OBSTETRICS AND GYNAECOLOGY
Helping to bring new life into the world is one of the main things that draw people to this specialty. If you choose obstetrics and gynaecology you will be involved in the lifelong care of women and the safe delivery of their babies. It is a broad-based specialty that gives you the opportunity to develop surgical and medical skills.
Obstetrics and gynaecology comprises the care of the pregnant woman, her unborn child and the management of diseases specific to women. Most consultants are generalists but the specialty offers a wide range of sub-specialties. You will need skills as a physician and as a surgeon.
Along with the pleasure of helping women give birth in the delivery suite, you will also be involved on an almost daily basis with life-threatening emergencies, the successful resolution of which brings enormous job satisfaction.
One of the challenges is dealing with unsuccessful outcomes - the devastating effect these can have on parents and the impact this may have on the NHS trust.
This is a practical specialty allowing for early trainee involvement in quite complex procedures. Supervised by consultants, you'll develop skills in delivering babies and working in a team as well as many surgical skills. There are plenty of choices for subspecialties, ranging from surgical subspecialties such as oncology and urogynaecology through to fetal and maternal medicine.
The specialty requires commitment and hard work. You will have to work at night as well as during the day and to be successful you will need to learn to deal with stressful situations where rapid decision-making can save lives. However, in future it is likely that the life of the consultant will be more predictable, allowing more time for family and development of other interests.
Entry, qualifications and training
Specialty training in obstetrics and gynaecology consists of basic, intermediate and advanced training over seven years.
Doctors who have successfully completed foundation training, and those with equivalent competences (one year of satisfactorily completed SHO training in the UK), will be able to compete for entry at ST1. Successful applicants will be appointed to a two-year basic specialty training (BST) programme within deanery-organised programmes.
During the first two years you will acquire generic skills and competences in obstetric and gynaecological practice and have a set of competences to manage acute obstetric and gynaecological presentations as the resident on-call doctor.
To progress from basic to intermediate training you will need to demonstrate specified competencies linked to the curriculum for BST and confirmed by completion of a range of assessments, including knowledge (MRCOG Part 1) and a satisfactory Record of in Training Assessment (RITA).
Progress through intermediate (ST3, ST4 and ST5) into advanced training ST6 and ST7 will require satisfactory acquisition and assessment of clearly defined competencies and a summative clinical assessment.
In advanced training (ST6 and ST7), core skills will continue to be developed to the point of independent practice and you will undertake advanced skills modules. Modules are based on the diversity of training and service needs.
A few skilled and motivated trainees can be selected into one of the five subspecialties (gynaecological oncology, maternal and fetal medicine, reproductive medicine, urogynaecology, sexual and reproductive health). Subspecialty training takes place during ST6 and ST7.
Personal qualities include:
- ability to make decisions under pressure
- good communication skills
- mental and physical stamina
- ability to cope with your own stress and that of others
- leadership abilities
- ability to work as a member of a team
- ability to sympathise and be non-judgmental
- manual dexterity.
To find out more about the qualifications and personal qualities you need to enter obstetrics and gynaecology specialty training, take a look at the person specification
The future
The need to comply with the European Working Time Directive has meant an increase in the number of consultants, and the increased numbers will need to be maintained to balance the numbers of consultants retiring or moving into other specialties.
The Royal College of Obstetricians and Gynaecologists is aiming to dramatically increase the number of consultants over the next years, from 1,500 to 2,500.
Obstetrics and gynaecology is a rapidly evolving specialty. It is an area that has led to the development of a number innovative techniques, which have spread to other specialties.
In future it is likely that consultants will work in larger units, providing more opportunities to develop subspecialties.
Because this is can be a highly stressful specialty, some consultants switch to 'softer', more focused areas of work later in their careers, such as oncology or foetal medicine. Management is also an option.
