OxfordDeaneryPostgraduateSchool
of
Obstetrics and Gynaecology
Job/Programme Description
The Oxford Deanery comprises 1 University Hospital and 5DistrictHospitals.
The programmes have been designed to give a wide variety of exposure to general Obstetrics and Gynaecology in the first five years, rotating through all / most of the hospitals, with special interests in the final two years.
The first 2 years introduce the trainee to Obstetrics and Gynaecology at the end of which Part 1 MRCOG must have been passed. For ST3-5, there is a full half day study programme in preparation for the Part II MRCOG examination.ST6 and 7 programmes have been carefully designed to provide ATSM training. Allocation to a particular programme will be determined by the interests of the trainee and in open competition with their colleagues.
All posts have educational approval of PMETB and the Postgraduate Dean (Dr Michael Bannon). The Deanery is committed to fulfilling the requirements of the European Working Time Directive. Progression through the programme is dependent on satisfactory assessment at the Annual Review of Competency Progression based on the curriculum from the RCOG.
Less than full time training is available if job shares can be organised.
Academic training in Obstetrics and Gynaecology is available through academic clinical fellowships and clinical lecturer posts. These are advertised at separate times.
The Head of School is Miss Felicity Ashworth who is based in Aylesbury.
Updated: November 2009
1
OXFORDPOSTGRADUATESCHOOL OF OBSTETRICS AND GYNAECOLOGY
The School is in the Oxford Deanery which is overseen by NHS Education South Central with (NESC)
The School Board has the responsibility of ensuring excellent training in O&G throughout the seven years of run through training. There are enthusiastic Educational Supervisors available to direct and support the training in each Trust. We are a small Deanery but can provide all the necessary training with options for research later (as well as the ACF, Academic Clinical Fellowship scheme) and subspecialty training.
TRAINING PROGRAMMES IN OBSTETRICS & GYNAECOLOGY
A run through training programme is available which rotates around the 6 hospitals in the Oxford Deanery.
The Hospitals are JohnRadcliffeHospital, Oxford,HortonHospital, Banbury, WexhamParkHospital, Slough, RoyalBerkshireHospital,Reading, Milton KeynesHospital, BuckinghamshireHospitals which has StokeMandevilleHospital, Aylesbury as the main base. Trainees should expect to work at all the Units and must be able to travel between them. Most placements are for a year at a time.
The Oxford Deanery scheme has an intake of 7 trainees at ST1 per year and an academic clinical fellow. At a senior level, all advanced training special interest modules can be offered apart from paediatric gynaecology. There is subspecialty training in all areas of interest.
The training scheme is divided into 3 parts, ST1-2, ST3-5 and ST6-7 based on the RCOG curriculum and competencies have to be achieved before progression, as determined each year by the ARCP process.
ST1 and ST2
These posts are paired and allocation is decided following interview when trainees can give their preferences. The person who scores highest at interview is placed in their first choice etc. All posts will allow the trainee to develop the skills of the basic curriculum and ST2 competencies have to be achieved before progressing to ST3.
ST3 – ST5
At present, we organise fixed 3 year rotations and allocation is made to rotate the trainees through most of the Units. We now aim for ST3 to be in the Unit as ST2. All the posts will allow trainees to gain their intermediate competencies and Part 2 MRCOG must be passed before moving into ST6. We have good success rates at Part 2 MRCOG.
ST6 and ST7
These posts allow trainees to develop their areas of special interest whilst completing their advanced curriculum. Allocation is by competitive interview and posts are in all the Units. A preceptor for the appropriate ATSM will be in each Unit and we have a Director of ATSMs in the Deanery, currently Miss Jane Siddall at Reading. Two ATSMs must be completed before CCT can be awarded.
CURRENT ST6 & 7 PROGRAMMES
ST6 / ST7MIXED ATSM
A / Milton Keynes:
Benign surgery: Laparoscopy
ALWP / Oxford:
Acute gynae and early pregnancy/benign surgery: Laparoscopy
Subfertility & Reproductive Medicine
B / Oxford:
ALWP
C / Reading:
ALWP / Oxford:
Hysteroscopic surgery/acute
gynae & early pregnancy
D / Wexham:
ALWP / Reading:
Benign abdominal + vaginal surgery
E / Reading:
Urogynaecology / Reading:
ALWP
OBSTETRIC ATSM
F / Bucks:
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 / Bucks:
Urogynaecology / Oxford:
Benign vaginal surgery/laparoscopy
I / Wexham:
Benign vaginal surgery/cervical disease / Oxford:
Oncology lead/ Benign abdominal surgery/vulval disease
Each post will offer general obstetric and gynae training to ensure completion of the advanced parts of the 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.
