These are being a healthcare professional, the researcher, scholar and educator, being a clinical expert, and last but not least, being a champion for women’s health.

Structure As I previously alluded to our new curriculum will be different with no modules. Each professional identity, however, will consist of a number of capabilities in practice or high-level learning outcomes. Each of these capabilities in practice will have a number of key skills and each key skills will have some descriptive outlining the learning which is expected from the trainee.

Generic and specialty-specific professional identities Developing the doctor Healthcare professional: 5 CiPs Research, scholar and educator: 3 CiPs Developing the obstetrician and gynaecologist Clinical expert: 4 CiPs Champion for women’s health: 2 CiPs Two of the professional identities are generic or develop the individual as a doctor. These skills are expected of all consultants of the future and many are non-technical skills and are transferrable between specialities. Two of the professional identities are specific to obstetrics and gynaecology.

Developing the doctor This next busy slide outlines the capabilities in practice in more detail and describes the high-level learning outcome which is expected by a doctor at the end of training.

Assessment principles Moving away from the current ‘tick box’ approach Championing the development of the adult learner Professional judgement and global assessment “The current toolkit will need modification but is essentially fit for purpose… but the key to increasing quality lies in how it is used” Piloting of modified WBA tools (miniCEX, CBD, MSF) started in March 2018 and will continue throughout the curriculum development timeline Particular focus on using self-assessment in parallel with team assessment in MSF. Assessment is a fundamental part of any postgraduate curriculum. There are some key principles to assessment in our new curriculum. Firstly, we will move away from the current tick box approach. We will champion the development of the adult learner and we will bring professional judgement and global assessment to our curriculum. Dr Rehan Khan, who led the Assessment Task and Finish Group, concluded that the current toolkit will need modification but is essentially fit for purpose and its key to increasing quality lies in how it is used. The modified workplace-based assessment tools have been piloted since March 2018 and will be continued to be reviewed throughout the curriculum development timeline. There will be a particular focus on the use of self-assessment and this will be introduced to the whole of the curriculum, but particularly within the team assessment multisource feedback.

New ePortfolio Improved functionality Available on mobile devices The new curriculum is going to be supported by a new ePortfolio, this will have improved functionality and will be available on all mobile devices.

How have we done this? Workshops Task and finish groups Public insight group So, how have we done this?   Well, this has been done with the support of trainees and trainers up and down the country. We are very grateful for the time and effort that people have been put into the workshops which have taken place over the last two to three years. There have also been a number of task and finish groups. We are very proud of the input from patients and women to the new curriculum and public insight group and webinars.

Consultation There has been wide consultation on the new curriculum. In the summer of last year, the consultation documents were sent out to all fellows, members and trainees and we are grateful for the feedback we received and it has allowed us to further enhance the curriculum. There was also consultation widely with other stakeholders including other Royal Colleges or specialist societies. There were a number of workshops with midwives and nurses and there were further webinars with patient groups and this has led to the further improvement of the curriculum.

GMC approval As many of you will be aware, the GMC is the regulator of postgraduate medical education and all curricula have to be approved by them. In the spring of last year, the purpose statement was submitted for the Core Curriculum to the GMC. The feedback was received in the summer and was very positive; however, the GMC required that advanced training was included within the curriculum review and not just the core curriculum.

Advanced training GMC have requested that the curriculum review includes ATSMs and Subspecialty training They will be ‘repackaged’ but the content and requirements will not change As a result of this, advanced training has been reviewed and it will be repackaged but the content and the requirements will not change.

Summary Curriculum to train obstetricians and gynaecologists for their job as a specialist in a 21st century healthcare system Developing professional and specialty-specific skills with a greater emphasis on non-technical skills So in summary, we have developed a curriculum aiming to train obstetricians and gynaecologists for their jobs as a specialist in a 21st century healthcare system, developing professional speciality specific skills with a great emphasis on non-technical skills.   Thank you for listening to this presentation today.

Acknowledgements RCOG Jo Mountfield (SEAC Chair) Kim Scrivener Rehan Khan (Core Curriculum Vice Chair) Bettina Cayetano Adalina Sacco (National Trainees’ Committee Chair) Sakinah Takeram Suzanne Wallace (Education Resources Adviser) Alex Baker Colin Duncan (Exams & Assessment Chair) Matthew Miles Core Curriculum Committee Jo Davies The Women’s Network