EDUCATIONAL SUPERVISION
Trainees will be allocated an educational supervisor in the Trust at the beginning of each year and this person will give educational support and organise the regular appraisals according to the RCOG curriculum. All trainees will be registered with the RCOG. The training will be reviewed annually at the ARCP to agree progress to the next year.
There is an annual interview at the Deanery to discuss this outcome and plan the next year of training.
At each hospital, trainees will be allocated to one or more clinical supervisors who will provide clinical training and perform many of the workplace based assessments. The trainee is responsible for requesting and arranging these as necessary.
TEACHING
ST1 – ST2: There is an alternate month, whole day training organised centrally for these trainees which is based on the basic modules of the curriculum. This is protected time and trainees will be released from their Units – although there may be rare occasions when this is not possible. Further teaching sessions are held in each Unit and focus on the basic practical skills which are required.
ST3 – ST5: At present, there is a protected weekly half day of teaching on a Friday afternoon which all trainees are expected to attend. This covers the intermediate curriculum and syllabus for Part 2 MRCOG. There may be occasions when Units cannot release all the trainees to attend because of rota commitments. There is also an alternate month, whole day central teaching which covers the training courses of each module.
STRATOG: All ST1-5 trainees are expected to purchase STRATOG modules (RCOG distance learning programme) as the topics are covered in the teaching sessions. At present, the Deanery is buying these for all ST1-5 trainees as required but there is uncertainty as to whether this funding will continue.
ST6 - ST7: There is no regular formal teaching apart from a central regional day once a year. The requirements of individual ATSMs will be addressed in the Units and RCOG organised essential courses have to be attended.
OXSFOG: (Oxford Scientific Forum for Obstetrics and Gynaecology) is an annual Deanery study day which all trainees and Consultants attend where trainees present their audits and there is a scientific programme.
Academic Clinical Fellows
These are appointed jointly between the Deanery and University by separate advertisement. We currently have 6 ACF and 2 clinical fellowships.
Research
The Nuffield Department of Obstetrics and Gynaecology supervises the ACFs and there can be access to research projects leading to MD or DPhil.
Less than full time training
We can arrange slot shares for trainees to work less than fulltime – subject to appropriate rotations. Dr. Rebecca Mather is the Associate Dean responsible for this training.
LEAVE
Annual leave must be arranged at least 6 weeks in advance and individual Units will have their own guidance. At most Units, there will be a maximum number of trainees who can be away at once.
Study leave is determined by each local Unit under the guidance of the Trust’s Director of Medical Education and Deanery guidelines. The fixed Deanery teaching sessions will count within the study leave allocation. Personal study will usually only be given before examinations or completing research work.
Pay Banding: Please check with the relevant Trust
All posts include prospective cover for annual and study leave of colleagues.
Transport:
It is expected that trainees can provide their own transport between Trusts particularly for the Friday teaching.
BOARD OF THE POSTGRADUATESCHOOL OF OBSTETRICS & GYNAECOLOGYHead of School/Lead TPD / Felicity Ashworth
Board Members / Deputy HOS/TPD South Circuit / Jane Siddall
Dean’s Representative / David Bailey
Pauline Hurley
TPD for ST1/2 / Nandini Gupta
Director ATSMs / Jane Siddall
College Tutor from each Trust:
Reading / Jill Ablett/Rajee Vijayanand
Oxford / Rebecca Black
Wexham / Pampa Sarkar
Banbury / Jonathan Nicholls
Milton Keynes / Nandini Gupta
Bucks (Stoke Mandeville and Wycombe) / Geraldine Tasker
University Representative / Stephen Kennedy
Director Ultrasound Training / Paul Chamberlain
Teaching Co-ordinator ST1/2 / Jane Moore
Trainee Representatives - Senior / Abdul Wagley
- ST1/2 / M Bhatia
Lay Representative / Elizabeth Howarth
Deanery Programme Manager / Jane Exell/Jenny Arthur
Responsibilities:
Trainees Placements/Recruitment / Felicity Ashworth
ARCP / Felicity Ashworth
Quality assurance / Felicity Ashworth
ST1/2 trainees (include teaching & ARCP) / Nandini Gupta
ST1/2 Teaching / Jane Moore
ST3-5 teaching - Local / Rebecca Black/Jane Siddall/Geraldine Tasker
- Deanery-wide / Jane Siddall
ATSM / Jane Siddall
E-portfolio / Rebecca Black
Academic Clinical Fellows / Joint responsibility with University Medical Academic Board
Stephen Kennedy/Felicity Ashworth
The Hospitals
Milton KeynesGeneralHospital.
Departmental Staff:
Seven Consultants Mr Christopher Balogun-Lynch FRCS FRCOG
Miss Meghana PanditMRCOG Mr Anthony Stock MRCOG
Miss Naomi Whitelaw MRCOG
Mr Ghaly Hanna MRCOG
Miss Kirsten Duckitt MRCOG
Mr Agboola MRCOG
College Tutor Miss Nandini Gupta MRCOG
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 accesssurgery. Miss Duckitt is labour ward lead with Miss Pandit taking special interest in urogynaecology and is the clinical director. Miss Gupta takes a special interest in early pregnancy assessment, minimal access surgery and is the College Tutor.
Trainees: At presentthere are nine SHO (2 ST1/2) and five StR posts (4 at ST 3-5 and 1 ST6). There are also four 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. There is also a out-patient hysteroscopy clinic. There is a pre-assessment clinic staffed by nurses.
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: 12
Maternity Beds: 32
Births: About 3,900 per year
Medical Students: from University of Oxford.
Rota: Full shift. Banding: 1b
OXFORD – The Women’s Centre, JohnRadcliffeHospital
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.
Mr Stephen Kennedy is Head of Department.
Readers: Mr Stephen Kennedy (Endometriosis and Pelvic Pain)
Oxford Fertility Unit
Mr Enda McVeighSenior Fellow, Reproductive Medicine
Mr Tim ChildSenior Fellow, Reproductive Medicine
Miss Jane MooreSenior Fellow, Reproductive Medicine
Mr Christian BeckerSenior Fellow, Reproductive Medicine
There are 3 clinical lecturer posts (0.5 WTE) employed by the University
The NHS consultant staff, giving their main interests comprise:-
Mr Mark Charnock (Oncology)
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)
Miss Rebecca Black(Maternal Fetal Medicine)
Miss Deborah Harrington(Maternal Fetal Medicine)
Miss Anita Makins(Maternal Fetal Medicine)
Mr Paul Chamberlain (Obstetric Ultrasound)
Mr Vic Rai(Emergency Gynaecology, Urogynaecology)
Miss Margaret Rees(Medical Gynaecology)
There are 5 subspecialty trainees, 2 in Fetal Maternal Medicine, 1 in Reproductive Medicine, 1 in Gynaecological Oncology and 1 in urogynaecology.
There are 18StR posts at the John Radcliffe by the end of 2008, 5 at ST1/2, 6 at ST3-5 and 7 at ST6/7.
There are, in addition, flexible trainees at StR grade, 13 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 StR on-call for the Delivery Suite as part of the rota.
Trainees at ST 3-5 level spend 6 months at the JohnRadcliffeHospital and then 6 months at the Horton, Banbury
Banding: 1b
All services are located within the Womens Centre.
Deliveries per year: 6,133 (2007), Caesarean Section Rate 21%
CNST:Level 2 achieved in 2007,
Obstetric beds:81+ 16 Delivery Suite beds
9 Observation area beds
Midwifery led Unit (The Spires) opened 2008
2 natural birthing rooms including 1 pool within the 16
delivery rooms
Obstetric Ultrasound:Total Scans – > 9,000
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 and nuchal scanning is offered as a routine.
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).
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 6/7 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 CambridgeUniversities plus Midwifery Undergraduates from OxfordBrookesUniversity.
Horton General (Banbury)
This hospital is part of Oxford Radcliffe Hospital Trust. The department comprises:
4 Consultants:Mr Stuart Canty
Mr Jonathan Nichols (DistrictCollege Tutor)
Mr H Naoum
Mr E Akrong (Locum)
Ms S Doshi (Staff Grade)
All consultants share the general obstetric and gynaecological workload of the department.
There are 6 StR 3-5 posts at the Horton.
In addition there are 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:1700 (2007)
Gynaecological operations:1136 (1994)
Neonatal facilities:3 special care cots
Facilities:
There are urogynaecology 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.
Trainees will spend 6 months at the Horton and then swap to 6 months at the JohnRadcliffeHospital, Oxford.
Buckinghamshire Hospitals: Stoke Mandeville (Aylesbury) and WycombeHospital:
The department has twelve Consultants: