Section 1 – Introduction

UK training in Obstetrics and Gynaecology comprises a minimum of 7 years specialist training in O & G. The programme is divided into three components: basic, intermediate and advanced training. Successful completion of the programme will lead to the award of a Certificate of Completion of Training (CCT) or a Certificate of Eligibility for Specialist Registration (CESR). The content and structure of the training programmes is determined by the Royal College of Obstetricians and Gynaecologists and approved by the Postgraduate Medical Education and Training Board (PMETB). The delivery of the programme is overseen by Postgraduate Deans in conjunction with the Deanery Specialty Training Committees.

Specialty Training & Education Programme
Full registration

Foundation

Basic Training

Intermediate Training

Advanced Training Modules

1

2

1

2

3

4
RITA

5

6

7

CCT Specialist Register Independent Practice

Core Log Book Women's Health Module
Subspecialty 2-3yr

NTN

PART 1 MRCOG

PART 2 MRCOG

Feb 2007

How to use the Postgraduate Training manual The Postgraduate Training manual will provide a comprehensive record of your training and will document your progression through training. You should commence your logbook at the start of your ST1 year. Attainment of competences to a defined level is required for progression from basic to intermediate training (ST2 to ST3) and from intermediate to advanced training (ST5 to ST6). Successful completion of the logbook is a prerequisite for the award of the CCT/CESR. The stages at which different competences need to be obtained are indicated in the logbook and are colour coded: a different colour for each training level. All basic competences must be signed off before progressing from ST2 to ST3, all intermediate competences to be completed prior to moving from year ST5 to ST6 and the advanced competences to be completed prior to your final assessment for the CCT, the RITA G award.

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The Logbook The logbook comprises 19 modules and each module needs to be signed off by your educational supervisors. As you acquire new competences you should ask your clinical trainer to SIGN and DATE the relevant section in the logbook. Unless the competency is signed and dated and a record of the signature of the trainer recorded in the logbook the completion of the module will not be accepted by the Specialist Training Committee. Signatures should also be obtained to confirm successful completion of the relevant course. There is a section at the end of each module for each of your clinical trainers to print and sign their names. These clinical trainers may be consultants in obstetrics and gynaecology but some skills will be taught by senior trainees in the discipline or by specialists in other disciplines, not all of whom will be doctors. The logbook is divided into modules for ease of reference but it is not intended that modules should be completed in isolation. You will acquire skills at different times depending upon the opportunities provided by each clinical post. By the end of intermediate training (ST5), however, you must have completed and have signed off all of the intermediate skills targets to the level indicated in the logbook. Failure to complete the logbook will delay progression into advanced training years 6&7. How will my training be assessed? The logbook makes use of a simple system for recording the acquisition of clinical skills. Each module has specific training targets and the final level of competence is reached in stages, ranging from observation through direct supervision to independent practice. Observation Prior to undertaking any clinical skill under direct supervision you must have observed the procedure on a number of occasions, have a thorough understanding of the principles of the procedure, the indication for the procedure and the complications. Once these skills have been obtained, the relevant competency box should be signed and dated and you can then move on to performing the procedure under direct supervision. Direct Supervision The time taken to acquire the necessary skills under direct supervision will depend on the complexity of the procedure and your aptitude for it. There is therefore no limit to the number of times the procedure needs to be supervised and there is no advantage in having a module signed up until you and your clinical supervisor can be certain that you can safely perform this procedure in a number of different clinical situations and levels of complexity. It is also important to be certain that when you are performing a procedure independently that you are able to deal with any unexpected complications and who to call on for help. Independent Practice The progression to independent practice will be the most difficult for you. Once you have been signed off for direct supervision you should start the process of performing

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procedures with less and less supervision as agreed by your trainer. You should only be signed off for independent practice when you and your trainer are confident that you can perform the procedure in situations when your trainer is out of the hospital. Once this competency has been attained you must keep a record of the numbers of the procedures you subsequently perform and any complications. You will need this information for revalidation and the necessary forms can be found in section eight of the Postgraduate Training Manual. Training Courses The RCOG approved Basic Surgical Skills Course (see RCOG website for course availability) is mandatory and must be undertaken by the completion of year 2. Evidence of completion will be sought at the RITA year 2 and will be a prerequisite for entry to ST3. All other courses, which are required for core training, and mentioned in the curriculum training and logbook will be provided within your Deanery. A certificate confirming attendance and, where relevant, documented confirmation of satisfactory completion of the course is required before the module can be completed and should be filed in section three of your Postgraduate Training Manual.

Section 2 – Regulations for the Certificate of Completion of Training (CCT) or the Certificate of Eligibility for Specialist Registration (CESR)
Section two contains the regulations for the Certificate of Completion of Training/Certificate of Eligibility for Specialist Registration. You will find this a useful document should you have a query concerning your CCT/CESR. If you need further advice you should speak to your College Tutor or email the Secretary to the Specialist Training Committee at the RCOG.

Section 3 – Training History
Section three contains a summary of your training history and information about any prolonged periods of leave. At the start of each new post you should record the region and unit you are working in and the name of your Educational Supervisor (ES). There are also areas for you to record details of any overseas or supplementary training you may have received and a further form for you to record details of all the courses and regional training days you have attended. Please file any certificates you have received from courses attended in this section. Some trainees are able to count time in research or out of programme OOPE towards training for the CCT/CESR. Prospective approval must be obtained from the Postgraduate Dean and the Chair of the Deanery Specialist Training Committee. Having obtained approval from the regional training committee, an application must be made to Specialist Training Committee at the RCOG. The STC at the RCOG will require to see your timetable and details of out of hours work before approving this time for CCT/CESR training. Generally a maximum of a year will be approved but there are exceptions. The appropriate forms for applying for approval can be found at the back of this section. Details of any such approval should be kept in this section.

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Your ES may also send out additional TO1 forms as and when required. Observations are made by your assessors from the impressions you create. The completed TO1 forms should be returned to your ES who will collate the forms onto the TO2 form. If problems are identified. such as audit projects and study leave. Prior to this first meeting you MUST complete the front section of the induction/appraisal form. anaesthetic and paediatric colleagues. You are responsible for ensuring that these forms are distributed and returned to you in time for your Educational Sperviser to collate the report prior to the assessemt interview. At this induction interview you should look together at your logbook to review your current competences and set achievable goals for further progress. then your ES working with the College Tutor will talk these over with you and implement an agreed action plan. and may be at variance with your perception of yourself. The dates of these appraisal interviews and a record of the discussion should be recorded on the induction/appraisal form and stored in your Postgraduate Training Manual (PTM) in section four. Generally it is felt not appropriate to ask clerical and support staff to complete TO1 forms. although in certain situations your ES may request TO1 forms from non clinical colleagues. The TO1 form is based on “Good Medical Practice” as defined by the GMC. Other appropriate staff includes midwives from other areas. This is the responsibility of the Postgraduate Dean in conjunction with the Deanery Specialist 4 . Section 5 . It is suggested that you include in your list of assessors at least three senior medical colleagues(consultant or senior SpR). You should meet with your ES on at least two further occasions at four and eight months to ensure you are making satisfactory progress and that you are on track to achieve your educational objectives. A record of this meeting must be made on the induction/appraisal form. staff from the specialist clinics you have been working in. You and your educational supervisor should agree on at least 10 observers. This multi source feedback tool will form part of your assessment and will inform the RITA process. A Summary entitled “Assessment and Training – what to do and when” provides an overview of the assessment process and can be found in section four. TO1 forms should be completed prior to your four and eight month meeting with your ES and the meeting you have with your ES before your RITA. Team Observations (TO1 & TO2) Trainees need feedback from a range of healthcare professionals and the TO1 form is to be used for this purpose.Record of In Training Assessment (RITA) At the end of each year of training a more formal assessment of your training will be made to determine whether you can progress to the next year. You do have a right to view the TO1 forms and you MUST look on the comments as constructive. should be identified with a time scale for achieving them.Section 4 – Induction and Appraisal You should meet with your Educational Supervisor (ES) within two weeks of starting your new post. a senior nurse from the gynaecology ward and a member of the theatre team. Additional educational objectives. The purpose of the TO1 forms is to try and close the gap. a senior midwife on delivery suite and from the antenatal clinic.

which if successfully completed will not delay your progression to CCT/CESR. Within six months of your anticipated CCT/CESR date you will be called up for your final RITA. A failure to acquire the educational objectives as laid out in the RITA D will lead to the award of a RITA E. and the forms are included within the relevant module in the logbook.Training Committee. You must complete the National Trainee Assessment Questionnaire and take it with you to the RITA. The RCOG will then make a recommendation to PMETB that you have completed the relevant training and are eligible for specialist registration. You do have a right of appeal at every stage of this process. The OSATS should be used to help you and your trainer to assess when you are ready to move on to independent practice for a procedure and when you are ready to be signed off for independent practice. They are: • Fetal blood sampling 5 . which are so fundamental to the practice of obstetrics and gynaecology that an objective assessment tool has been developed to aid the assessment process. which is a recommendation for targeted training. You need to submit your signed RITA G form to the Postgraduate Training Department at the RCOG and the Secretary to the Specialty Advisory Committee will contact you directly with the relevant forms for you to complete. The curriculum indicates those skills. At this review the entirety of your training will be reviewed and. Failure to achieve these objectives within the indicated time frame will lead to you being removed from the training programme. At this point. Deficiencies in your training or poor performance will usually result in you being awarded a RITA D. The same OSATS may be used to assess increasing levels of complexity for any particular procedure. subject to satisfactory completion. Ten OSATS have been developed to assess those procedures that are fundamental to the practice in obstetrics and gynaecology. your training clock stops while you undergo a period of repeat experience with clearly defined educational objectives. A Record of In-Training Assessment (RITA)form will be issued after every assessment and copies must be kept in this section of your manual and a further copy forwarded to the Specialist Advisory Committee (SAC) at the RCOG.Assessment Tools Objective Structured Assessment of Technical Skill (OSATS) There are a small number of procedures. If the evidence provided at your RITA is satisfactory you will be awarded a RITA C indicating successful transition to the next training year. you will be issued with a RITA G form. Section 6 . Your educational supervisor will also complete the structured reference section of this form and the TO2 form. The OSATS is a validated assessment tool to assess your technical competency in a particular technique. which need to be assessed with OSATS. In preparation for your RITA you must meet with your ES and together complete the RITA review form detailing your educational achievements and logbook modules completed for the year.

It is not envisaged that you will successfully complete the assessment at the first attempt and this should not be seen as failure. You must not use the same assessor for all five OSATS assessments. There are two parts to the OSATS form. You will need to involve at least two different assessors for this process. When you feel ready to undertake the relevant OSATS. you will meet with your clinical supervisor who will assess the procedure and complete the OSATS form. Prior to undertaking an OSATS assessment you must be able to perform the procedure competently under direct supervision. and a consultant must do at least one assessment. The first is a checklist. which breaks down the procedure into steps. Review of these forms allows your assessor to see the progress you are making. The department will nominate an assessor for you and in some situations will give you discretion to choose your own assessor.e. however the taking of consent must be assessed separately using a mini-CEX. The second is a generic technical skills assessment. not all of which will be relevant to every OSATS. The generic technical skills. Taking consent for the procedure is not part of the assessment. Once you have been signed up for independent practice it is recommended that in order to demonstrate continued competency in this area you have an annual OSATS assessment.• • • • • • • • • Diagnostic hysteroscopy Diagnostic laparoscopy Opening and closing the abdomen Uterine evacuation Perineal repair Caesarean section Operative vaginal delivery Operative laparoscopy Manual removal of placenta Before the competences can be signed off in the logbook each OSATS must have been successfully completed (i. A record of the date that each OSATS is signed off should be entered in the relevant section of the logbook module. will form an important part of the assessment process. in order to be signed off for independent practice you must have the generic skill “fully understands areas of weakness” within the generic skill of insight/attitude consistently ringed. 6 . prior to the first OSATS assessment. A total of five OSATS will need to be successfully completed for the competency to be signed off in your logbook. However. every box ticked for independent practice) on at least five separate occasions. Trainees will proceed at different rates and the competency levels are the minimum that must be achieved prior to moving to the next stage of training. and you will be required to demonstrate this on several occasions. It is anticipated that to pass the OSATS you will have the majority of competences ringed in the middle or right of the generic skills assessment list. You MUST retain all OSATS assessment forms whether satisfactorily completed or otherwise. all of which must be successfully completed.

Copies of the relevant forms can be found in your PTM for you to reproduce as and when indicated. If you are involved in a difficult situation record the event and your thoughts about it on the reflective practice form. Reflective practice can only occur after you have been involved in a difficult situation which will usually be clinical but could also include difficult situations occurring with colleagues. are satisfactorily completed for each clinical encounter before the competency is signed off. the caesarean section OSATS may be used for assessing competency for a simple caesarean section or a complex caesarean section. For this to be a meaningful process you will need to examine previously and often firmly held beliefs about your practice and also learn to accept that you may have been wrong. Each case based discussion should involve slightly different clinical situations in the competency area to be tested. The competencies required to be assessed in this way and the forms are in the relevant modules for completion. The level of complexity should be indicated on the assessment form. Indicated in the curriculum are the competencies that can be tested using this tool.g. This tool enables your trainer to directly observe and assess you in the process of history taking. formulating management plans and communicating with your patient. They can be used to assess clinical decision-making. with a variety of different trainers. Only by continuously evaluating previously held beliefs and assumptions will you be able to learn and move forward. 7 . Inevitably there will have been a poor outcome and the purpose of reflection is to allow you to identify potential learning opportunities and develop your clinical practice by learning from them. This section of your logbook is designed to assist you in this process. Mini-Clinical Evaluation (Mini-CEX) This tool tests many different and varied competences and is a generic tool. If the case has been particularly distressing for you please seek help and support quickly. A minimum of 6 successfully completed CBDs will be required to have a competency signed up. You should aim to discuss these forms either with your ES or the consultant directly involved with the case. Indicated in the curriculum are the competencies that can be tested using this tool.The OSATS form may be used to assess technical skills at differing levels of complexity e. It also allows your trainer to assess your professional and interpersonal skills. Trainees use CBD to document objective assessments of discussion about cases. Copies of the relevant forms can be found in your PTM for you to reproduce as and when indicated. Section 7 – Reflective Practice Learning to reflect on and learn from difficult clinical situations that you have been directly involved in is a vital part of being a good doctor. It is suggested that a minimum of 10 mini CEX. The discussion will focus on the information given to the patient and recorded in the notes. Case Based Discussions (CBD) This generic tool formalises case discussion with your trainer. The mini-CEX is designed to take about 20 minutes to perform and the results should be fed back to you and discussed immediately after the assessment. clinical examination. knowledge and application of that knowledge.

The trainee should discuss within their deanery which modules they are considering in years four and five to allow for local planning and educational programmes and workforce numbers. You should also record any complications from the procedures you have undertaken. per week should be ring fenced for ATSMs. Research. 8 . Nineteen modules have been developed and trainees will choose from the mandatory list and optional list in order to gain sufficient credits prior to the award of the CCT.Log of Experience Once you enter advanced training you will need to keep a log of operative experience to confirm that you have been able to maintain your newly acquired skills. The recommendations from the audit must be also clearly recorded. Evidence of a successfully completed audit will be expected at each of your RITA panel assessments. following structured interviews. eight hours. Publications and Formal Presentations Involvement in audit is a crucial part of the learning process. You will need to continue to collect this information after you become a consultant for revalidation purposes. In addition to the advanced competences as set out in the logbook. Section 9 – Audit. If you undertake any periods of research details should also be kept in this section. Failure to complete an audit may hold up progress to the next year of training. To be acceptable the audit must be complete and have been presented at a departmental meeting or discussed in detail with the audit supervisor. For the full list of ATSMs and corresponding credits please refer to the Education and Training section of the RCOG website. Case reports and peer review papers should also be stored here. Section 10 – Advanced Training Skills Modules In the final two years of the training programme trainees will be expected to develop professional interests commensurate with their skills and interest and future health service needs. The audit may be something you have planned and undertaken on your own but may also include departmental audits that you have participated in. In this section you need to retain copies of all presentations and audit projects with their recommendations. In some instances modules may be oversubscribed in which case trainees will be ‘selected’ competitively eg. The ATSM section of the website will be developed to include full details concerning the registration aspects of the new modules and the corresponding credit system. Trainees will spend the majority of their working week completing the core curriculum but an absolute minimum of two half days.Section 8 . Please check the website when you are planning the ATSMs in year 6 and 7 of your training. The completed ATSM modules should then be filed in section ten of the postgraduate training manual. trainees will be expected to complete a number of advanced training skills modules (ATSMs) during years six and seven. You will also find a form for summarising details of publications in peer-reviewed journals.

org.uk 9 .In Summary It is hoped that you have been provided with all the information you require in order to commence your training programme. If you have any queries which cannot be resolved locally please refer these to the secretary to the Specialist Advisory Committee: tchambers@rcog.

Diploma of the Faculty of Family Planning Doctor’s Interpersonal Skills Questionnaire Consultant assigned by the College Tutor to supervise a trainee’s period of training. Responsible for the delivery of the training programme within the unit/hospital/trust. College Tutor (CT) Deanery College Adviser (DCA) Elected by Fellows and Members within the region to represent their views at College meetings. The superviser is responsible for the process of appraisal. acceptable to the RCOG. Modernising Medical Careers Managing Obstetric Emergencies and Trauma National Institute for Clinical Excellence DFFP DISQ Educational Supervisor (ES) MMC MOET NICE . Deanery Specialist Committee (DSTC) Training The Committee is formulated by the postgraduate dean in order to manage and deliver training. It is chaired by a deanery appointee. A consultant with at least two years’ experience as educational supervisor.Glossary of Terms ALSO CbD CCT CESR Advanced Life Support in Obstetrics Case based Discussion Certificate of Completion of Training Certificate of Registration Eligibility of Specialist CEX Clinical Trainer (CLT) Clinical Evaluation Exercise The Consultant assigned to a trainee who provides training during episodes of ‘direct clinical care’. accepted jointly by the Deanery Specialist Training Committee (DSTC) and the RCOG.

OSATS Objective Structured Assessment of Technical Skills Postgraduate Medical Education and Training Board Advisory This College committee is responsible for all aspects of the specialist training programme and makes recommendations and approves applications for the Certificate of Completion of Training. PMETB RCOG Specialty Committee RITA (Record of In-training Assessment carried out by the Deanery Specialist Training Committee at the end of each period of Assessment) training. SANDS SIGN TO Stillbirth and Neonatal Death Society Scottish Intercollegiate Guidelines Network Team Observation Training Programme Director This is an executive post appointed by the Deanery STC to organise and manage the (TPD) delivery and training within that deanery. USS Ultrasound Scanning .

JMedit/16-11-2006 The Postgraduate Training Manual Module 1 Module 2 Module 3 Module 4 Module 5 Module 6 Module 7 Module 8 Module 9 Module 10 Module 11 Module 12 Module 13 Module 14 Module 15 Module 16 Module 17 Module 18 Module 19 Basic Clinical Skills Teaching Appraisal and Assessment Information Technology. Clinical Governance and Research Ethics and Legal Issues Core Surgical Skills Postoperative Care Surgical Procedures Antenatal Care Maternal Medicine Management of Labour Management of Delivery Postpartum Problems (The Puerperium) Gynaecological Problems Subfertility Women’s Sexual and Reproductive Health Early Pregnancy Care Gynaecological Oncology Urogynaecology and Pelvic Floor Problems Professional Development .

educational and mental impairment ¾ Use interpreters and health advocates appropriately Professional skills and attitudes ¾ Show empathy and develop rapport with patients ¾ Acknowledge and respect cultural diversity ¾ Appreciate the importance of psychological factors for patients and their relatives ¾ Demonstrate an awareness of the interaction of social factors with the patient’s illness ¾ Demonstrate an awareness of the impact of health problems on the ability to function at work and at home Training support ¾ Evidence/assessment ¾ Mini CEX ¾ MRCOG Part 2 ¾ MSF (TO1 and TO2) .JMedit/16-11-2006 Curriculum Module 1: Basic Clinical Skills Learning outcomes: • • • To understand and demonstrate the appropriate knowledge. skills and attitudes to perform specialist assessment of patients by means of clinical history taking and physical examination. To manage problems effectively and to communicate well with patients. relatives and colleagues in a variety of clinical situations. physical. History taking Knowledge criteria ¾ Define the patterns of symptoms in women presenting with obstetric and gynaecological problems Clinical competency ¾ Take and analyse an obstetric and gynaecological history in a succinct and logical manner ¾ Manage difficulties of language. To demonstrate effective time management.

1900364-77-8) ¾ Evidence/assessment ¾ Logbook ¾ Reflective diary • . rectum Cervical smear • ¾ Perform investigations competently where relevant ¾ Interpret the results of investigations ¾ Liaise and discuss investigations with colleagues Professional skills and attitudes ¾ Respect patients’ dignity and confidentiality ¾ Acknowledge and respect cultural diversity ¾ Involve relatives appropriately ¾ Be aware of Fraser competence issues ¾ Appreciate the need for a chaperone ¾ Appreciate the need for a patient to seek a female attendant ¾ Provide explanations to patients in language they can understand ¾ Insight into ones ability and the need to ask for help Training support ¾ GMC Good Medical Practice ¾ Maintaining Good Medical Practice in Obstetrics and Gynaecology: the Role of the RCOG (RCOG. cervix.JMedit/16-11-2006 Internal clinical examination and investigation: Knowledge criteria ¾ Understand the pathophysiological basis of physical signs ¾ Understand the indications. February 1999. July 2002. including: Breast examination Abdominal examination Nonpregnant Pregnant • Vaginal examination Bimanual Cusco’s. ISBN 1-900364-22-0) ¾ Gynaecological Examinations: Guidelines for Specialist Practice (RCOG. urethra. risks. vagina. benefits and effectiveness of investigations Clinical competency ¾ Perform a reliable and appropriate examination. Sims’ speculum • Microbiology swabs Throat.

examination. name and status Professional skills and attitudes ¾ Appreciate the importance of timely dictation. confidentially and legibly the results of the history. cost effective use of medical secretaries and increasing use of electronic communication ¾ Understand the limitations and problems of electronic communication ¾ Communicate promptly and accurately with primary care and other agencies ¾ Demonstrate courtesy towards secretaries. accurately.JMedit/16-11-2006 Note keeping: Knowledge criteria ¾ Understand the importance and conventions of accurate clinical note keeping ¾ Know the relevance of data protection pertaining to patient confidentiality Clinical competency ¾ Record and communicate concisely. differential diagnosis and management plan ¾ Mark each note entry with date. signature. clerical and other staff Training support ¾ Caldicott Committee Report on the review of patient identifiable information (DH. 1997) ¾ Evidence/assessment ¾ TO1 and 2 forms . investigations.

JMedit/16-11-2006 Time management and decision making: Knowledge criteria ¾ Understand clinical priorities Clinical competency ¾ Prioritise tasks Professional skills and attitudes Training support ¾ Evidence/assessment ¾ TO1 and 2 ¾ MRCOG part 2 ¾ Have realistic expectations of tasks to be completed and ¾ Work with increasing efficiency timeframe for tasks as clinical skills develop ¾ Have the ability to prioritise ¾ Know when to get help workload ¾ Anticipate future clinical events ¾ Appreciate the internal signs of and plan appropriately one’s own stress and ask for help ¾ Be willing to consult and work as part of a team ¾ Be receptive to feedback on performance ¾ Learn to be flexible and be willing to take advice and change in the light of new information .

Communication skills e-tutorial ¾ SANDS guidance for professionals Evidence/assessment ¾ TO1 and 2 ¾ MRCOG Part 2 ¾ Mini CEX ¾ MSF .org.uk) ¾ StratOG.net: The Obstetrician and Gynaecologist as a Teacher and Researcher.rcog.JMedit/16-11-2006 Communication: Knowledge criteria ¾ Understand the components of effective verbal and nonverbal communication Clinical competency ¾ Demonstrate listening skills ¾ Use open questions where possible ¾ Avoid jargon ¾ Communicate clearly both verbally and in writing to patients. including those whose first language may not be English ¾ Give clear information and feedback and share communication with patients and relatives ¾ Break bad news sensitively Professional skills and attitudes ¾ Demonstrate an ability to: • • • • • Involve patients in decision making Offer choices Acknowledge and respect diversity Respect patients’ views Use appropriate non-verbal communication Training support ¾ Local and regional courses in ‘breaking bad news’ ¾ RCOG patient information (www.

JMedit/16-11-2006 MODULE 1 Skills TOPIC: Basic clinical skills Competence level: Basic training Observation Date History taking Take and analyse an obstetric history Take and analyse a gynaecological history Appropriate use of interpreters Clinical examination and investigation Breast examination Abdominal examination: Nonpregnant Pregnant Speculum examination: Cusco’s Sims’ Take microbiology swabs: Vagina Cervix Urethra Signature Intermediate training Direct supervision Dates Signature Advanced training Independent practice Dates Signature .

JMedit/16-11-2006 Perform cervical cytology screening Training courses or sessions Title Breaking bad news Signature of educational supervisor Date Authorisation of signatures – please print your name and sign Name (please print) Signature Completion of Module 1 I confirm that all components of the module have been successfully completed: Date Name of Educational Superviser Signature of Educational Superviser .

needs and styles ¾ Understand the principles of evaluation Clinical competency ¾ Facilitate the learning process ¾ Use varied teaching strategies appropriate to audience and context (including one-to-one. short course or multidisciplinary meeting Training support ¾ Local and regional Courses in presentation skills ¾ StratOG. learning opportunities. small and large groups. e.net: The Obstetrician and Gynaecologist as a Teacher and Researcher. Teaching e-tutorial ¾ Observation of and discussion with senior medical staff ¾ Appropriate postgraduate courses Evidence/assessment ¾ Logbook ¾ Reflective diary ¾ Feedback summaries ¾ MSF . Teaching: Knowledge criteria ¾ Understand the principles of adult learning ¾ Understand the skills and practices of a competent teacher ¾ Identify learner needs and learning styles ¾ Understand the principles of giving feedback ¾ Identify teaching strategies appropriate to adult learning ¾ ¾ Identify of learning principles. Appraisal and Assessment Learning outcomes: • • To understand and demonstrate the knowledge. To acquire the knowledge and skills to cope with and to understand the ethical and legal issues which occur during the management of obstetric and gynaecological patients. skills and attitudes to provide appropriate teaching.JMedit/16-11-2006 Curriculum Module 2: Teaching.g. assessment and mentorship. appraisal. formal lectures) ¾ Use of audiovisual aids effectively ¾ Prepare teaching session ¾ Teach in small (< 10) and large groups (> 20) and ‘at the bedside’ ¾ Teach some practical procedures (including ultrasound) Professional skills and attitudes ¾ Demonstrate the ability to set objectives and structure of educational session ¾ Demonstrate the ability to present a teaching session with audience participation ¾ Demonstrate the ability to achieve rapport ¾ Demonstrate the skills to evaluate a training event and act upon feedback ¾ Demonstrate the ability to communicate effectively ¾ Demonstrate the ability to teach on various topic(s) using appropriate teaching resources ¾ Participate in the organisation of a programme of postgraduate education.

rcog.net: The Obstetrician and Gynaecologist as a Professional.JMedit/16-11-2006 Appraisal: Knowledge criteria ¾ Understand the difference between appraisal and assessment ¾ Understand the importance of appraisal and the qualities of a good appraiser ¾ Know the principles of appraisal and the structure of the appraisal interview ¾ Understand the principles of mentoring Clinical competency ¾ Perform effective appraisal ¾ Assess objectivity in appraisal and use of methodical.uk) Training support ¾ StratOG. Appraisal. Assessment e-tutorial ¾ Local educational session ¾ Appraisal and assessment ¾ Equal opportunity training Evidence/assessment ¾ Logbook ¾ Reflective diary Assessment . Mentoring and Reflective practice e-tutorials ¾ StratOG. structured approach Professional skills and attitudes ¾ Acknowledge and respect cultural diversity ¾ Demonstrate the ability to deal with conflict ¾ Have the ability to deal with a trainee in difficulty and the difficult trainee ¾ Be prepared to act as a mentor (for RCOG definition see www.org.net: The Obstetrician and Gynaecologist as a Teacher and Researcher.

JMedit/16-11-2006 Knowledge criteria ¾ Understand the difference between assessment and appraisal ¾ Understand the reasons for assessment ¾ Know different assessment methods and when to use them appropriately ¾ Be aware of the differences between formative and summative assessment Clinical competency ¾ Perform appropriate assessments ¾ Use appropriate assessment methods Professional skills and attitudes ¾ Have the ability to assess performance honestly and objectively ¾ Acquire the necessary skills to give constructive and effective feedback Training support ¾ Training the Trainers Course ¾ Local educational session ¾ StratOG.net: The Obstetrician and Gynaecologist as a Teacher and Researcher. Assessment e-tutorial Evidence/assessment ¾ Logbook ¾ Reflective diary MODULE 2 TOPIC: Teaching. appraisal and assessment Competence level: Basic training Intermediate training Advanced training Independent practice Date Signature Skill Date D Teaching Small group teaching Large group teaching Formal lecture One-to-one teaching at the bedside Teaching practical procedures Organisation of teaching Observation Signature Direct supervision Date Signature .

JMedit/16-11-2006 Appraisal Perform effective appraisal Assessment Perform appropriate assessments Training courses or sessions Title Appraisal and assessment Presentation skills Teaching skills Signature of educational supervisor Date .

JMedit/16-11-2006 Authorisation of signatures – please print your name and sign Name (please print) Signature Completion of Module 2 I confirm that all components of the module have been successfully completed: Date Name of Educational Superviser Signature of Educational Superviser .

meaning and implementation of clinical standards and governance. Use of information technology: Knowledge criteria ¾ Understand the principles of storage. retrieval. skills and attitudes in the use and management of health information. Data handling.JMedit/16-11-2006 Curriculum Module 3: Information Technology. Research and Assessing evidence e-tutorials Evidence/assessment . To know and understand the audit cycle and to have knowledge of research methodology. To have an understanding of the context. and healthrelated databases ¾ Present data in an understandable manner Professional skills and attitudes ¾ Demonstrate the ability to apply IT solutions in the management of patients ¾ Adopt a proactive and enquiring attitude to new technology Training support ¾ IT courses ¾ StratOG. Clinical Governance and Research Learning outcomes: • • • To understand and demonstrate appropriate knowledge. word processing techniques. statistics programmes and electronic mail ¾ Undertake searches and access web sites.net: The Obstetrician and Gynaecologist as a Teacher and Researcher. analysis and presentation of data ¾ Understand the effective use of computing systems ¾ Understand the range of uses of clinical data and its effective interpretation ¾ Be aware of the confidentiality issues Clinical competency ¾ Retrieve and use data recorded in clinical systems ¾ Demonstrate appropriate use of IT for patient care and for personal development ¾ Demonstrate competent use of databases.

JMedit/16-11-2006 Clinical governance: audit: Knowledge criteria ¾ Understand the audit cycle ¾ Understand clinical effectiveness: • • • Principles of evidencebased practice Types of clinical trial and evidence classification Grades of recommendation Clinical competency ¾ Perform an audit exercise: • • • • Define standard Prepare project Collate data Formulate policy Professional skills and attitudes ¾ Show how the use of audit can improve clinical practice Training support ¾ Understanding Audit (RCOG. perform clinical audit: • • • • Define standard based on evidence Prepare project and collate data Re-audit and close audit loop Formulate policy ¾ Understand guidelines and integrated care pathways: • Formulation • Advantages and disadvantages ¾ Develop and implement a clinical guideline: • • • • Purpose and scope Identify and classify evidence Formulate recommendations Identify auditable standards .net: The Obstetrician and Gynaecologist as a Professional. Clinical governance e-tutorial Evidence/assessment ¾ Presentation at audit meeting ¾ Logbook ¾ Reflective diary ¾ Part 2 MRCOG ¾ RITA ¾ Repeat audit cycle. October 2003) ¾ Principles for best practice in audit (NICE) ¾ Ability to perform a clinical audit ¾ Ability to develop and implement a clinical guideline ¾ StratOG.

integrated care pathways and protocols ¾ Understand the organisational framework for clinical governance at local. NSF. and use them appropriately Training support ¾ Searching for Evidence (RCOG.g. SHA and national levels ¾ Understand standards.JMedit/16-11-2006 Clinical governance: clinical standards: Knowledge criteria ¾ Understand the definitions and relevance of levels of evidence ¾ Understand the development and application of clinical guidelines. October 2001) ¾ Ability to practice evidencebased medicine ¾ StratOG. NICE. Clinical governance e-tutorial Evidence/assessment ¾ Logbook ¾ Reflective diary ¾ MRCOG Part 2 ¾ Presentation to colleagues ¾ RITA .net: The Obstetrician and Gynaecologist as a Professional. e. RCOG guideline Clinical competency ¾ Review evidence ¾ Evaluate guidelines ¾ Prepare a protocol ¾ Critically appraise publications and evaluate multicentre trials ¾ Critically evaluate a care pathway Professional skills and attitudes ¾ Have the skills to be able to discuss the relevance of evidence in the clinical situation ¾ Acknowledge and show regard for individual patient needs when using guidelines ¾ Be aware of advantages and disadvantages of guidelines and protocols.

relatives and colleagues ¾ Demonstrate the ability to act constructively when a complaint is made Training support ¾ Clinical Risk Management for Obstetricians and Gynaecologists (RCOG.clinicalgovernance.JMedit/16-11-2006 Clinical governance: risk management: Knowledge criteria ¾ Know the principles of risk management and their relationship to clinical governance ¾ Understand complaints procedures and risk management: • • • incidents/near miss reporting complaints management litigation and claims management Clinical competency ¾ Report and review critical incidents ¾ Discuss risks with patients ¾ Document adverse incidents ¾ Prepare a report relating to an adverse incident ¾ Participate in risk management ¾ Investigate a critical incident: • • • Assess risk Formulate recommendations Debrief staff Professional skills and attitudes ¾ Demonstrate respect and accept patients’ views and choices ¾ Display eagerness to use evidence in support of patient care when evaluating risk ¾ Show probity by being truthful and be able to admit error to patients.com ¾ StratOG. Clinical governance e-tutorial Evidence/assessment ¾ Logbook ¾ Reflective diary ¾ MRCOG Part 2 ¾ Presentation at risk management meetings ¾ Patient/user involvement .net: The Obstetrician and Gynaecologist as a Professional. January 2001) ¾ GMC: Good Medical Practice ¾ Clinical Governance Bulletin series (DH funded) www.

net: The Obstetrician and Gynaecologist as a Teacher and Researcher etutorials ¾ Introduction to Research Methodology. 2006) Evidence/assessment ¾ Logbook ¾ Reflective diary ¾ MRCOG Part 2 ¾ Presentations at journal club meetings ¾ Publications ¾ RITA Patient Public Involvement Knowledge criteria ¾ Understand the principles of Patient Public Involvement Clinical competency ¾ Undertake a project on Patient Public Involvement Professional skills and attitudes ¾ Practice patient-centred care at all times ¾ Involve patient and carers in decision making ¾ Demonstrate skill in information giving Training support ¾ Local courses ¾ Evidence/assessment ¾ Observation of clinical practice .JMedit/16-11-2006 Research: Knowledge criteria ¾ Understand the difference between audit and research ¾ Understand how to plan and analyse a research project ¾ Understand statistical methods ¾ Know the principles of research ethics and conflicts of interest Clinical competency ¾ Appraise a scientific paper ¾ Evaluate a multicentre trial ¾ Understand the principles of critical reading and undertake critical review of scientific literature Professional skills and attitudes ¾ Have the ability to be receptive to innovations resulting from research publications ¾ Acquire skills to put research findings into practice ¾ Be aware of the issues underlying plagiarism and how this relates to the duties of a doctor Training support ¾ GMC Duties of a Doctor (www. 2nd edition (RCOG Press.org) ¾ Local and RCOG courses ¾ StratOG.gmc-uk.

JMedit/16-11-2006 MODULE 3 TOPIC: Information technology. clinical governance and research Competence Level: Basic Training Skill Observation Date Audit Perform an audit Clinical governance Prepare or revise a guideline or care pathway Deal effectively with complaint Appraisal Participate in NHS appraisal Risk management Present at risk management meeting Research Critically appraise a scientific paper Signature Direct supervision Date Signature Independent practice Date Signature Intermediate Training Advanced Training .

JMedit/16-11-2006 Authorisation of signatures – please print your name and sign Name (please print) Signature Completion of Module 3 I confirm that all components of the module have been successfully completed Date Name of Educational Superviser Signature of Educational Superviser .

uk) ¾ Obtaining Valid Consent (RCOG.org.JMedit/16-11-2006 Consent: Knowledge criteria ¾ Understand the principles and legal issues surrounding informed consent ¾ Understand specific legal issues about consent in under 16-year-olds and vulnerable adults ¾ Understand the implications of the Sexual Offences Act 2003 ¾ Be aware of diversity ¾ Be aware of the implications of the legal status of the unborn child ¾ Understand appropriateness of consent to postmortem examination Clinical competency ¾ Use written material correctly and accurately ¾ Gain valid consent from patients and know when to ask for a second opinion ¾ Discuss clinical risk ¾ Know when to involve social services and police and how to do so Professional skills and attitudes ¾ Demonstrate the ability to give appropriate information in a manner that patients and relatives understand and assess their comprehension ¾ Show an awareness of the patient’s needs as an individual ¾ Respect diversity Training support ¾ StratOG.net: The Obstetrician and Gynaecologist as a Professional.uk/justi ce/sentencing/sexualoffencesb ill Evidence/assessment . 1: Law and Ethics in Relation to Court-authorised Obstetric Intervention (RCOG. October 2004) ¾ RCOG Consent Advice Series (www.dh. Ethical and legal issues e-tutorial ¾ Informed consent and minimum standards of communication ¾ DH guidance on consent (www.rcog.gov.gov. October 2006) ¾ www.uk) ¾ RCOG Ethics Guideline No.homeoffice.

1997) ¾ GMC Good Medical Practice ¾ StratOG.net: The Obstetrician and Gynaecologist as a Professional. Ethical and legal issues e-tutorial Evidence/assessment ¾ .JMedit/16-11-2006 Confidentiality: Knowledge criteria ¾ Be aware of relevant strategies to ensure confidentiality ¾ Be aware when confidentiality might be broken ¾ Understand the principles of data protection including electronic and administrative systems ¾ Understand the role of interpreters and patient advocates Clinical competency ¾ Use and share information appropriately Professional skills and attitudes ¾ Respect the right to confidentiality ¾ Be aware of the requirements of children. adolescents and patients with special needs Training support ¾ Confidentiality and Disclosure of Health Information: RCOG Ethics Committee comments on BMA document October 2000 ¾ Caldicott Committee Report on the Review of Patient Identifiable Information (DH.

birth.net: The Obstetrician and Gynaecologist as a Professional. sickness and death certificates ¾ Understand abortion certificates HSA 1 and HSA 4 and be aware of exemptions for those who will not participate in abortion services for moral or religious reasons ¾ Know the types of deaths that should be referred to the Coroner/Procurator Fiscal ¾ Understand the principles of advance directives and living wills ¾ Be aware of the indications for section under the Mental Health Act Clinical competency ¾ Complete relevant medical certification Professional skills and attitudes ¾ Have the ability to know how to obtain suitable evidence and whom to consult ¾ Act with compassion at all times Training support ¾ Local courses ¾ Registration of Stillbirths and Certification for Pregnancy Loss before 24 Weeks of Gestation (RCOG. Ethical and legal issues Evidence/assessment .JMedit/16-11-2006 Legal issues relating to medical certification: Knowledge criteria ¾ Know the legal responsibilities of completing maternity. January 2005) ¾ StratOG.

there is no expectation that they will start to obtain consent until after completion of core training. While trainees may observe obtaining consent for a postmortem examination after a maternal death or a death of a gynaecological patient. Signature Intermediate Training Advanced Training Independent Practice Dates Signature Direct Supervision Dates Signature .JMedit/16-11-2006 MODULE 4 TOPIC: Ethics and legal issues Competence level: Basic Training Observation Date Consent: Obtain valid consent* Ability to discuss clinical risk Consent for neonatal post mortem examination Legal: Attend CNST meeting or equivalent for Scotland and Wales *Trainees may only obtain consent for those procedures with which they are familiar and performing either under direct supervision of independently.

JMedit/16-11-2006 Authorisation of signatures – please print your name and sign below Name (please print) Signature *Trainees may only obtain consent for those procedures with which they are familiar and performing either under direct supervision of independently. While trainees may observe obtaining consent for a post mortem after a maternal death or a death of a gynaecological patient there is no expectation that they will start to obtain consent until after completion of core training Completion of Module 4 I confirm that all components of the module have been successfully completed: Date Name of Educational Superviser Signature of Educational Superviser .

including consent of children. likely pathology and anticipated prognosis ¾ Have an awareness of the need to meet national targets ¾ Develop the ability to work under pressure and recognise own limitations ¾ Show the need to appreciate and recognise that decision making is a collaborative process between doctor and patient Training support ¾ Basic Surgical Skills Course ¾ Obtaining Valid Consent (RCOG. water. electrolyte and acid base balance and cell biology ¾ Appropriate use of blood and blood products ¾ General pathological principles .JMedit/16-11-2006 Curriculum Module 5: Core Surgical Skills Learning outcomes: • To understand and demonstrate appropriate knowledge. October 2004) ¾ RCOG Consent Advice series ¾ DH website ¾ Local courses ¾ StratOG. during and after surgery ¾ Demonstrate the ability to select the operative procedure with due regard to degree of urgency.net: The Obstetrician and Gynaecologist as a Professional. before. including an understanding of the principles of infection control ¾ Principles of nutrition. skills and attitudes in relation to basic surgical skills. adults with incapacity and adults and children in emergency situations ¾ Name and mode of use of common surgical instruments and sutures ¾ Complications of surgery ¾ Regional anatomy and histology ¾ Commonly encountered infections. Ethical and legal issues Evidence/assessment ¾ Logbook ¾ Audit project ¾ MRCOG Parts 1 and 2 ¾ OSATS: opening and closing abdomen Knowledge criteria ¾ Legal issues around consent to surgical procedures. Clinical competency ¾ Interpret preoperative investigations ¾ Arrange preoperative management ¾ Recognise potential comorbidity ¾ Obtain valid consent ¾ Explain procedures to patient ¾ Advise patient on postoperative course ¾ Within agreed level of competency for the procedure you may: • • • • • Choose appropriate operation Exhibit technical competence Make intraoperative decisions Manage intraoperative problems Communicate with colleagues and relatives Professional skills and attitudes ¾ Recognise the need for and initiate collaboration with other disciplines.

JMedit/16-11-2006 Appendix to Curriculum Module 5: Details of Knowledge Criteria ¾ Legal issues around consent to surgical procedures. therapeutic intervention (especially by the use of irradiation. fungi. urinary tract. Rickettsia. ¾ General pathological principles. conscious sedation. ¾ Knowledge and awareness of anaesthesia: general anaesthetic. infection. nerve supply and histology. ¾ Relevant bones. ¾ Knowledge and awareness of use in complications of diathermy and other energy sources. viruses. protozoa. muscles. ¾ Relevant clinical anatomy. ¾ Prevention and complications of surgery including: • • • venous thromboembolism infection (wound. parasites and toxins. tissue and cellular responses to trauma. recognition. regional and local. disturbances in blood flow. ¾ Characteristics. ¾ Knowledge of sutures and their appropriate use. including general. water. including an understanding of the principles of infection control. blood vessels. lymphatics. including consent of minors (and Fraser competency). . hyperplasia and neoplasia. cytotoxic drugs and hormones). joints. prevention. intra-abdominal and pelvic) primary and secondary haemorrhage (intraoperative and postoperative). ¾ Principles of nutrition. ¾ Name and mode of use of common surgical instruments. eradication and pathological effects of all commonly encountered bacteria. inflammation. electrolyte and acid base balance and cell biology. respiratory. loss of body fluids. adults with incapacity and adults and children in emergency situations.

JMedit/16-11-2006 MODULE 5 TOPIC: Core Surgical Skills Competence level: Basic Training Skills Observation Dates Interpret preoperative investigations Arrange preoperative management Obtain informed consent Choose appropriate operation Open and close the abdomen Exhibit technical competence Make appropriate operative decisions Manage intraoperative problems Signature Direct supervision Dates Signature Dates Independent practice Signature Intermediate Training Advanced Training .

JMedit/16-11-2006 Training Courses or sessions Title Obtaining consent Basic Surgical Skills (RCOG approved) Signature of educational supervisor Date Authorisation of signatures – please print your name and sign Name (please print) Signature .

JMedit/16-11-2006 OSAT Opening and closing the abdomen Each OSAT should be successfully completed for Independent Practice on 5 occasions before the module can be signed off Date Signat ure Date Signature Date Signature Date Signature Date Signature Completion of Module 5 I confirm that all components of the module have been satisfactorily completed: Date Signature of Educational Superviser Name of Educational Superviser .

instruments and technique Ensure haemostasis of peritoneum and posterior surface of rectus sheath Secure closure of rectus sheath using appropriate suture material. position) with safe use of surgical knife Subcutaneous fascia opened with attention to haemostasis Rectus sheath incised either side of linea alba. length.g. extended with scissors and dissected off rectus muscle with attention to haemostasis Safe entry of peritoneal cavity by either sharp or blunt dissection Item under observation: closing Identification of peritoneal edge and closure (optional) using appropriate suture material.JMedit/16-11-2006 OPENING AND CLOSING THE ABDOMEN Trainee Name: Assessor Name: Post: Date: Level of training: Grade/Year Clinical details of complexity/ difficulty of case Performed Needs independently help PLEASE TICK RELEVANT BOX Item under observation: opening Appropriate preoperative preparation: bladder empty. prepare and drape abdomen Appropriate skin incision (e. no inappropriate movements Comments (please state skin closure method) Examples of minimum levels of complexity for each stage of training: ST1 Intermediate Training CCT Patient with no previous lower transverse incision Patient with previous lower transverse incision but without suspicion of severe abdominal adhesions Patient with previous abdominal surgery and likely severe abdominal adhesions Both sides of this form to be completed and signed . no touch technique. instruments and technique (trainees should demonstrate competence in the full range of closure methods) Appropriate and safe use of needle holder: needle loaded correctly. instruments and technique for knot tying and placement of sutures Ensure haemostasis before skin closure Accurate skin closure using appropriate method.

Obviously planned course of operation with effortless flow from one move to the next. Knotting and suturing usually reliable but sometimes awkward. Competent use of instruments but occasionally awkward or tentative. Strategically used assistants to the best advantage at all times. Documentation of procedures Please complete the relevant box Needs further help with: * * Date Signed (trainer) Signed (trainee) Competent to perform the entire procedure without the need for supervision Date Signed Signed . Consistently placed sutures accurately with appropriate and secure knots and with proper attention to safety. Obvious familiarity with instruments. Limited documentation. Time. Careful handling of tissue but occasionally causes inadvertent damage. Communicated poorly or frequently showed lack of awareness of the needs of the patient and/or the professional team. Lack of knowledge of instruments. Appropriate use of assistant most of the time. indicating findings.JMedit/16-11-2006 GENERIC TECHNICAL SKILLS ASSESSMENT Assessor. please ring the candidate’s performance for each of the following factors: Respect for tissue Frequently used unnecessary force on tissue or caused damage by inappropriate use of instruments. Economy of movement and maximum efficiency. Consistently placed assistants poorly or failed to use assistants. Comprehensive legible documentation. Fully understands areas of weakness. Placed sutures inaccurately or tied knots insecurely and lacked attention to safety. Adequate documentation but with some omissions or areas that need elaborating. Insight/attitude Some understanding of areas of weakness. Reasonable communication and awareness of the needs of the patient and/or of the professional team. Poor understanding of areas of weakness. motion and flow of operation and forward planning Knowledge and handling of instruments Suturing and knotting skills as appropriate for the procedure Technical use of assistants Relations with patient and the surgical team Makes reasonable progress but some unnecessary moves. Sound knowledge of operation but slightly disjointed at times. Consistently communicated and acted with awareness of the needs of the patient and/or of the professional team. Consistently handled tissues appropriately with minimal damage. poorly written. Many unnecessary moves. Frequently stopped operating or needed to discuss next move. procedure and postoperative management.

JMedit/16-11-2006 Curriculum Module 6: Postoperative Care Learning outcomes: • To understand and demonstrate appropriate knowledge. Clinical competency ¾ Make appropriate postoperative plans for management. gynaecological and nongynaecological procedures ¾ Fluid/electrolyte balance ¾ Wound healing ¾ Late postoperative complications. bladder or ureteric injury ¾ Offer psychological support for patients and relatives ¾ Initiate management for secondary haemorrhage . e. including secondary haemorrhage ¾ Manage complications. skills and attitudes in relation to postoperative care. thromboembolism and infection ¾ Deal competently with the unexpected complications. including wound. including investigation ¾ Conduct appropriate review of: • • • • fluid/electrolyte balance catheter surgical drainage sutures Professional skills and attitudes ¾ Recognise the need and initiate collaboration with other disciplines ¾ Demonstrate the need for effective communication with other healthcare professionals ¾ Demonstrate the need for effective communication with patients and relatives ¾ Document the surgical procedure with appropriate notes ¾ Construct an appropriate discharge letter ¾ Recognise personal limitation and the need for appropriate referral Training support ¾ Basic Surgical Skills course (RCOG approved) ¾ RCOG guidelines on thromboembolism ¾ StratOG.net: Surgical Procedures and Postoperative Care e-tutorials Evidence/assessment ¾ Morbidity and Mortality meetings attended ¾ Audit project ¾ MRCOG Part 2 ¾ Reflective diary Knowledge criteria ¾ General pathological principles of postoperative care ¾ Postoperative complications related to obstetric.g.

JMedit/16-11-2006 MODULE 6 TOPIC: Postoperative care Competence level: Basic Training Skill Observation Date Conduct appropriate review of: Fluid/electrolyte balance Catheter Surgical drainage Sutures Wound complications Communicate: With colleagues With relatives Explain procedure to patient Advise on postoperative progress Manage postoperative complications. collaborating with others where appropriate: Gynaecological Non-gynaecological Signature Intermediate Training Advanced Training Independent Practice Date Signature Direct Supervision Date Signature .

JMedit/16-11-2006 Late complications Training courses or sessions Title Signature of educational supervisor Date Authorisation of signatures – please print your name and sign Name (please print) Signature Completion of Module 6 I confirm that all components of the module have been satisfactorily completed: Date Signature of Educational Superviser Name of Educational Superviser .

uk www. sutures.nice.org.rcog. Clinical competency ¾ Marsupialisation of Bartholin’s abscess ¾ Evacuation of uterus ¾ Diagnostic laparoscopy ¾ Sterilisation ¾ Polypectomy ¾ First-trimester surgical termination (unless conscientious objection) ¾ Diagnostic hysteroscopy ¾ Minor cervical procedures ¾ Excision of vulval lesions ¾ Laparotomy for ectopic pregnancy ¾ Ovarian cystectomy for benign disease ¾ Elective perineal adhesiolysis ¾ Myomectomy Professional skills and attitudes ¾ Have the knowledge to choose appropriate instruments.org.ac.net: Surgical Procedures and Postoperative Care e-tutorials . drains and catheters ¾ Know own limitations and when to seek help ¾ Demonstrate the use of diathermy. skills and attitudes in relation to surgical procedures. endoscopic and other equipment safely and efficiently ¾ Show evidence of thinking ahead during procedure ¾ Have the ability to alter the surgical procedure appropriately when necessary following consultation ¾ Demonstrate the ability to work effectively with other members of the theatre team. assisting and discussion with senior medical staff ¾ Useful websites: • • • www.JMedit/16-11-2006 Curriculum Module 7: Surgical Procedures Learning outcomes: • To understand and demonstrate appropriate knowledge.sign.uk www. taking a leadership role where appropriate ¾ ¾ Training support ¾ Observation of.uk Evidence/assessment ¾ OSATS Diagnostic laparoscopy ¾ OSATS Operative laparoscopy ¾ Successful Patient Outcomes ¾ Logbook ¾ Reflective diary ¾ RITA ¾ OSATS Diagnostic Hysteroscopy Knowledge criteria ¾ Relevant basic sciences ¾ Knowledge of instruments and sutures ¾ StratOG.

JMedit/16-11-2006 MODULE 7 TOPIC: Surgical procedures Competence level: Basic Training Skills Observation Date Signature Evacuation of uterus Marsupialisation of Bartholin’s cyst Laparotomy for ectopic pregnancy Laparoscopy management ectopic pregnancy Excision of vulval lesions Abdominal hysterectomy ± bilateral salpingooophorectomy Oophorectomy Ovarian cystectomy Adhesiolysis Transabdominal myomectomy Diagnostic laparoscopy Management of pelvic abscess Laparoscopic sterilisation Diagnostic hysteroscopy Intermediate Training Advanced Training Independent Practice Dates Signature Direct Supervision Date Signature s .

JMedit/16-11-2006 Hysteroscopy and polypectomy Minor cervical procedures Elective perineal operations Training courses or sessions Title Surgical Skills course (RCOG approved) Signature of educational supervisor Date Authorisation of signatures – please print your name and sign Name (please print) Signature .

JMedit/16-11-2006 OSAT Diagnostic laparoscopy Each OSAT should be successfully completed for Independent Practice on 5 occasions before the module can be signed off Date Signature Operative laparoscopy Date Signature Diagnostic Date hysteroscopy Signature Date Signature Date Signature Date Signature Date Signature Date Signature Date Signature Date Signature Date Signature Date Signature Date Signature Date Signature Date Signature Completion of Module 7 I confirm that all components of the module have been satisfactorily completed Date Signature of Educational Superviser Name of Educational Superviser .

JMedit/16-11-2006 DIAGNOSTIC LAPAROSCOPY Trainee Name: Level of training: Preparation of the patient Assessor Name: Post: Date: Performed independently Needs help Not applicable PLEASE TICK RELEVANT BOX Ensures correct positioning of the patient Checked or observed catheterisation. pelvic examination and insertion of uterine manipulator where appropriate Establishing pneumoperitoneum Demonstrates knowledge of instruments and can trouble shoot problems Check patency and function of Veress (if used) Correct incision Controlled insertion of Veress (if used) Insufflation to at least 20 mmHg Controlled insertion of primary port Controlled insertion of secondary port under direct vision Operative procedure Maintains correct position of optics Clear inspection of pelvic and abdominal structures Movements: fluid and atraumatic Appropriate use of assistants (if applicable) Correct interpretation of operative findings Removal of ports under direct vision Deflation of pneumoperitoneum Appropriate skin closure Both sides of this form to be completed and signed .

motion and flow of operation and forward planning Knowledge and handling of instruments Makes reasonable progress but some unnecessary moves. Consistently communicated and acted with awareness of the needs of the patient and/or of the professional team. Obviously planned course of operation with effortless flow from one move to the next. Lack of knowledge of instruments. Appropriate use of assistant most of the time. Fully understands areas of weakness Comprehensive legible documentation. Strategically used assistants to the best advantage at all times. Date Signed (trainer) Signed (trainee) . indicating findings. Communicated poorly or frequently showed lack of awareness of the needs of the patient and/or the professional team. procedure and postoperative management. Suturing and knotting skills as Placed sutures inaccurately or appropriate for tied knots insecurely and the procedure lacked attention to safety. Adequate documentation but with some omissions or areas that need elaborating. Sound knowledge of operation but slightly disjointed at times. Many unnecessary moves. Consistently placed assistants poorly or failed to use assistants. Knotting and suturing usually reliable but sometimes awkward. Documentation of procedures Limited documentation. poorly written. Poor understanding of areas of weakness. Consistently handled tissues appropriately with minimal damage. Time. Obvious familiarity with instruments. Careful handling of tissue but occasionally causes inadvertent damage.JMedit/16-11-2006 GENERIC TECHNICAL SKILLS ASSESSMENT Assessor. Economy of movement and maximum efficiency. Frequently stopped operating or needed to discuss next move. Please complete the relevant box Needs further help with: * * Date Signed (trainer) Signed (trainee) Competent to perform the entire procedure without the need for supervision. Technical use of assistants Relations with patient and the surgical team Consistently placed sutures accurately with appropriate and secure knots and with proper attention to safety. Insight/attitude Some understanding of areas of weakness. please ring the candidate’s performance for each of the following factors: Respect for tissue Frequently used unnecessary force on tissue or caused damage by inappropriate use of instruments. Reasonable communication and awareness of the needs of the patient and/or of the professional team. Competent use of instruments but occasionally awkward or tentative.

catheterisation and insertion of uterine manipulator Patient habitus Laparoscopic entry: Safe use of Veress needle (if used) Safe insertion primary port Appropriate position of and safe insertion of secondary ports Operative procedure: Maintains good view of operative field Uses appropriate instruments for the task Knowledge and safe use of energy modalities in laparoscopic surgery Identifies important anatomical structures (ureter.JMedit/16-11-2006 OPERATIVE LAPAROSCOPY Trainee name: Level of training: Grade/Year Assessor Name: Post: Date: Clinical details of complexity/difficulty of case Performed independently Needs help Not applicable PLEASE TICK RELEVANT BOX Preparation of the patient: Ensures correct positioning of the patient. internal iliac artery/vein) Shows efficiency of movement and demonstrates good three dimensional spatial awareness Appropriate use of assistants (if applicable) Examples of minimum levels of complexity for each stage of training: ST1 Laparoscopic clip sterilisation Core Training Bipolar diathermy to endometriosis Aspiration of fluid form pouch of Douglas Aspiration of ovarian cyst Ectopic pregnancy CCT Salpingectomy Oophrectomy Both sides of this form to be completed and signed .

Appropriate use of assistant most of the time. Insight/attitude Some understanding of areas of weakness. Strategically used assistants to the best advantage at all times. motion and flow of operation and forward planning Made reasonable progress but some unnecessary moves. Knowledge and handling of instruments Suturing and knotting skills as appropriate for the procedure Technical use of assistants Relations with patient and the surgical team Lack of knowledge of instruments. Time. Consistently handled tissues appropriately with minimal damage. procedure and postoperative management. Reasonable communication and awareness of the needs of the patient and/or of the professional team. Adequate documentation but with some omissions or areas that need elaborating. Obvious familiarity with instruments. Documentation of procedures Limited documentation. Careful handling of tissue but occasionally caused inadvertent damage. Communicated poorly or frequently showed lack of awareness of the needs of the patient and/or the professional team. indicating findings. Poor understanding of areas of weakness. Sound knowledge of operation but slightly disjointed at times. Consistently placed assistants poorly or failed to us assistants. Placed sutures inaccurately or tied knots insecurely and lacked attention to safety. please ring the candidate’s performance for each of the following factors: Respect for tissue Frequently used unnecessary force on tissue or caused damage by inappropriate use of instruments. poorly written. Competent use of instruments but occasionally awkward or tentative. Many unnecessary moves. Consistently placed sutures accurately with appropriate and secure knots and with proper attention to safety. Fully understands areas of weakness Comprehensive legible documentation. Obviously planned course of operation with effortless flow from one move to the next. Please complete the relevant box Needs further help with: * * Date Competent to perform the entire procedure without the need for supervision Date Signed (trainer) Signed (trainer) Signed (trainee) Signed (trainee) .JMedit/16-11-2006 GENERIC TECHNICAL SKILLS ASSESSMENT Assessor. Economy of movement and maximum efficiency. Consistently communicated and acted with awareness of the needs of the patient and/or of the professional team. Knotting and suturing usually reliable but sometimes awkward. Frequently stopped operating or needed to discuss next move.

JMedit/16-11-2006 DIAGNOSTIC HYSTEROSCOPY Trainee name: Level of training: Assessor name: Post: Date: Performed independently Needs help Not applicable PLEASE TICK RELEVANT BOX Preparation of the patient: Supervises positioning of patient – correct as required Preps and drapes correctly Assembles equipment Chooses appropriate distension medium Demonstrates knowledge of equipment and can trouble shoot problems Operative procedure: Correct use of speculum and tenaculum Correct use of cervical dilators (if needed) Inserts hysteroscope into uterine cavity under direct vision Clear inspection of entire uterine cavity Correct interpretation of findings Correct technique to obtain endometrial biopsy if appropriate Careful removal of tenaculum Both sides of this form to be completed and signed .

Obvious familiarity with instruments. Placed sutures inaccurately or tied knots insecurely and lacked attention to safety. poorly written. Knowledge and handling of instruments Suturing and knotting skills as appropriate for the procedure Technical use of assistants Relations with patient and the surgical team Lack of knowledge of instruments.JMedit/16-11-2006 GENERIC TECHNICAL SKILLS ASSESSMENT Assessor. Appropriate use of assistant most of the time. Poor understanding of areas of weakness. please ring the candidate’s performance for each of the following factors: Respect for tissue Frequently used unnecessary force on tissue or caused damage by inappropriate use of instruments. indicating findings. procedure and postoperative management. Please complete the relevant box Needs further help with: * * Date Competent to perform the entire procedure without the need for supervision Date Signed (trainer) Signed (trainer) Signed (trainee) Signed (trainee) . Adequate documentation but with some omissions or areas that need elaborating. Consistently handled tissues appropriately with minimal damage. Frequently stopped operating or needed to discuss next move. Sound knowledge of operation but slightly disjointed at times. Strategically used assistants to the best advantage at all times. Economy of movement and maximum efficiency. Knotting and suturing usually reliable but sometimes awkward. Insight/attitude Some understanding of areas of weakness. Consistently communicated and acted with awareness of the needs of the patient and/or of the professional team. Careful handling of tissue but occasionally caused inadvertent damage. motion and flow of operation and forward planning Made reasonable progress but some unnecessary moves. Consistently placed assistants poorly or failed to us assistants. Competent use of instruments but occasionally awkward or tentative. Time. Consistently placed sutures accurately with appropriate and secure knots and with proper attention to safety. Reasonable communication and awareness of the needs of the patient and/or of the professional team. Many unnecessary moves. Obviously planned course of operation with effortless flow from one move to the next. Communicated poorly or frequently showed lack of awareness of the needs of the patient and/or the professional team. Limited documentation. Fully understands areas of weakness Comprehensive legible documentation.

including CTG interpretation courses ¾ Perinatal morbidity and mortality meetings ¾ Risk assessment meetings ¾ StratOG.show. K2) ¾ TO1/TO2 Knowledge criteria ¾ Preconception care ¾ Purposes and practice of antenatal care ¾ Recognition of domestic violence ¾ Problems of teenage pregnancy ¾ Awareness of drug and alcohol misuse ¾ Management of normal pregnancy. Clinical competency ¾ Undertake pregnant and nonpregnant abdominal examination ¾ Take obstetric history and make relevant referral in cases of domestic violence ¾ Conduct booking visit ¾ Conduct follow-up visits ¾ Arrange appropriate investigations ¾ Manage: • • • • • • • • • growth restriction mode of delivery after caesarean section multiple pregnancy antepartum haemorrhage malpresentation preterm prelabour rupture of the fetal membranes reduced fetal movements prolonged pregnancy drug and alcohol abuse in pregnancy Professional skills and attitudes ¾ Have the skills to liaise with midwives and other health professionals to optimise care of the woman ¾ Demonstrate the skills to empower and inform woman to make appropriate choices for herself and her family in pregnancy and childbirth ¾ Demonstrate an ability to explain correctly and place in context for the woman: • • detection rates and limitations of anomaly screening principles of screening for neural tube defects.g. Perinatal in PDF ¾ Case reports ¾ Audit project ¾ Certificate of completion of CTG training package (e. including HIV. with examples such as Tay-Sachs disease.rcog.ac. prevention. rubella. Down syndrome and haemoglobinopathies genetic disorders and their inheritance.uk www. diagnosis. complications of: • • • pregnancy-induced hypertension haemorrhage preterm prelabour • • .uk www.nice.scot. birth and puerperium ¾ Placental abnormalities and diseases ¾ Genetic modes of inheritance. aetiology.uk www.org. Training support ¾ Appropriate postgraduate educational courses. measles.g. chickenpox. delivery.sign. pathogenesis. cystic fibrosis and thalassaemia effects upon fetus and neonate of infections during pregnancy.uk/sp cerh Evidence/assessment ¾ MRCOG Part2 ¾ Logbook ¾ Local meetings attended.net: Antenatal Care e-tutorials ¾ Useful websites: • • • • www.JMedit/16-11-2006 Curriculum Module 8: Antenatal care Learning outcomes: • To understand and demonstrate appropriate knowledge.org. common genetic conditions and the diagnosis thereof ¾ Epidemiology. management. e.nhs. skills and attitudes in relation to antenatal care.

JMedit/16-11-2006 • • • • • • • rupture of membranes multiple pregnancy malpresentation fetal growth restriction: fetal haemolysis prolonged pregnancy congenital malformation social and cultural factors ¾ Observe: • • • • • • • • external cephalic version cervical cerclage cytomegalovirus. parvovirus and toxoplasmosis ¾ Show awareness of the need to identify and deal with domestic violence and have a working knowledge of child protection issues as they relate to the practice of obstetrics and gynaecology ¾ Counsel about: screening for Down syndrome genetic disease fetal abnormality haemolytic disease infection mode of delivery ¾ Immunology and immunological disorders affecting pregnancy ¾ ¾ Basic fetal and placental anatomy to define fetal orientation ¾ Assessment of liquor volume 35 .

abdomen ¾ Determine fetal lie and presentation ¾ Determine placental site ¾ Assess liquor volume by deepest pool Professional skills and attitudes ¾ Demonstrate the use of appropriate referral pathways and local protocols if abnormal ultrasound findings are suspected Training support ¾ Mandatory education and training sessions ¾ Theoretical accredited course (local or RCOG) ¾ Supervised structured clinical learning sessions ¾ Observation by attendance at sessions in an obstetric ultrasound department. including anomaly and fetal assessment scans Evidence/assessment ¾ Certificate of course attendance ¾ MRCOG Part 2 36 . if less than 14 weeks refer for transvaginal scanning to confirm absent fetal heart beat ¾ Perform a transabdominal scan after 14 weeks of gestation ¾ Identify features of the head. chest.JMedit/16-11-2006 Ultrasound: Knowledge criteria ¾ Role and use of ultrasound in antenatal care (refer to Module 16 for principles of ultrasound examination) Clinical competency ¾ Assess fetal wellbeing by interpretation of CTG and ultrasound ¾ Determine fetal viability by transabdominal ultrasound.

monitoring) ¾ Feeding ¾ Higher order multiple pregnancies (counselling. including lactation ¾ Neonate. including feeding Placental: ¾ Abnormalities (shape. timing. intrapartum. community care) . implantation) ¾ Chorioamnionitis ¾ Infarcation ¾ Chorioangioma ¾ Multiple pregnancy ¾ Intrauterine growth retardation ¾ Cord abnormalities ¾ Trophoblastic disease Immunology: ¾ Immunological pregnancy tests ¾ Rhesus and other isoimmunisation ¾ Autoimmune diseases Preterm prelabour rupture of membranes: ¾ Fetal pulmonary maturity ¾ Therapy (steroids. including delivery outside specialist unit ¾ Puerperium. size. antibiotics. management) ¾ Delivery (induction of labour. postnatal) ¾ Special procedures (prenatal diagnosis. mode) Haemorrhage: ¾ Placental abruption ¾ Placenta praevia ¾ Vasa praevia ¾ Placenta accreta ¾ Trauma Multiple pregnancy: ¾ Zygosity ¾ Impact of assisted reproduction techniques ¾ Placentation ¾ Diagnosis ¾ Management (antenatal. tocolytics) ¾ Infection (risks.JMedit/16-11-2006 Appendix to Curriculum Module 8: details of knowledge criteria Preconception care: ¾ Sources of detailed information accessed by patients ¾ Effect of pregnancy upon disease ¾ Effect of disease upon pregnancy ¾ Principles of inheritance of disease ¾ Teratogenesis ¾ Drugs and pregnancy Purposes and practice of antenatal care: ¾ Arrangements for and conduct of booking visit ¾ Arrangements for and conduct of follow-up visits ¾ Use of imaging techniques ¾ Screening for abnormality ¾ Health education ¾ Liaison between health professionals ¾ Recognition of domestic violence Physiology and management of normal: ¾ Pregnancy ¾ Childbirth.

variable lie) ¾ Diagnosis ¾ Management (antenatal. imaging. congenital malformations) ¾ Antenatal diagnosis (chromosomal defects. shoulder. placental. fetal) Diagnosis (clinical. referral) ¾ Delivery (timing. method) Prognosis (fetal. aetiology. surgical) . DNA translation.JMedit/16-11-2006 Malpresentation: ¾ Types (breech. principles of gene tracking) ¾ Counselling (history taking. neural tube defects. DNA blotting techniques. delivery. inborn errors of metabolism. delivery. renal. brow. prognosis with regard to the following: Pregnancy-induced hypertension: ¾ Definitions ¾ Aetiological theories ¾ Prophylaxis ¾ Assessment of severity ¾ Consultation ¾ Therapy ¾ Delivery (timing. antenatal intervention. intrapartum) ¾ Mode of delivery ¾ ¾ ¾ ¾ ¾ Fetal growth restriction: Aetiology (maternal. face. pathogenesis. gene amplification techniques. Turner syndrome. diagnosis. prevention. Patau syndrome. biochemical. pedigree analysis) ¾ Population screening (genetic disease. Klinefelter syndrome. neonatal care (medical. multiple Y) ¾ Translocation ¾ Miscarriage ¾ Molecular genetics (DNA transcription. triple X. management. other major structural abnormalities) ¾ Management: referral to specialist team. methods) Genetic: ¾ Modes of inheritance (Mendelian. haemorrhagic. method) ¾ Counselling Prolonged pregnancy: ¾ Risks ¾ Fetal monitoring ¾ Delivery (indications. neonatal) Epidemiology. fetal) Hypotensive disorders: ¾ Hypovolaemia ¾ Sepsis ¾ Neurogenic shock ¾ Cardiogenic shock ¾ Anaphylaxis ¾ Trauma ¾ Amniotic fluid embolism ¾ Thromboembolism ¾ Uterine inversion Fetal haemolysis: ¾ Relevant antigen–antibody systems ¾ Prevention ¾ Fetal pathology ¾ Diagnosis ¾ Assessment of severity ¾ Intrauterine transfusion (indications. Edward syndrome. neonatal investigation. genetic) Monitoring (ultrasound. cardiotocography) Delivery (timing. method) ¾ Complications (eclampsia. techniques. hepatic. multifactorial) ¾ Cytogenetics ¾ Phenotypes of common aneuploidies (Down syndrome. complications.

urinary tract obstruction) o genital (intersex. microcephaly. polycystic kidneys. viability. oligohydramnios) ¾ Management: diagnosis. place. method). consultation. factors interfering) ¾ Bereavement counselling 39 . oesophageal atresia.JMedit/16-11-2006 Congenital malformation: ¾ Screening ¾ Amniotic fluid volume (polyhydramnios. counselling ¾ Specific abnormalities: o head (anencephaly. hydranencephaly. encephalocele. duodenal atresia. genital tract abnormalities. diaphragmatic hernia. delivery (time. chondrodysplasia. hydrocephalus. intrauterine amputation) o heart (major defects. other defects) o lungs (pulmonary hypoplasia) o urinary (renal agenesis. ovarian cyst) o gastrointestinal (abdominal wall defects. phocomelia. holoprosencephaly) o skeleton (spina bifida. bowel obstruction) o other (cystic hygroma) ¾ Other fetal disorders: o non-haemolytic hydrops fetalis o tumours o pleural effusion o fetal bleeding Social and cultural factors: ¾ Effect upon pregnancy outcome ¾ Single parenthood ¾ Teenage motherhood ¾ Parent–baby relationships (factors promoting.

femur length. estimation of fetal weight) Localise the placenta in the third trimester: ¾ Find the placenta ¾ Describe its features: o texture o echolucent areas o chorionic plate o echogenicity ¾ Define its upper and lower borders ¾ Relate it to other features such as bladder and cervix 40 . gestational age. fetal growth) ¾ Biophysical profile ¾ Use of Doppler to assess blood flow (fetus. abdominal circumference. uterus) ¾ Indications and limitations of scanning in late pregnancy ¾ Ultrasound surveillance in twin pregnancy Techniques of fetal anomaly scanning and non-invasive fetal diagnosis: ¾ Use of nuchal translucency measurements to identify fetuses at high risk of Down syndrome ¾ Combination of ultrasound and other risk markers to create an individual risk profile for each woman Invasive procedures: ¾ Amniocentesis ¾ Chorionic villus sampling ¾ Placentesis ¾ Cordocentesis Identify fetal position and fetal heart in later pregnancy and to create a three-dimensional image of the fetus in the mind: ¾ Identify the fetus ¾ Determine the lie of the fetus ¾ Be familiar with maneuvers to identify position of fetal heart ¾ Identify fetal heart pulsations (use of transvaginal ultrasound at less than 14 weeks) ¾ Demonstrate fetal heart pulsations to mother Orientate ultrasound findings in the second and third trimesters and orientate the fetus correctly in the uterus: ¾ Determine lie and position of fetus ¾ Identify features of the head ¾ Identify features of the chest ¾ Identify features of the abdomen ¾ Locate best position to measure abdominal circumference ¾ Identify the spine ¾ Identify the limbs ¾ Perform basic fetal measurements (e.g. those of biparietal diameter. head circumference.JMedit/16-11-2006 Principles of ultrasound: ¾ Basic physics ¾ Safety ¾ Relationship between two dimensional screen image and three dimensional object Ultrasound assessment of fetal wellbeing: ¾ Fetal biometry (pregnancy dating.

JMedit/16-11-2006 MODULE 8 TOPIC: Antenatal care Competence level: Basic Training Intermediate Training Advanced Training Independent Practice Date Signature Skill Observation Date Conduct a booking visit Conduct a follow up visit Arrange appropriate investigations Assess fetal wellbeing by interpretation of: Maternal history CTG Ultrasound assessment Manage: Oligohydramnios/polyhydramnios Growth restriction Multiple pregnancy Malpresentation Reduced fetal movements Prolonged pregnancy Drug and alcohol problems in pregnancy Infections in pregnancy Signature Direct Supervision Date Signature .

chest. abdomen Transvaginal confirmation viability <14 weeks Third-trimester scanning: Viability Fetal presentation Assess liquor volume by deepest pool Placental localisation 42 .JMedit/16-11-2006 Preterm premature rupture of the membranes Antepartum haemorrhage External cephalic version Insertion of cervical cerclage Counsel about: Screening for Down syndrome Screening for other fetal abnormalities Haemolytic disease Mode of delivery after caesarean section Cervical cerclage Basic obstetric ultrasound: Identify features head.

JMedit/16-11-2006 Training courses or sessions Title CTG interpretation Basic obstetric ultrasound theoretical course Signature of educational supervisor Date Authorisation of signatures – please print your name and sign Name (please print) Signature Completion of Module 8 I confirm that all components of the module have been satisfactorily completed: Date Signature of Educational Superviser Name of Educational Superviser 43 .

clinical characteristics.ac.show. Clinical competency ¾ Diagnose.rcog. aetiology.net: Maternal Medicine e-tutorials ¾ Useful websites: • • • • • www.org.uk www. both clinical and nonclinical Training support ¾ Local and regional courses ¾ Attendance at medical disorders antenatal clinic ¾ StratOG.org. with direct supervision: • • • • • • • • • • • • • • • • pregnancy-induced hypertension thromboembolism impaired glucose tolerance insulin-dependent diabetes essential hypertension kidney disease liver disease maternal haemoglobinopathy coagulation disorders acute abdominal pain asthma inflammatory bowel disease intercurrent infection psychological disorders infectious disease epilepsy Professional skills and attitudes ¾ Have the ability to recognise the normal from the abnormal ¾ Develop the skills to competently formulate a list of differential diagnoses ¾ Have the skills to request the relevant investigations to support the differential diagnoses ¾ Competently demonstrate the skills to formulate a management plan ¾ Have the ability to implement a plan of management and modify if necessary ¾ Develop the skills to liaise effectively with colleagues in other disciplines. investigate and manage.sign. skills and attitudes in relation to maternal medicine. uk/spcerh www.bmfms. pathophysiology. prognostic features and management of: • • • • • • • • • • • • • • hypertension kidney disease heart disease liver disease circulatory disorders disorders of carbohydrate metabolism other endocrinopathies gastrointestinal disorders pulmonary diseases connective tissue diseases bone and joint disorders psychiatric disorders infectious diseases neurological diseases ¾ maternal complications due to pregnancy ¾ endocrinopathies 44 .uk www.nhs.JMedit/16-11-2006 Curriculum Module 9: Maternal Medicine Learning outcomes: • To understand and demonstrate appropriate knowledge.nice.uk Evidence/assessment ¾ Logbook ¾ Reflective diary ¾ MRCOG Part 2 ¾ Case reports ¾ Audit projects Knowledge criteria ¾ Understand the epidemiology.uk www.org.scot.

prognostic features and management of: Hypertension: ¾ Definitions ¾ Aetiological theories ¾ Organ involvement (mother. depression) ¾ Mood disorders ¾ Schizophrenia ¾ Reaction to pregnancy loss Gastrointestinal disorders: ¾ Nausea ¾ Vomiting ¾ Hyperemesis ¾ Gastric reflux ¾ Abdominal pain ¾ Appendicitis ¾ Inflammatory bowel disease Intestinal obstruction Heart disease: ¾ Congenital ¾ Rheumatic ¾ Ischaemic ¾ Cardiomyopathy ¾ Heart failure . clinical characteristics. fetus) ¾ Diagnosis ¾ Drug therapy Kidney disease: ¾ Urinary tract infection ¾ Pyelonephritis ¾ Glomerulonephritides ¾ Nephrotic syndrome ¾ Tubular necrosis ¾ Cortical necrosis ¾ Transplantation Pulmonary diseases: ¾ Asthma ¾ Infection ¾ Embolism ¾ Aspiration syndrome Neurological disorders: ¾ Epilepsy ¾ Cerebrovascular disease ¾ Multiple sclerosis ¾ Migraine ¾ Neuropathies ¾ Myasthenia gravis ¾ Paraplegia Bone and joint disorders: ¾ Backache ¾ Symphyseal separation ¾ Metabolic bone disease ¾ Neoplasms (benign and malignant): ¾ Genital tract ¾ Breast ¾ Other Psychiatric disorders: ¾ Manic depressive disorders ¾ Psychoneurosis ¾ Puerperal disorders (blues.JMedit/16-11-2006 Appendix to Curriculum Module 9: Details of Knowledge Criteria Understand the epidemiology. aetiology. pathophysiology.

influenza. fetal. wound infections. human immunodeficiency virus. antibiotics. chorioamnionitis. rubella. antibodies. oral hypoglycaemic agents and pregnancy) Other endocrinopathies: ¾ Thyroid (diagnosis. urinary tract infection. neonatal sepsis) Maternal complications due to pregnancy: ¾ Antepartum haemorrhage ¾ Amniotic fluid embolism ¾ Sheehan syndrome 46 . varicella. preterm labour. listeria. acute adrenal failure. chlamydia. diabetes insipidus) Infectious diseases: ¾ Investigation of pyrexia ¾ Serological tests ¾ Principles (prevention. immunization. haemorrhoids) Connective tissue diseases: ¾ Systemic lupus erythematosus ¾ Rheumatoid arthritis ¾ Immunosupressant drugs Disorders of carbohydrate metabolism: ¾ Diagnosis ¾ Type 1 and type 2 diabetes ¾ Hazards (maternal. congenital adrenal hyperplasia. haemophilus. cytomegalovirus. isolation) ¾ Therapy (prophylaxis. hepatitis A.JMedit/16-11-2006 Liver disease: ¾ Cholestasis ¾ Hepatitis ¾ Acute fatty degeneration Circulatory disorders: ¾ Anaemia ¾ Sickle cell disease ¾ Thalassaemias ¾ Coagulation defects ¾ Thrombocytopenias ¾ Thromboembolism ¾ Transfusion ¾ Replacement of blood constituents ¾ Varicose veins (legs. toxoplasma. assessment. gonococcus. herpes hominis. septic shock. hepatitis B. phaeochromacytoma) ¾ Pituitary (prolactinoma. other tropical infections and infestations) ¾ Fetus and neonate (streptococcus. neonatal) ¾ Ketoacidosis ¾ Diet ¾ Drugs (insulins. ureaplasma. vulva. parvovirus. malaria. antiviral agents) ¾ Maternal (preterm prelabour rupture of membranes. mycoplasma. syphilis. hypopituitarism. fetal hazards) ¾ Adrenal (Addison’s disease. puerperal sepsis. therapy. hepatitis C. mastitis. detection.

Hydronephrosis Renal disease – Reflux nephropathy Renal disease – Renal transplantation Acute renal failure (not PET) Cardiac disease-congenital heart disease Cardiac disease – Rheumatic heart disease Cardiac disease.Ischaemic heart disease Cardiac disease – Artificial heart valve . investigate and manage with appropriate consultation: Chronic hypertension Pre eclampsia with HELP Pre eclampsia with renal failure Pre eclampsia with severe liver disease Pre eclampsia with pulmonary oedema Pre eclampsia with eclampsia Renal disease .JMedit/16-11-2006 MODULE 9 TOPIC: Maternal medicine Competence level: Basic Training Skills Observation Date Signature Direct Supervision Date Signature Date Independent Practice Signature Intermediate Training Advanced Training Diagnose.

ARDS Respiratory disease .Asthma Respiratory disease – Cystic fibrosis Respiratory disease .JMedit/16-11-2006 Cardiac disease .Arrhythmia Cardiac disease – Perpartum cardiomyopathy Liver disease – Obstetric cholestasis Liver disease – Acute fatty liver of pregnancy Respiratory disease .Pneumothorax Gastrointestinal disease – Crohns disease Gastrointestinal disease – Ulcerative colitis Gastrointestinal disease – Irritable bowel disease Gastrointestinal disease – Reflex oesophagitis Gastrointestinal disease – Hyperemesis gravidarum Diabetes-impaired glucose tolerance Insulin-dependent diabetes no complications Insulin-dependent diabetes complications Hypothyrodism Hyperthyroidsm .

Epilepsy Neurological disease – Migrane Neurological disease – Multiple sclerosis Neurological disease – Previous CVA Neurological disease – Bell’s palsy Neurological disease – Carpel tunnel syndrome Systemic lupus erythematosis Rheumatoid arthritis APS no complications APS with complications Sickle cell disease & other haemoglobinopathies Haemophilia & von Willebrands disease ITP Previous DVT Thrombophilias .JMedit/16-11-2006 Microprolactinoma Adrenal disease Postpartum thyroiditis Neurological disease .

JMedit/16-11-2006 Acute DVT Non massive pulmonary embolism Psychiatric disorders .Anxiety Psychiatric disorders – Depression Psychiatric disorders – Bipolar affective disorder Psychiatrid disorders – schizophrenia Psychiatric disorders – postnatal depression Substance abuse – Alcohol Substance abuse Skin disease – Eczema Skin disease .Psoriasis Skin disease – Polymorphic eruption of pregnancy Skin disease – Pemphigoid gestations Breast cancer HIV Authorisation of signatures – please print your name and sign Name (please print) Signature .

JMedit/16-11-2006 Completion of Module 9 I confirm that all components of the module have been satisfactorily completed: Date Signature of Educational Superviser Name of Educational Superviser .

skills and attitudes in relation to labour.org. clinical and nonclinical ¾ Demonstrate the ability to deal sensitively with the issues regarding intrauterine fetal death ¾ Recognise personal limitations and the need to refer appropriately Training support ¾ CTG training ¾ Eclampsia drill ¾ Drill for obstetric collapse ¾ Communication in an emergency ¾ ‘Breaking bad news’ study session ¾ Perinatal mortality and morbidity meetings ¾ StratOG.rcog. Clinical competency ¾ Manage: • • • • • • in-utero transfer intrauterine fetal death women who decline blood products obstetric haemorrhage severe pre-eclampsia obstetric collapse Professional skills and attitudes ¾ Demonstrate the appropriate use of protocols and guidelines ¾ Demonstrate the ability to prioritise cases and have the skills to supervise the workload on a labour ward ¾ Respect cultural and religious differences in attitudes to childbirth ¾ Practice effective liaison with colleagues in other disciplines.uk www.scot.JMedit/16-11-2006 Curriculum Module 10: Management of Labour Learning outcomes: • To understand and demonstrate appropriate knowledge.ac.net: Management of Labour and Delivery etutorials ¾ Disposal of fetal parts ¾ Disposal Following Pregnancy Loss Before 24 Weeks of Gestation (RCOG.org.nhs. analgesia and sedation ¾ Fetal wellbeing and compromise ¾ Prolonged labour ¾ Emergency policies/maternal collapse/haemorrhage ¾ Preterm labour/premature rupture of membranes ¾ Cervical cerclage ¾ Multiple pregnancy in labour ¾ Severe pre-eclampsia and eclampsia ¾ Intrauterine fetal death. including legal issues ¾ Prioritise labour ward problems ¾ Evaluate clinical risk ¾ Liaise with other staff ¾ Interpret a CTG ¾ Manage: • • • • induction of labour delay in labour labour after a previous lower-segment caesarean section preterm labour ¾ Perform and interpret a fetal blood sample ¾ Prescribe blood products appropriately ¾ Advise on pain relief .sign.nice.uk www. January 2005) ¾ Courses such as MOET/ALSO ¾ Useful websites: • • • • www.uk www.show.u k/spcerh Evidence/assessment ¾ Meetings attended ¾ Case reports ¾ Audit project ¾ RITA ¾ MRCOG Part 2 ¾ Logbook ¾ Reflective diary ¾ OSATS ¾ Fetal blood sampling Knowledge criteria ¾ Mechanisms of normal labour and delivery ¾ Induction and augmentation of labour ¾ Drugs acting upon the myometrium ¾ Structure and use of partograms ¾ Fluid balance in labour ¾ Blood products ¾ Regional anaesthesia.

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¾ Acute abdominal pain ¾ Remove a cervical suture ¾ Counsel and consent for fetal postmortem examination in cases of intrauterine fetal death ¾ Manage abdominal pain

JMedit/16-11-2006

Appendix to Curriculum Module 10: Details of Knowledge Criteria
¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ ¾ Mechanisms of normal and abnormal labour. Mechanism of spontaneous vaginal delivery. Methods of induction of labour; indications, contraindications and complications. Methods of augmentation of labour; indications, contraindications and complications. Drugs acting upon the myometrium and cervix. Structure and use of partograms. Fluid balance in labour. Transfusion. Types and methods of action of regional anaesthesia including epidural (lumbar, caudal), spinal, pudendal nerve block; indications and contraindications. Types and methods of action of analgesia and sedation including narcotics, hypnotics, psychotropics, nonsteroidal anti-inflammatory drugs; indications, contraindications. Complications of anaesthesia and analgesia including cardiac arrest, respiratory arrest, aspiration, drug reactions. Assessment of fetal wellbeing using fetal heart rate monitoring, acid/base balance, and fetal scalp blood sampling. Causes and management of fetal compromise, including cord prolapse and intrauterine fetal death. Intrauterine fetal death: legalities regarding registration and disposal of fetal tissue. Causes and management of prolonged labour. Causes and management of maternal collapse, including massive haemorrhage, cardiac problems, pulmonary and amniotic embolism, drug reactions, trauma. Emergency guidelines and procedures. Ante- and intrapartum haemorrhage, including placenta praevia, vasa praevia, ruptured uterus, coagulation defects, iatrogenic causes. Causes, mechanisms of action and complications of pre-term labour/ premature rupture of membranes including fetal pulmonary maturity, infection risks Preterm labour, including therapy (antibiotics, steroids, tocolysis), consultation with neonatologists, in utero transfer, methods of delivery (induction of labour, timing, mode), outcomes, risks. Role and types of cervical cerclage. Multiple pregnancy in labour. Severe pre-eclampsia and eclampsia. placental abruption.

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MODULE 10 MODULE 10 TOPIC: Management of labour TOPIC : Management of Labour Competence level: Basic Training Skill Observation Induce labour Manage delay in first labour Manage delay in second stage of labour Advise on pain relief Interpret cardiotocograph Perform fetal blood sampling Manage fetal acidemia Manage preterm labour & delivery Manage labour after previous CS Management of the breech in labour Management of transverse lie in labour Cord prolapse Manage severe pre-eclampsia Manage eclampsia Direct Supervision Independent Practice Intermediate Training Advanced Training

JMedit/16-11-2006 Manage obstetrical antepartum haemorrhage Safe use of blood products Manage obstetrical collapse Manage intrauterine infection Prioritise labour ward problems Evaluate clinical risk Coordinate and run labour ward Liaise with other staff Manage in utero transfer Manage in utero fetal death Leadership in acute emergency Training Courses or sessions Title Eclampsia Drill Drill for Obstetric Collapse ALSO/MOET or similar Signature of educational supervisor Date .

JMedit/16-11-2006 Training courses or sessions Title Eclampsia drill Drill for obstetric collapse ALSO/MOET or similar Signature of Educational Supervisor Date Authorisation of signatures – please print your name and sign: Name (please print) Signature OSAT Fetal blood sampling Each OSAT should be successfully completed for independent practice on five occasions before the module can be signed off Date Signature Date Signature Date Signature Date Signature Date Signature Completion of Module 10 I confirm that all components of the module have been satisfactorily completed Date Signature of Educational Superviser Name of Educational Superviser .

well-lit view of fetal scalp Collects uncontaminated good-sized sample without air bubbles Applies pressure to scalp wound Has strategies to overcome technical difficulties such as high head.JMedit/16-11-2006 FETAL BLOOD SAMPLING Trainee Name: Level of training: Assessor Name: Post: Date: Performed independently PLEASE TICK RELEVANT BOX Preparation of the patient Ensures patient and partner understand procedure Establishes level of pain relief and acts appropriately Supervises positioning of patient – corrects as required Appropriate use of assistants Assembles/positions equipment Demonstrates knowledge of equipment and can trouble shoot problems Operative procedure PLEASE TICK RELEVANT BOX Assesses dilatation and position of cervix Obtains clear. inadequate bleeding Correct interpretation of results Performed independently Needs help Not applicable Needs help Not applicable Both sides of this form to be completed and signed .

Poor understanding of areas of weakness. Consistently placed sutures accurately with appropriate and secure knots and with proper attention to safety. Economy of movement and maximum efficiency. Please complete the relevant box: Needs further help with: * * Date Competent to perform the entire procedure without the need for supervision Date Signed (trainer) Signed (trainer) Signed (trainee) Signed (trainee) . Consistently handled tissues appropriately with minimal damage. Appropriate use of assistant most of the time. Obviously planned course of operation with effortless flow from one move to the next. Many unnecessary moves. Consistently communicated and acted with awareness of the needs of the patient and/or of the professional team. Insight/attitude Some understanding of areas of weakness. Frequently stopped operating or needed to discuss next move. Strategically used assistants to the best advantage at all times. Careful handling of tissue but occasionally caused inadvertent damage. Time. Consistently placed assistants poorly or failed to us assistants. Communicated poorly or frequently showed lack of awareness of the needs of the patient and/or the professional team. Competent use of instruments but occasionally awkward or tentative. please ring the candidate’s performance for each of the following factors: Respect for tissue Frequently used unnecessary force on tissue or caused damage by inappropriate use of instruments. motion and flow of operation and forward planning Made reasonable progress but some unnecessary moves. Obvious familiarity with instruments. procedure and postoperative management. indicating findings.JMedit/16-11-2006 GENERIC TECHNICAL SKILLS ASSESSMENT Assessor. Knowledge and handling of instruments Suturing and knotting skills as appropriate for the procedure Technical use of assistants Relations with patient and the surgical team Lack of knowledge of instruments. Reasonable communication and awareness of the needs of the patient and/or of the professional team. Adequate documentation but with some omissions or areas that need elaborating. Limited documentation. Fully understands areas of weakness Comprehensive legible documentation. Sound knowledge of operation but slightly disjointed at times. Knotting and suturing usually reliable but sometimes awkward. Placed sutures inaccurately or tied knots insecurely and lacked attention to safety. poorly written.

sign.scot. skills and attitudes relating to management of delivery.org.net: Management of Labour and Delivery etutorials ¾ MOET/ALSO course ¾ Local protocols ¾ Useful websites: • • • • www.nice. Clinical competency ¾ Normal delivery ¾ Vacuum extraction without rotation ¾ Forceps delivery without rotation ¾ Shoulder dystocia ¾ Retained placenta ¾ Recognition of malpresentation ¾ Caesarean section with sterilisation ¾ Cord prolapse ¾ Uncomplicated caesarean section ¾ Repeat caesarean section ¾ Acute emergency caesarean section ¾ Rotational assisted delivery ¾ Vaginal delivery of twins ¾ Vaginal breech delivery ¾ Delivery with fetal malpresentation ¾ Previously undiagnosed breech ¾ Caesarean section with placenta Professional skills and attitudes ¾ Make appropriate decisions in the choice of delivery in partnership with the mother and respect the views of other healthcare workers (midwives) ¾ Be aware of emotional implications for woman.show.rcog.uk www.uk www.ac.JMedit/16-11-2006 Curriculum Module 11: Management of Delivery Learning outcomes: • To understand and demonstrate appropriate knowledge.uk www. family and staff ¾ Acknowledge and respect cultural diversity ¾ Respect individual dignity and privacy ¾ Respect confidentiality ¾ Demonstrate the ability to communicate clearly and effectively at times of stress ¾ Show ability to prioritise workload ¾ Demonstrate team management and show leadership according to year of training ¾ Be realistic recognition of own competence level and have self-awareness to call for Training support ¾ Shoulder dystocia drill ¾ Perinatal mortality and morbidity meetings ¾ StratOG.org.nhs.u k/spcerh Evidence/assessment ¾ Audit project ¾ RITA ¾ MRCOG Part 2 ¾ Logbook ¾ Reflective diary ¾ ALSO course ¾ OSATS: • • • Operative vaginal delivery Caesarean section Manual removal of Placenta Knowledge criteria ¾ Normal vaginal delivery ¾ Operative vaginal delivery ¾ Complex vaginal delivery ¾ Retained placenta ¾ Caesarean section ¾ Sterilisation procedures ¾ General anaesthesia ¾ Regional anaesthesia ¾ The unconscious patient ¾ .

JMedit/16-11-2006 praevia ¾ Uterine rupture ¾ Vaginal breech delivery including second twin help when necessary ¾ Demonstrate the use of appropriate protocols and guidelines .

variable lie) ¾ Malposition ¾ Manual rotation of the fetal head ¾ Outlet forceps/ventouse ¾ Mid-cavity forceps/ventouse ¾ Rotational forceps/ventouse ¾ Pelvic floor anatomy ¾ Episiotomy ¾ Perineal trauma and repair ¾ Assisted breech delivery ¾ Breech extraction ¾ Twin delivery ¾ High order multiple births ¾ Shoulder dystocia ¾ Caesarean section: • Indications and complications • Routine • Repeat • Acute emergency • Sterilisation procedures Intensive care ¾ Anaesthesia: ¾ General ¾ Regional ¾ Induction agents ¾ Inhalation agents ¾ Prophylactic measures ¾ Complications The unconscious patient Resuscitation . shoulder.JMedit/16-11-2006 Appendix to Curriculum Module 11: Details of Knowledge Criteria Operative/complex vaginal delivery: ¾ Malpresentation (brow. face.

JMedit/16-11-2006 MODULE 11 TOPIC: Management of delivery Competence level: Basic Training Intermediate Training Advanced Training Independent Practice Date Signature Skill Observation Date Normal delivery Shoulder dystocia Ventouse extraction without rotation Uncomplicated acute/elective caesarean section Repeat caesarean section Retained placenta Cord prolapse Forceps delivery without rotation Caesarean section with sterilisation Vaginal delivery of twins Preterm (< 28 weeks) caesarean section Rotational assisted ventouse delivery Complex emergency caesarean section Caesarean section for placenta praevia Signature Direct Supervision Date Signature .

JMedit/16-11-2006 Recognise undiagnosed breech Vaginal breech delivery Delivery with fetal malpresention Uterine rupture Training courses or sessions Title ALSO/MOET or similar Shoulder dystocia drill Signature of educational supervisor Date Authorisation of signatures – please print your name and sign below Name (please print) Signature .

JMedit/16-11-2006 OSAT Operative vaginal delivery Caesarean section Each OSAT should be successfully completed for independent practice on five occasions before the module can be signed off Date Signature Date Signature Date Signature Date Signature Date Signature Date Signature Date Signature Date Signature Date Signature Date Signature Date Signature Date Signature Date Signature Date Signature Manual removal of placenta Date Signature Completion of Module 11 I confirm that all components of the module have been satisfactorily completed Date Signature of Educational Superviser Name of Educational Superviser .

Correct delivery of shoulders and body Delivery of placenta and membranes Checks for uterine laxity and vaginal trauma EBL and manages blood loss Appropriate use of team Awareness of maternal and fetal wellbeing throughout Comments: Examples of minimum levels of complexity for each stage of training: ST1 Core Training Advanced Training Uncomplicated. moulding. non-rotational Rotational ventouse Rotational forceps/ventouse in theatre Both sides of this form to be completed and signed . descent with contraction. pelvic size and shape Decision making: choice of instrument Correct assembly and checking of equipment Correct application of instrument Appropriate direction. caput.JMedit/16-11-2006 OPERATIVE VAGINAL DELIVERY Trainee Name: Level of training: Clinical details of complexity/ difficulty of case Instrument used: Performed independently Assessor Name: Post: Date: Item under observation Needs help PLEASE TICK RELEVANT BOX Ensure patient and accompanying partner understand procedure Appropriate preoperative preparation: adequate analgesia. station. bladder empty Examination: engagement. Ensures head descends with traction Appropriate alteration of traction with delivery of head Protects perineum and assess need for episiotomy Checks for cord. position. force and timing of pull.

Consistently placed assistants poorly or failed to us assistants. motion and flow of operation and forward planning Made reasonable progress but some unnecessary moves. Obviously planned course of operation with effortless flow from one move to the next.JMedit/16-11-2006 GENERIC TECHNICAL SKILLS ASSESSMENT Assessor. Appropriate use of assistant most of the time. Strategically used assistants to the best advantage at all times. indicating findings. Limited documentation. Obvious familiarity with instruments. Competent use of instruments but occasionally awkward or tentative. Knowledge and handling of instruments Suturing and knotting skills as appropriate for the procedure Technical use of assistants Relations with patient and the surgical team Lack of knowledge of instruments. Insight/attitude Some understanding of areas of weakness. Consistently handled tissues appropriately with minimal damage. Many unnecessary moves. Consistently placed sutures accurately with appropriate and secure knots and with proper attention to safety. Placed sutures inaccurately or tied knots insecurely and lacked attention to safety. Fully understands areas of weakness Comprehensive legible documentation. please ring the candidate’s performance for each of the following factors: Respect for tissue Frequently used unnecessary force on tissue or caused damage by inappropriate use of instruments. poorly written. Frequently stopped operating or needed to discuss next move. Poor understanding of areas of weakness. Reasonable communication and awareness of the needs of the patient and/or of the professional team. Economy of movement and maximum efficiency. Adequate documentation but with some omissions or areas that need elaborating. Time. Consistently communicated and acted with awareness of the needs of the patient and/or of the professional team. Sound knowledge of operation but slightly disjointed at times. Please complete the relevant box: Needs further help with: * * Date Competent to perform the entire procedure without the need for supervision Date Signed (trainer) Signed (trainer) Signed (trainee) Signed (trainee) . Communicated poorly or frequently showed lack of awareness of the needs of the patient and/or the professional team. Knotting and suturing usually reliable but sometimes awkward. procedure and postoperative management. Careful handling of tissue but occasionally caused inadvertent damage.

configuration) Safe securing of uterine angles Check for ovarian pathology Appropriate closure of rectus sheath Attention to haemostasis Neatness of skin closure Comments: Levels of complexity for each stage of training: ST1 Core Training CCT First or second caesarean section with longitudinal lie Twins/transverse lie Preterm at gestation over 28 weeks Preterm less than 28 weeks or grade 4 placenta praevia Fibroids in lower uterine segment Both sides of this form to be completed and signed . position) Safe and systematic delivery of baby Appropriate delivery of placenta Check uterine cavity (e. length.g.g. length. intact. empty.JMedit/16-11-2006 CAESAREAN SECTION Trainee Name: Level of training: Grade/Year Assessor Name: Post: Date: Clinical details of complexity/difficulty of case Item under observation Performed independently Needs help PLEASE TICK RELEVANT BOX Appropriate skin incision (e. position) Safe entry of peritoneal cavity Careful management of bladder Appropriate uterine incision (e.g.

Many unnecessary moves. Knowledge and handling of instruments Suturing and knotting skills as appropriate for the procedure Technical use of assistants Relations with patient and the surgical team Lack of knowledge of instruments. Adequate documentation but with some omissions or areas that need elaborating. Fully understands areas of weakness Comprehensive legible documentation. Consistently handled tissues appropriately with minimal damage. procedure and postoperative management. motion and flow of operation and forward planning Made reasonable progress but some unnecessary moves. Sound knowledge of operation but slightly disjointed at times. Poor understanding of areas of weakness. Knotting and suturing usually reliable but sometimes awkward. Obviously planned course of operation with effortless flow from one move to the next. Frequently stopped operating or needed to discuss next move. Consistently communicated and acted with awareness of the needs of the patient and/or of the professional team. Placed sutures inaccurately or tied knots insecurely and lacked attention to safety. Insight/attitude Some understanding of areas of weakness. Reasonable communication and awareness of the needs of the patient and/or of the professional team. Competent use of instruments but occasionally awkward or tentative. Strategically used assistants to the best advantage at all times.JMedit/16-11-2006 GENERIC TECHNICAL SKILLS ASSESSMENT Assessor. please ring the candidate’s performance for each of the following factors: Respect for tissue Frequently used unnecessary force on tissue or caused damage by inappropriate use of instruments. Economy of movement and maximum efficiency. poorly written. Communicated poorly or frequently showed lack of awareness of the needs of the patient and/or the professional team. Limited documentation. Consistently placed sutures accurately with appropriate and secure knots and with proper attention to safety. Time. indicating findings. Appropriate use of assistant most of the time. Please complete the relevant box: Needs further help with: * * Date Competent to perform the entire procedure without the need for supervision Date Signed (trainer) Signed (trainer) Signed (trainee) Signed (trainee) . Consistently placed assistants poorly or failed to us assistants. Obvious familiarity with instruments. Careful handling of tissue but occasionally caused inadvertent damage.

JMedit/16-11-2006 MANUAL REMOVAL OF PLACENTA Trainee Name: Level of training: Grade/ Year Assessor Name: Post: Date: Clinical details of complexity/difficulty of case Item under observation Done independently Needs help PLEASE TICK RELEVANT BOX Ensures adequate analgesia Ensures empty bladder/catheterises Performs procedure with appropriate abdominal countertraction Ensures cavity empty Ensures adequate uterine contraction Checks blood loss and haemostasis Checks for trauma Comments: Both sides of this form to be completed and signed .

Careful handling of tissue but occasionally caused inadvertent damage. Limited documentation. Many unnecessary moves. Poor understanding of areas of weakness. Insight/attitude Some understanding of areas of weakness. indicating findings. Appropriate use of assistant most of the time. Adequate documentation but with some omissions or areas that need elaborating. Competent use of instruments but occasionally awkward or tentative. Time. Knotting and suturing usually reliable but sometimes awkward. procedure and postoperative management. Consistently handled tissues appropriately with minimal damage. Placed sutures inaccurately or tied knots insecurely and lacked attention to safety. Sound knowledge of operation but slightly disjointed at times. Please complete the relevant box: Needs further help with: * * Date Competent to perform the entire procedure without the need for supervision Date Signed (trainer) Signed (trainer) Signed (trainee) Signed (trainee) . Obviously planned course of operation with effortless flow from one move to the next. Consistently communicated and acted with awareness of the needs of the patient and/or of the professional team. Strategically used assistants to the best advantage at all times. Reasonable communication and awareness of the needs of the patient and/or of the professional team. Consistently placed assistants poorly or failed to us assistants. please ring the candidate’s performance for each of the following factors: Respect for tissue Frequently used unnecessary force on tissue or caused damage by inappropriate use of instruments. Communicated poorly or frequently showed lack of awareness of the needs of the patient and/or the professional team. Obvious familiarity with instruments. Frequently stopped operating or needed to discuss next move. Consistently placed sutures accurately with appropriate and secure knots and with proper attention to safety. poorly written.JMedit/16-11-2006 GENERIC TECHNICAL SKILLS ASSESSMENT Assessor. Knowledge and handling of instruments Suturing and knotting skills as appropriate for the procedure Technical use of assistants Relations with patient and the surgical team Lack of knowledge of instruments. motion and flow of operation and forward planning Made reasonable progress but some unnecessary moves. Economy of movement and maximum efficiency. Fully understands areas of weakness Comprehensive legible documentation.

physiotherapists) ¾ Be aware of Breastfeeding Initiative ¾ Display empathy with women with puerperal problems and their families Training support ¾ Massive haemorrhage drill ¾ Problems after childbirth ¾ Counselling after perinatal loss ¾ Perineal trauma course ¾ Perinatal mortality and morbidity meetings ¾ StratOG. psychiatrists. social workers.uk /spcerh Evidence/assessment ¾ Meetings attended ¾ Case reports ¾ Reflective diary ¾ Audit project ¾ RITA ¾ MRCOG Part 2 ¾ OSATS: • • Perineal repair Manual removal of placenta Knowledge criteria ¾ Normal and abnormal postpartum period ¾ Techniques for control of postpartum haemorrhage ¾ Appropriate use of blood and blood products ¾ Perineal surgery ¾ Postpartum and postoperative complications ¾ Retained placenta ¾ Normal and abnormal postpartum period ¾ Infant feeding .rcog. Clinical competency ¾ Demonstrate skills in acute resuscitation ¾ The normal puerperium.ac.org.org.nhs.uk www.uk www.sign. skills and attitudes in relation to postpartum problems.uk www.JMedit/16-11-2006 Curriculum Module 12: Postpartum Problems (the Puerperium) Learning outcomes: • To understand and demonstrate appropriate knowledge. including contraception ¾ Breast problems ¾ Perineal and vaginal tears ¾ Damage to rectum and anal sphincters ¾ Manual removal of placenta ¾ Postpartum sepsis ¾ Primary.scot.show. secondary and other postpartum haemorrhage ¾ Acute maternal collapse ¾ Puerperal psychiatric disorders Professional skills and attitudes ¾ Demonstrate the ability to counsel women about management and implications of anal sphincter trauma ¾ Understands the roles of other healthcare professionals (e.nice.g.net: Postpartum and Neonatal Problems etutorials ¾ Useful websites: • • • www.

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Appendix to Curriculum Module 12: Details of knowledge criteria
Epidemiology, aetiology, pathogenesis, recognition, diagnosis, prevention, management, complication, prognosis regarding: ¾ uterine involution ¾ bleeding, including placenta accreta, atonic uterus ¾ retained placenta, retained products of conception ¾ pyrexia ¾ infections ¾ maternal collapse, including massive haemorrhage, cardiac problems, pulmonary and amniotic embolism, drug reactions, trauma ¾ thromboembolism ¾ lactation (inadequate, suppression) ¾ medical disorders (diabetes mellitus, renal disease, cardiac disease) ¾ postnatal review ¾ contraception. Techniques for the control of haemorrhage: ¾ manual removal of placenta ¾ bimanual compression of uterus ¾ exploration of genital tract ¾ cervical laceration (identification and repair) ¾ drug management ¾ balloon tamponade of uterus ¾ laparotomy including B-Lynch stitch ¾ radiological embolisation ¾ ligation of internal iliac arteries ¾ caesarean hysterectomy. Perineal surgery: ¾ repair of episiotomy, second-, third-, fourth-degree laceration. Postpartum and postoperative complications, including pathophysiology, diagnosis, management and prognosis in puerperal psychological disorders (blues, depression), mood disorders, reactions to pregnancy loss. Puerperal sepsis, mastitis, urinary tract infection. Breast cancer.

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Curriculum Module 12A: Neonatal Problems
Learning outcomes:
• To understand and demonstrate appropriate knowledge, skills and attitudes in relation to neonatal problems. Clinical competency ¾ Appropriately manage immediate resuscitation of the neonate Professional skills and attitudes ¾ Liaise with paediatricians and the neonatal team Training support ¾ StratOG.net: Postpartum and Neonatal Problems e-tutorials ¾ Basic neonatal resuscitation ¾ Perinatal morbidity and mortality meetings ¾ Useful website: www.nice.org.uk Evidence/assessment ¾ MRCOG Part 2 ¾ Logbook ¾ Neonatal resuscitation drill

Knowledge criteria ¾ Sequelae of obstetric complications ¾ Recognition of normality ¾ Resuscitation of the newborn ¾ Common neonatal problems ¾ Feeding

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Appendix to Curriculum Module 12A: Details of knowledge criteria
Sequelae of obstetric events: ¾ antenatal ¾ intrapartum. Recognition of normality: ¾ postnatal management ¾ clinical evaluation. Resuscitation of the newborn: ¾ collapse ¾ primary apnoea ¾ secondary apnoea ¾ ventilation ¾ effect of maternal drugs ¾ cardiac massage ¾ umbilical catheterisation ¾ volume replacement ¾ temperature control ¾ acid/base status. Common problems (aetiology, management sequelae): ¾ respiratory distress ¾ hyperbilirubinaemia ¾ infection ¾ seizures ¾ hypoglycaemia ¾ hypothermia ¾ heart disease ¾ intracranial haemorrhage ¾ necrotising enterocolitis ¾ the preterm infant ¾ the growth-restricted infant ¾ congenital anomalies ¾ syndromes ¾ cerebral palsy. Feeding: ¾ breast (advantages, promotion, techniques) ¾ artificial (formulae, techniques).

JMedit/16-11-2006 MODULE 12 TOPIC: Postpartum problems (the puerperium) Competence level: Basic Training Observation Date Signature Intermediate Training Direct Supervision Date Signature Date Advanced Training Independent Practice Signature Conduct a postnatal consultation Bladder dysfunction Bowel dysfunction Primary postpartum haemorrhage Secondary postpartum haemorrhage Other obstetric haemorrhage Acute maternal collapse Running obstetric emergency drill Perineal and vaginal tears Damage to rectum and to anal sphincters Immediate resuscitation of neonate Puerperal sepsis Puerperal psychiatric problems Contraceptive advice .

JMedit/16-11-2006 Breast problems Management of mastitis Management of thromboembolic problems Training courses or sessions Title Basic neonatal resuscitation Massive obstetric haemorrhage Perineal trauma course Signature of Educational Supervisor Date Authorisation of Signatures – please print your name and sign below Name (please print) Signature .

JMedit/16-11-2006 OSAT Perineal repair Each OSAT should be successfully completed for independent practice on five occasions before the module can be signed off Date Date Date Date Date Signature Manual removal of placenta Date Signature Signature Date Signature Signature Date Signature Signature Date Signature Signature Date Signature Completion of Module 12 I confirm that all components of the module have been satisfactorily completed: Date Signature of Educational Superviser Name of Educational Superviser .

JMedit/16-11-2006 PERINEAL REPAIR Trainee Name: Level of training: Grade/Year Assessor Name: Date: Post: Clinical details of complexity/difficulty of case Item under observation Performed Needs help independently PLEASE TICK RELEVANT BOX Assessment of anatomical damage including rectal examination Ensures adequate analgesia Secures apex of vaginal tear Suture of vaginal skin Suture of perineal muscles Anatomical apposition of vaginal and perineal skin Subcuticular suture to perineal skin Checks haemostasis Needle and swab count Vaginal examination Rectal examination Comments: Both sides of this form to be completed and signed .

Obviously planned course of operation with effortless flow from one move to the next. procedure and postoperative management. Sound knowledge of operation but slightly disjointed at times. Consistently placed sutures accurately with appropriate and secure knots and with proper attention to safety. Please complete the relevant box: Needs further help with: * * Date Competent to perform the entire procedure without the need for supervision Date Signed (trainer) Signed (trainer) Signed (trainee) Signed (trainee) .JMedit/16-11-2006 GENERIC TECHNICAL SKILLS ASSESSMENT Assessor. Many unnecessary moves. poorly written. Frequently stopped operating or needed to discuss next move. Consistently handled tissues appropriately with minimal damage. Limited documentation. Knotting and suturing usually reliable but sometimes awkward. Knowledge and handling of instruments Suturing and knotting skills as appropriate for the procedure Technical use of assistants Relations with patient and the surgical team Lack of knowledge of instruments. motion and flow of operation and forward planning Made reasonable progress but some unnecessary moves. Poor understanding of areas of weakness. Careful handling of tissue but occasionally caused inadvertent damage. Communicated poorly or frequently showed lack of awareness of the needs of the patient and/or the professional team. Strategically used assistants to the best advantage at all times. Fully understands areas of weakness Comprehensive legible documentation. Competent use of instruments but occasionally awkward or tentative. Obvious familiarity with instruments. Reasonable communication and awareness of the needs of the patient and/or of the professional team. Insight/attitude Some understanding of areas of weakness. Consistently placed assistants poorly or failed to us assistants. Consistently communicated and acted with awareness of the needs of the patient and/or of the professional team. Placed sutures inaccurately or tied knots insecurely and lacked attention to safety. indicating findings. Adequate documentation but with some omissions or areas that need elaborating. Appropriate use of assistant most of the time. please ring the candidate’s performance for each of the following factors: Respect for tissue Frequently used unnecessary force on tissue or caused damage by inappropriate use of instruments. Economy of movement and maximum efficiency. Time.

JMedit/16-11-2006 MANUAL REMOVAL OF PLACENTA Assessor Name: Post: Date: Trainee Name: Level of training: Grade/ Year Clinical details of complexity/difficulty of case Item under observation Performed Needs help independently PLEASE TICK RELEVANT BOX Ensures adequate analgesia Ensures empty bladder/catheterises Performs procedure with appropriate abdominal countertraction Ensures cavity empty Ensures adequate uterine contraction Checks blood loss and haemostasis Checks for trauma Comments: Both sides of this form to be completed and signed .

Knotting and suturing usually reliable but sometimes awkward. Fully understands areas of weakness Comprehensive legible documentation. Consistently communicated and acted with awareness of the needs of the patient and/or of the professional team. Limited documentation. Obvious familiarity with instruments. please ring the candidate’s performance for each of the following factors: Respect for tissue Frequently used unnecessary force on tissue or caused damage by inappropriate use of instruments. indicating findings. Competent use of instruments but occasionally awkward or tentative. Obviously planned course of operation with effortless flow from one move to the next. procedure and postoperative management.JMedit/16-11-2006 GENERIC TECHNICAL SKILLS ASSESSMENT Assessor. Consistently handled tissues appropriately with minimal damage. Appropriate use of assistant most of the time. Poor understanding of areas of weakness. Knowledge and handling of instruments Suturing and knotting skills as appropriate for the procedure Technical use of assistants Relations with patient and the surgical team Lack of knowledge of instruments. Economy of movement and maximum efficiency. Consistently placed assistants poorly or failed to us assistants. poorly written. Frequently stopped operating or needed to discuss next move. Time. Sound knowledge of operation but slightly disjointed at times. Many unnecessary moves. Careful handling of tissue but occasionally caused inadvertent damage. Please complete the relevant box: Needs further help with: * * Date Competent to perform the entire procedure without the need for supervision Date Signed (trainer) Signed (trainer) Signed (trainee) Signed (trainee) . motion and flow of operation and forward planning Made reasonable progress but some unnecessary moves. Consistently placed sutures accurately with appropriate and secure knots and with proper attention to safety. Reasonable communication and awareness of the needs of the patient and/or of the professional team. Adequate documentation but with some omissions or areas that need elaborating. Insight/attitude Some understanding of areas of weakness. Placed sutures inaccurately or tied knots insecurely and lacked attention to safety. Communicated poorly or frequently showed lack of awareness of the needs of the patient and/or the professional team. Strategically used assistants to the best advantage at all times.

nice.rcog.ac.org. aetiology.sign.uk Evidence/assessment ¾ Logbook ¾ Reflective diary ¾ MRCOG Part 2 ¾ Audit project ¾ TO1/2 ¾ RITA ¾ OSATS: Diagnostic laparoscopy Knowledge criteria ¾ To understand the epidemiology.uk www.net: Gynaecological Problems and Early Pregnancy Loss e-tutorials ¾ Supervised clinical sessions ¾ Specific courses and academic meetings ¾ Local and regional courses in paediatric gynaecological problems and problems of puberty ¾ DFFP ¾ Useful websites: • • • www. clinical characteristics. biological behaviour. To understand paediatric and adolescent gynaecological disorders. skills and attitudes in relation to common gynaecological disorders. pathophysiology. Clinical competency ¾ Diagnose. prognostic features and management of: • • • • • • • • • • Menstrual disorders Benign conditions of the genital tract Endocrine disorders Problems of the climacteric Pelvic pain Vaginal discharge Emergency gynaecology Congenital abnormalities of the genital tract Paediatric gynaecology Puberty .org. complications and adverse effects of medical and surgical treatments ¾ Demonstrate the ability to formulate and implement a plan of management and have the ability to modify this as necessary ¾ Recognise the need for appropriate referral for more complex or detailed evaluation with ultrasound or other imaging techniques ¾ Have the skills to liaise with colleagues in other disciplines where required ¾ Demonstrate an understanding of the use appropriate referral pathways and local protocols if abnormal findings suspected Training support ¾ StratOG. investigate and manage common gynaecological disorders ¾ Perform ultrasound scan to diagnose and facilitate appropriate management of women with common ovarian and uterine abnormalities ¾ Perform transvaginal ultrasound scan and diagnose uterine fibroids and endometrial polyps ¾ Diagnose polycystic ovaries and hydrosalpinges on ultrasound ¾ Perform saline sonohysterography ¾ Endometrial assessment ¾ Diagnostic hysteroscopy ¾ Diagnostic laparoscopy: staging of endometriosis ¾ See Module 7 for other surgical competencies Professional skills and attitudes ¾ Demonstrate the ability to communicate prognosis and counsel women sensitively about the options available ¾ Have the necessary skills to explain the nature.JMedit/16-11-2006 Curriculum Module 13: Gynaecological Problems Learning outcomes: • • To understand and demonstrate appropriate knowledge.uk www.

¾ Vagina: Vaginal discharge (non-sexually transmitted causes) ¾ Pelvic pain: Dysmenorrhoea Dyspareunia Endometriosis (staging. Fibroids. . treatment) Pelvic inflammatory disease Non-gynaecological disorders.JMedit/16-11-2006 Appendix to Curriculum Module 13: Details of Knowledge Criteria Menstrual disorders: ¾ Menstrual irregularity ¾ Excessive menstrual loss ¾ Investigation of menstrual disorders ¾ Medical and surgical management of menstrual disorders. postcoital). Puberty: ¾ Physiology and chronology ¾ Precocious puberty ¾ Delayed puberty ¾ Excessive menstrual loss. Amenorrhoea and endocrine disorders: ¾ Investigation and interpretation ¾ Hypothalamic/pituitary disorders ¾ Hyperprolactinaemia ¾ Premature ovarian failure ¾ Polycystic ovaries and polycystic ovary syndrome ¾ Other causes of hyperandrogenism ¾ Thyroid/adrenal disorders ¾ Autoimmune endocrine disease Congenital abnormalities of genital tract: ¾ Ambiguous genitalia ¾ Imperforate hymen ¾ Vaginal septae ¾ Uterine anomalies ¾ Müllerian duct development ¾ Gonadal dysgenesis. Nonmenstrual bleeding (intermenstrual. Premenstrual syndrome. Benign conditions of the lower genital tract: ¾ Vulva: • • • • • • • • • • Pruritus vulvae Non-neoplastic cysts Non-neoplastic epithelial disorders Vulvodynia. Problems of the climacteric: ¾ Abnormal bleeding ¾ Postmenopausal bleeding ¾ Hormone replacement therapy ¾ Non hormonal therapy ¾ Osteopenia and osteoporosis ¾ Breast cancer in relation to the climacteric.

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¾ Ovary: • • Benign ovarian neoplasms Functional ovarian cysts.

Emergency gynaecology: ¾ Pelvic inflammatory disease ¾ Bartholin’s and vulval abscess ¾ Ovarian cyst accidents ¾ Acute vaginal bleeding outwith pregnancy ¾ Miscarriage and ectopic pregnancy.

JMedit/16-11-2006
MODULE 13 TOPIC: Gynaecological problems

Competence level: Basic Training Skill Observation Diagnose, investigate and manage the following clinical problems: Menstrual disorders: Menstrual irregularity Excessive menstrual loss Premenstrual syndrome Amenorrhoea/oligomenorrhoea Dysmenorrhoea

Intermediate Training Direct Supervision

Advanced Training Independent Practice

Pelvic pain: Dyspareunia Endometriosis (medical management) Endometriosis (surgical management) Pelvic inflammatory disease Non-gynaecological disorders Problems of the climacteric: Postmenopausal bleeding Hormone replacement therapy

JMedit/16-11-2006 Others: Benign ovarian cysts Vaginal discharge Fibroids Hirsutism Non-neoplastic vulval disorders Use transvaginal ultrasound to diagnose: Polycystic ovaries and hydrosalpinges Uterine fibroids and endometrial polyps Perform saline infusion sonohysterography .

JMedit/16-11-2006 Training Courses or sessions Title Problems of puberty (L) Rape/ forensic gynaecology (L) Paediatric gynaecological problems (L) Signature of educational supervisor Date Authorisation of signatures – please print your name and sign: Name (please print) Signature .

JMedit/16-11-2006 OSAT Diagnostic laparoscopy Each OSAT should be successfully completed for independent practice on five occasions before the module can be signed off Date Signature Date Signature Date Signature Date Signature Date Signature Completion of Module 13 I confirm that all components of the module have been satisfactorily completed Date Signature of Educational Superviser Name of Educational Superviser .

JMedit/16-11-2006 DIAGNOSTIC LAPAROSCOPY Trainee Name: Level of training: Assessor Name: Post: Date: Done independently PLEASE TICK RELEVANT BOX Preparation of the patient: Ensures correct positioning of the patient Checked or observed catheterisation. pelvic examination and insertion of uterine manipulator where appropriate Establishing pneumoperitoneum: Demonstrates knowledge of instruments and can troubleshoot problems Check patency and function of Veress (if used) Correct incision Controlled insertion of Veress (if used) Insufflation to at least 20 mmHg Controlled insertion of primary port Controlled insertion of secondary port under direct vision Operative procedure: Maintains correct position of optics Clear inspection of pelvic and abdominal structures Movements fluid and atraumatic Appropriate use of assistants (if applicable) Correct interpretation of operative findings Removal of ports under direct vision Deflation of pneumoperitoneum Appropriate skin closure Needs help Not applicable Both sides of this form to be completed and signed .

Appropriate use of assistant most of the time. Reasonable communication and awareness of the needs of the patient and/or of the professional team. Consistently handled tissues appropriately with minimal damage. Please complete the relevant box: Needs further help with: * * Date Competent to perform the entire procedure without the need for supervision Date Signed (trainer) Signed (trainer) Signed (trainee) Signed (trainee) . Placed sutures inaccurately or tied knots insecurely and lacked attention to safety. motion and flow of operation and forward planning Made reasonable progress but some unnecessary moves. Limited documentation. Adequate documentation but with some omissions or areas that need elaborating. Sound knowledge of operation but slightly disjointed at times. Obvious familiarity with instruments. Knowledge and handling of instruments Suturing and knotting skills as appropriate for the procedure Technical use of assistants Relations with patient and the surgical team Lack of knowledge of instruments. indicating findings. Obviously planned course of operation with effortless flow from one move to the next. Fully understands areas of weakness Comprehensive legible documentation. Strategically used assistants to the best advantage at all times. Consistently communicated and acted with awareness of the needs of the patient and/or of the professional team.JMedit/16-11-2006 GENERIC TECHNICAL SKILLS ASSESSMENT Assessor. Knotting and suturing usually reliable but sometimes awkward. Economy of movement and maximum efficiency. Competent use of instruments but occasionally awkward or tentative. Insight/attitude Some understanding of areas of weakness. poorly written. Communicated poorly or frequently showed lack of awareness of the needs of the patient and/or the professional team. Poor understanding of areas of weakness. please ring the candidate’s performance for each of the following factors: Respect for tissue Frequently used unnecessary force on tissue or caused damage by inappropriate use of instruments. procedure and postoperative management. Frequently stopped operating or needed to discuss next move. Careful handling of tissue but occasionally caused inadvertent damage. Consistently placed assistants poorly or failed to us assistants. Time. Consistently placed sutures accurately with appropriate and secure knots and with proper attention to safety. Many unnecessary moves.

uk Evidence/assessment ¾ Logbook ¾ Reflective diary ¾ RITA ¾ MRCOG Part 2 ¾ Case reports ¾ Audit projects ¾ OSATS: Diagnostic laparoscopy Knowledge criteria ¾ Epidemiology.nice. pathogenesis. limitations and complications of surgery in relation to: • • • male and female subfertility endometriosis developmental disorders ¾ Indications. aetiology. clinical features.hfea. skills and attitudes in relation to subfertility. Clinical competency ¾ Take history and examine a couple presenting with subfertility ¾ Arrange basic investigations ¾ Counsel couples about diagnosis and management options ¾ Perform the following: • • • • diagnostic laparoscopy staging of endometriosis assessment of tubal patency diagnostic hysteroscopy Professional skills and attitudes ¾ Shows an appreciation of the importance of psychological factors for women and their partners ¾ Demonstrates respect for woman’s dignity and confidentiality ¾ Has an understanding of the issues relating to NHS funding and rationing of treatment ¾ Demonstrates the ability to deal sensitively with issues relating to the welfare of the child ¾ Has the ability to acknowledge cultural issues and issues relating to same sex partnerships and single parenthood ¾ Demonstrates the need to liaise effectively with colleagues in other disciplines.JMedit/16-11-2006 Curriculum Module 14: Subfertility Learning outcomes: • To understand the issues and demonstrate appropriate knowledge.gov. techniques.uk www. treatment and prognosis of male and female subfertility ¾ Indications.net: Subfertility etutorials ¾ Subfertility clinics ¾ Assisted reproduction sessions ¾ Useful websites: • • www. limitations and complications of assisted reproduction techniques: • ovulation induction .org. clinical and nonclinical Training support ¾ Appropriate postgraduate education courses ¾ Multidisciplinary and clinical team meetings ¾ StratOG. limitations and interpretation of investigations: • • • • • • endocrine measurements (male and female) semen analysis ultrasound other imaging techniques genetic analysis operative procedures ¾ Indications.

JMedit/16-11-2006 • • IVF and ICSI gamete donation ¾ Legal and ethical issues .

Ultrasound: ¾ Normal uterine and ovarian morphology. ¾ Long-term sequelae of cancer treatment. techniques and complications of: ¾ Ovulation induction (clomifene. genetic). pharmacological.g. gonadotrophins. ¾ Embryo storage.JMedit/16-11-2006 Appendix to Curriculum Module 14: Details of Knowledge Criteria Epidemiology. ¾ Sterilisation regret. ¾ Genetic analysis: chromosome analysis. ¾ intracytoplasmic sperm injection. ¾ Adhesiolysis. e. ¾ Gamete donation. ¾ Tubal patency. limitations and interpretation of investigative techniques: ¾ Semen analysis. gonadotrophin-releasing hormone). ¾ Other medical interventions (e. dopaminergic drugs). cervical and uterine factors.g. ¾ Intrauterine insemination. endometriosis. ¾ Follicular tracking ¾ Polycystic ovaries. Indications. ¾ Magnetic resonance imaging. ¾ Male (structural. aetiology. Indications.g. ¾ Pituitary imaging. pathogenesis. cystic fibrosis. infectious. endocrine. ¾ Surrogacy. ¾ Endocrine assessment (see also Module 13): • • • • • • • • • assessment of ovulation assessment of the subfertile male amenorrhoea and oligomenorrhoea polycystic ovary syndrome hyperprolacinaemia thyroid/adrenal function gonadal failure. tubal disorders. ¾ Surgical sperm recovery. Legal and ethical issues: ¾ Human Fertilisation and Embryology Act. clinical features. Operative investigative procedures: ¾ Diagnostic laparoscopy. . e. Other imaging techniques: ¾ Hysterosalpingography. Indications. ¾ Computed tomography. limitations and complications of surgery in relation to male and female infertility: ¾ Reversal of sterilisation and vasectomy. ¾ Diagnostic hysteroscopy. sex chromosome abnormalities Genetic abnormities. metformin. limitations. ¾ Welfare of the child. lifestyle. genetic and developmental disorders). ¾ Unexplained infertility. ¾ In vitro fertilisation. treatment and prognosis of male and female subfertility: ¾ Female (ovulatory disorders.

¾ Myomectomy.JMedit/16-11-2006 ¾ Salpingostomy. ¾ Varicocoele. ¾ Surgical management of endometriosis. ¾ Hysteroscopic surgery. ¾ Ovarian diathermy. .

JMedit/16-11-2006 MODULE 14 TOPIC: Subfertility Competence level: Basic Training Intermediate Training Direct Supervision Date Signature Date Advanced Training Independent Practice Signature Skill Observation Date Take history from couple Investigate female subfertility Interpret semen analysis Manage anovulation Investigate tubal function Counsel about management options Signature .

JMedit/16-11-2006 Training Courses or sessions Title Assisted reproduction Signature of educational supervisor Date Authorisation of signatures – please print your name and sign: Name (please print) Signature OSAT Diagnostic laparoscopy Each OSAT should be successfully completed for Independent Practice on 5 occasions before the module can be signed off Date Signature Date Signature Date Signature Date Signature Date Signature Completion of Module 14 I confirm that all components of the module have been satisfactorily completed Date Signature of Educational Superviser Name of Educational Superviser .

JMedit/16-11-2006 DIAGNOSTIC LAPAROSCOPY Trainee Name: Level of training: Assessor Name: Post: Date: Done independently Needs help Not applicable PLEASE TICK RELEVANT BOX Preparation of the patient Ensures correct positioning of the patient Checked or observed catheterisation. pelvic examination and insertion of uterine manipulator where appropriate Establishing pneumoperitoneum Demonstrates knowledge of instruments and can trouble shoot problems Check patency and function of Veress (if used) Correct incision Controlled insertion of Veress (if used) Insufflation to at least 20 mmHg Controlled insertion of primary port Controlled insertion of secondary port under direct vision Operative procedure Maintains correct position of optics Clear inspection of pelvic and abdominal structures Movements fluid and atraumatic Appropriate use of assistants (if applicable) Correct interpretation of operative findings Removal of ports under direct vision Deflation of pneumoperitoneum Appropriate skin closure Both sides of this form to be completed and signed .

Careful handling of tissue but occasionally caused inadvertent damage. Fully understands areas of weakness Comprehensive legible documentation. indicating findings. Insight/attitude Some understanding of areas of weakness. Economy of movement and maximum efficiency. Consistently communicated and acted with awareness of the needs of the patient and/or of the professional team. Adequate documentation but with some omissions or areas that need elaborating. Please complete the relevant box: Needs further help with: * * Date Competent to perform the entire procedure without the need for supervision Date Signed (trainer) Signed (trainer) Signed (trainee) Signed (trainee) . motion and flow of operation and forward planning Made reasonable progress but some unnecessary moves. Consistently placed assistants poorly or failed to us assistants. Knowledge and handling of instruments Suturing and knotting skills as appropriate for the procedure Technical use of assistants Relations with patient and the surgical team Lack of knowledge of instruments. Consistently placed sutures accurately with appropriate and secure knots and with proper attention to safety. Communicated poorly or frequently showed lack of awareness of the needs of the patient and/or the professional team. Frequently stopped operating or needed to discuss next move. procedure and postoperative management. poorly written. Sound knowledge of operation but slightly disjointed at times. Consistently handled tissues appropriately with minimal damage. Poor understanding of areas of weakness. Many unnecessary moves. Obviously planned course of operation with effortless flow from one move to the next. Knotting and suturing usually reliable but sometimes awkward. Time.JMedit/16-11-2006 GENERIC TECHNICAL SKILLS ASSESSMENT Assessor. Reasonable communication and awareness of the needs of the patient and/or of the professional team. Limited documentation. Appropriate use of assistant most of the time. Placed sutures inaccurately or tied knots insecurely and lacked attention to safety. Strategically used assistants to the best advantage at all times. Competent use of instruments but occasionally awkward or tentative. please ring the candidate’s performance for each of the following factors: Respect for tissue Frequently used unnecessary force on tissue or caused damage by inappropriate use of instruments. Obvious familiarity with instruments.

skills and attitudes in relation to fertility control (contraception and termination of pregnancy). Skills targets not attempted should be clearly recorded in the logbook and signed off by a trainer. Sexually Ttransmitted Infections and HIV. indications. dignity and confidentiality ¾ Is able to explain clearly and openly treatments. empathy and concern ¾ Demonstrates the ability to listen actively and respects silences ¾ Understands the need to respect women’s rights. sexually transmitted infections (STIs).JMedit/16-11-2006 Curriculum Module 15: Sexual and Reproductive Health (Contraception. commercial sex workers.g. consent. irreversible and emergency contraception and termination of pregnancy: • • mode of action and efficacy methods. contraindications and complications ¾ Counsel about: contraceptive options (reversible and irreversible) unplanned pregnancy options ¾ The laws relating to termination of pregnancy. young people. Sexual Problems) Learning outcomes: • • To understand and demonstrate appropriate knowledge. Termination of Pregnancy. There may be conscientious objection to the acquisition of certain skills within the contraception and abortion components.net: Sexual and Reproductive Health etutorials ¾ Family Planning/genitourinary medicine sessions ¾ Diploma of the Faculty of Family Planning and Reproductive Health Care of the RCOG ¾ Faculty of Family Planning Letter of Competence in Intrauterine Techniques (LoC IUT) ¾ Faculty of Family Planning Letter of Competence in Subdermal Implants (Loc SdI) ¾ Sexually Transmitted Infections Foundation course ¾ Use of training models ¾ National Sexual Health Strategy documentation ¾ Recommended standards for Evidence/assessment ¾ Direct Observation of Clinical Practice ¾ Mini CEX ¾ Logbook ¾ RITA ¾ Achievement of: • • • • DFFP LoCIUT LoCSdI MRCOG Part 2 Knowledge criteria ¾ Reversible. the diagnosis and management of sexually transmitted infections including HIV and sexual dysfunction. clinical and nonclinical ¾ Understands the need to respect Training support ¾ StratOG. drug users and prisoners ¾ Sexually transmitted infections including ¾ Manage the following clinical situations: • • • • emergency contraception hormonal contraception Insertion of intrauterine contraceptive device medical termination of pregnancy (early/late) ¾ Case-based discussions ¾ Reflective diary ¾ Deliver all methods of reversible contraception: • female sterilisation . e. asylum seekers. child protection and the Sexual Offences Act 2003 ¾ Recognise and manage the sexual healthcare needs of vulnerable groups. complications and adverse effects of drug treatment ¾ Demonstrates the ability to formulate and implement a management plan ¾ Demonstrates effective liaison with colleagues in other disciplines. Clinical competency ¾ Take a history in relation to: • • • • contraceptive and sexual health needs and risk assessment unplanned pregnancy Professional skills and attitudes ¾ Demonstrates the ability to counsel women sensitively about their options and the associated sexual health issues ¾ Displays tact.

uk www. e.ffprhc.Ipms ¾ Network with other providers in multidisciplinary team. implications for doctors in genital ulcerations practice clinical presentations of complications of common STIs.rcog.g.org.org. clinical features. including the knowledge of the support systems available for patients ¾ Demonstrates the ability to promote healthy lifestyles ¾ Is aware of the BMA/GMC Guidance for Doctors with Conscientious Objections to Abortions sexual health services (March 2005) ¾ DH Chlamydia screening programme ¾ SIGN guidelines ¾ Useful websites: • • • • • • • www.org. aetiology.nice.g.JMedit/16-11-2006 HIV/AIDS: • transmission.bashh. genital candidiasis ¾ Treat and arrange follow-up .g: • • • • • • • counsellors social workers genitourinary medicine specialists contraception specialists primary care voluntary sector/self-help groups police • • ¾ Sexual problems: • • anatomy and physiology of the human sexual response epidemiology.g.medfash.org. e. discharge. Doctor publications and their dysuria. clinical features and prognosis of psychosexual/sexual problems ¾ Recognise and manage the following: • • common clinical ¾ Is aware of the GMC Good presentations of STIs in Medical Practice and Duties of a the female patient.uk www.baasart www. e.uk www.uk www. bacterial vaginosis. acute pelvic infection ¾ Perform appropriate microbiological investigations to investigate the common presentations of STIs ¾ Recognise and manage clinical presentations of nonSTI genital infections. management.uk www.org. transmission and prevention National Chlamydia Screening Programme and local implementation Understand local care pathways for multiagency working and cross referrals for individuals with sexual health needs • surgical termination of early pregnancy cultural and religious beliefs as well as sexual diversity ¾ Appreciates the importance of psychological factors for women and their partners ¾ Has an understanding of the psychosocial impact of STIs and living with HIV/AIDS. pathogenesis. e.

JMedit/16-11-2006 for women with STIs as local protocols ¾ Explain the principles of partner notification and epidemiological treatment for sexual contacts ¾ Perform an HIV risk assessment and discuss HIV transmission with women ¾ Give appropriate advice to an HIV-positive woman about interventions available to reduce vertical HIV transmission in pregnancy ¾ Perform an HIV pre-test discussion and provide appropriate management for positive and negative results ¾ Assess risk for hepatitis A/B/C infections and arrange HAV and HBV vaccination appropriately for at-risk groups according to local protocol ¾ Liaise effectively with local genitourinary medicine colleagues for effective multiagency working ¾ Take a history from the couple – or individual . counsel and plan initial management of sexual/psychosexual problems .with a sexual/ psychosexual problem ¾ Recognise.

JMedit/16-11-2006 and know when to refer ¾ ¾ .

¾ Reversal of sterilisation. intrauterine contraceptive devices). ¾ Chemical. ¾ Parasitic infections. ¾ Test of cure. Sexually transmitted infections. ¾ Postcoital methods (progestagen. ¾ Management options: abortion adoption . ¾ HIV. ¾ Screening programmes. subdermal. • keep baby. e. ¾ Health advisors. ¾ Fungal infections. Population trends. ¾ Contact tracing. intrauterine. Persona). transdermal. progesterone-containing). ¾ Bacterial infections.JMedit/16-11-2006 Appendix to Curriculum Module 15: Details of Knowledge Criteria Fertility control methods: ¾ Natural family planning (physical. ¾ Genitourinary medicine services. ¾ Prevention. ¾ Barrier (condom: male and female.g: social factors cultural factors sexual/domestic abuse poor service access/delivery. ¾ Socio-economic consequences: cycle of deprivation population trends. ¾ Intrauterine contraception. ¾ Advances in contraception (including male reversible). ¾ Protozoal infections. intramuscular. diaphragm. ¾ Detection. ¾ Viral infections. ¾ Clinical features. ¾ Treatments. including HIV/ AIDS: ¾ Transmission. ¾ Specific conditions: ¾ Chlamydia. ¾ Male and female sterilisation. ¾ Hormonal (including pharmacodynamics and metabolic effects) oral. ¾ Non-use of contraception owing to. caps). Unplanned/unwanted pregnancy: ¾ Contraceptive failure • • • • • • • • • • • method iatrogenic user. (copper-containing.

¾ Principles of psychosexual counselling. Other issues: ¾ Age. anorgasmia. ¾ Covert presentations of psychosexual problems and childhood sexual abuse. ¾ Socio-economic deprivation. ¾ Consent. ¾ Gender dysphoria. Sexual problems: ¾ Anatomy and physiology of human sexual response. ¾ Contraceptive supplies on discharge. homeless and rootless. ¾ Vulnerable adults. ¾ Importance of networks and multi-agency working. suction evacuation of uterus. cultural influences. ¾ High-risk groups for sexual poor health. medical termination). dilatation and evacuation. ¾ Psychogenic aetiology and presentation of common sexual problems such as loss of sexual interest and arousal. ¾ Counselling and support. ¾ Effect of age. ¾ Confidentiality. vaginismus. ¾ Counselling and support. ¾ Negative psychosocial impact of STIs. ¾ Special needs and vulnerable groups. ¾ Estimation of maturity. Techniques: ¾ Methods (manual vacuum aspiration. ¾ Adolescents. illness and drugs on sexual behaviour and performance. ¾ Learning disability. . ¾ STI screen and prophylaxis. mental illness). ¾ Service organisation. ¾ ‘Hard to reach’ groups (asylum seekers. substance abusers. Aftercare: ¾ Contraception. ¾ Legality.JMedit/16-11-2006 Termination of pregnancy: ¾ Pre-procedure consultation/assessment. ¾ Method options/choice. ¾ Complications of procedures. commercial sex workers. ¾ Sexual problems in special needs groups such as physical and learning disability. in particular HIV/AIDS. ¾ Sexual health. ¾ Referral pathways to local expertise in the field of psychosexual medicine and sexual dysfunction.

JMedit/16-11-2006 .

surgical) Unplanned pregnancy: Outpatient consultation and referral Perform (to indicated level): Early medical termination of pregnancy Late medical termination of pregnancy Early surgical termination of pregnancy Late surgical termination of pregnancy Signature Date Direct Supervision Signature Date Independent Practice Signature Intermediate Training Advanced Training . regarding all options Provide: Reversible contraception Emergency contraception: hormonal Emergency contraception: intrauterine Permanent (female only. termination of pregnancy. discuss and manage the following issues: A sexual health risk assessment A request for contraception: Discuss and inform. sexual problems) Competence level: Basic Training Skill Observation Date Identify.JMedit/16-11-2006 MODULE 15 TOPIC: Sexual and reproductive health (contraception. STIs and HIV.

JMedit/16-11-2006 Post-procedure follow-up consultation STIs including HIV/AIDS: Diagnosis and management of the common STIs Chlamydia screening and treatment Explain the principles of partner notification Perform an HIV risk assessment Psychosexual problems Take a history from individual/couple Plan initial management/know when to refer .

JMedit/16-11-2006 Training Courses or sessions Title

Signature of educational supervisor

Date

Authorisation of signatures – please print your name and sign: Name (please print)

Signature

Completion of Module 15 I confirm that all components of the module have been satisfactorily completed: Date Signature of Educational Superviser

Name of Educational Superviser

JMedit/16-11-2006

Curriculum Module 16: Early pregnancy care
Learning outcomes:
• To understand and to demonstrate appropriate knowledge, skills and attitudes in relation to early pregnancy loss. Clinical competency ¾ Clinical assessment of miscarriage and ectopic pregnancy ¾ Ultrasonagraphic (transabdominal and transvaginal) and biochemical assessment of early pregnancy ¾ Communication of findings ¾ Appropriate referral for more complex or detailed evaluation with ultrasound or other imaging techniques ¾ Surgical, minimal access surgery and non-surgical management of miscarriage and ectopic by appropriate techniques ¾ Exhibit technical competence surgically and make appropriate operative decisions Professional skills and attitudes ¾ Demonstrates the ability to communicate effectively with patients and relatives ¾ Has the ability to break bad news and appreciate and describe the possible long-term consequences for the woman in a sensitive manner ¾ Has the desired skills necessary to counsel patients in an acute and outpatient environment ¾ Demonstrates the ability to communicate findings to patients and other healthcare professionals ¾ Has the skills to work with other healthcare professionals to achieve better patient outcomes ¾ Has the ability to recognise limits of own competence and develop the skills to refer appropriately Training support ¾ Basic Surgical Skills Course ¾ StratOG.net: Gynaecological Problems and Early Pregnancy Loss e-tutorials ¾ Ultrasound skills course ¾ Management of Early Pregnancy Loss (25) Oct 2006 Evidence/assessment ¾ Meetings attended ¾ Case reports ¾ Reflective diary ¾ Audit project ¾ MRCOG Part 2

Knowledge criteria ¾ Epidemiology, aetiology, pathogenesis and clinical features of miscarriage ¾ Trophoblastic disease and ectopic pregnancy ¾ Medical management of ectopic pregnancy ¾ Indications and limitations of Investigations: • • • • • • endocrine anatomical immmunological genetic radiological bacteriological

¾ Understanding of management options ¾ Prognosis after miscarriage(s) and ectopic pregnancy

JMedit/16-11-2006
Knowledge criteria ¾ Role and use of ultrasound in early pregnancy loss ¾ Anatomy and embryology ¾ Ultrasound examination ¾ Site of gestation ¾ Sac(s) size ¾ Yolk sac ¾ Fetal pole(s) ¾ Heart beat Clinical competency ¾ Perform transabdominal early pregnancy assessment (up to 14 weeks) ¾ Awareness of role of transvaginal US scanning ¾ Record and interpret nonviable or early pregnancy failure (including ectopic pregnancy) ¾ Diagnose viable intrauterine pregnancy ¾ Determine gestational age by gestation sac size or crown–rump length ¾ Diagnose multiple pregnancy with appropriate referral for chorionicity ¾ Record and interpret early pregnancy failure ¾ Recognise ectopic pregnancy/absence of intrauterine pregnancy ¾ Recognise a molar pregnancy ¾ Recognise an intrauterine device in the presence of a pregnancy ¾ Failed intrauterine contraception Professional skills and attitudes ¾ Training support ¾ Theoretical accredited course (local or RCOG) ¾ Supervised structured clinical learning sessions ¾ Supervised participation at an early pregnancy unit ¾ Observe transvaginal scanning ¾ Attendance at a gynaecology ultrasound list ¾ Personal study ¾ RCOG/RCR report 2005 “Guidance on ultrasound procedures in early pregnancy” ¾ Relevant green-top guidelines Evidence/assessment ¾ Certificate of course attendance ¾ MRCOG Part 2

JMedit/16-11-2006 Knowledge criteria ¾ Principles of ultrasound examination including Doppler: • • • • • • physics safety machine set-up patient care principles of report writing benchmarking Clinical competency ¾ Understand the principles of conducting a safe and appropriate ultrasound examination ¾ Use an ultrasound machine competently and independently Professional skills and attitudes ¾ Respects patient dignity and privacy during intimate examinations ¾ Is aware of the need for a chaperone ¾ Is aware of health and safety issues when using imaging technology ¾ Demonstrates the ability to communicate within teams. and with patients Training support ¾ Course including both: • • theory practical demonstration of machine use and reporting Evidence/assessment ¾ Certificate of attendance at MRCOG-accredited course ¾ MRCOG Part 2 ¾ OSATS ¾ Uterine evacuation .

inherited and acquired activated Protein C resistance) Genetic (parental karyotype. follow up. hysteroscopy) Ectopic pregnancy: Endocrine (beta-hCG) Radiological/imaging (transvaginal ultrasound) Bacteriological (Chlamydia screening) Trophoblastic disease: Endocrine (beta-hCG) Understanding of management options: Miscarriage (conservative. contraception). fetal karyotype) Radiological/imaging (pelvic ultrasound. HVS. . medical. Prognosis after: Miscarriage (recurrence) Ectopic (recurrence. future pregnancy management. surgical) Ectopic (medical. surgical) Trophoblastic disease (understanding of surgical procedure/precautions). BV screen) Thrombophilia (antiphospholipid syndrome screen) Radiological/Imaging (pelvic/cervical ultrasound. contraception) Trophoblastic disease (prognostic factors. hysteroscopy) Recurrent: Endocrine (gonadotrophins) Thrombophilia ( antiphospholipid syndrome screen.JMedit/16-11-2006 Appendix to Curriculum Module 16: Details of Knowledge Criteria Indications and Limitations of investigations Miscarriage: Sporadic: Mid-trimester: Endocrine (beta-hCG) Radiological (TVS) Bacteriological (Chlamydia.

JMedit/16-11-2006 MODULE 16 TOPIC : Early pregnancy care Competence level: Basic Training Skill Observation Date Miscarriage: clinical assessment First-trimester scanning: Management of patient Use of machine Communication of findings Viability Number of fetuses Measurement of CRL Medical management of miscarriage Surgical management of miscarriage Counselling Manage recurrent miscarriage Signature Date Intermediate Training Direct Supervision Signature Date Advanced Training Independent Practice Signature .

JMedit/16-11-2006 Ectopic pregnancy: Diagnosis Conservative management Laparoscopic management Laparotomy for ectopic pregnancy Other conditions: Early management of trophoblastic disease .

Date Date Date Date Date Signature Signature Signature Signature Signature Completion of Module 16 I confirm that all components of the module have been satisfactorily completed Date Signature of Educational Superviser Name of Educational Superviser .JMedit/16-11-2006 Training courses or sessions Title Basic obstetric ultrasound theoretical course Signature of educational supervisor Date Authorisation of signatures – please print your name and sign: Name (please print) Signature OSAT Uterine evacuation Each OSAT should be successfully completed for Independent Practice on five occasions before the module can be signed off.

JMedit/16-11-2006 UTERINE EVACUATION Trainee name: Level of training: Grade/Year Assessor name: Post: Date: Clinical details of complexity/difficulty of case Item under observation Performed Needs independently help PLEASE TICK RELEVANT BOX Vaginal examination to assess uterine size and cervical size and dilatation Careful dilatation of cervix if appropriate Appropriate choice of instrument for evacuation Safe introduction of instrument Ensure cavity is empty Ensure adequate uterine contractions Check blood loss Careful removal of Volsellum Comments: Both sides of this form to be completed and signed .

Insight/attitude Some understanding of areas of weakness. Frequently stopped operating or needed to discuss next move. Communicated poorly or frequently showed lack of awareness of the needs of the patient and/or the professional team. Consistently communicated and acted with awareness of the needs of the patient and/or of the professional team. please ring the candidate’s performance for each of the following factors: Respect for tissue Frequently used unnecessary force on tissue or caused damage by inappropriate use of instruments.JMedit/16-11-2006 GENERIC TECHNICAL SKILLS ASSESSMENT Assessor. Consistently placed sutures accurately with appropriate and secure knots and with proper attention to safety. Obvious familiarity with instruments. Reasonable communication and awareness of the needs of the patient and/or of the professional team. Consistently placed assistants poorly or failed to us assistants. motion and flow of operation and forward planning Made reasonable progress but some unnecessary moves. Careful handling of tissue but occasionally caused inadvertent damage. Knowledge and handling of instruments Suturing and knotting skills as appropriate for the procedure Technical use of assistants Relations with patient and the surgical team Lack of knowledge of instruments. Many unnecessary moves. Sound knowledge of operation but slightly disjointed at times. indicating findings. Poor understanding of areas of weakness. Appropriate use of assistant most of the time. Obviously planned course of operation with effortless flow from one move to the next. Time. Strategically used assistants to the best advantage at all times. Competent use of instruments but occasionally awkward or tentative. Limited documentation. Economy of movement and maximum efficiency. poorly written. Placed sutures inaccurately or tied knots insecurely and lacked attention to safety. Please complete the relevant box: Needs further help with: * * Date Competent to perform the entire procedure without the need for supervision Date Signed (trainer) Signed (trainer) Signed (trainee) Signed (trainee) Please complete the relevant box . Knotting and suturing usually reliable but sometimes awkward. Consistently handled tissues appropriately with minimal damage. procedure and postoperative management. Adequate documentation but with some omissions or areas that need elaborating. Fully understands areas of weakness Comprehensive legible documentation.

prevention. aetiology.uk www. management.nhs. especially with respect to death and burial practices Training support ¾ Appropriate postgraduate education courses ¾ Multidisciplinary and clinical team meetings ¾ StratOG. clinical and nonclinical ¾ Demonstrates an awareness of cultural and religious issues. complications and anatomical considerations of premalignant and malignant conditions of: • • • • • • vulva vagina cervix uterus fallopian tube ovary ¾ FIGO classifications for gynaecological tumours ¾ Palliative and terminal care ¾ Relief of symptoms ¾ Community support roles ¾ Indications and limitations in relation to screening and investigative techniques: • • • • cytology colposcopy gastrointestinal endoscopy minor procedures ¾ Recognise.uk www.sign.rcog. complications and adverse effects of drug treatment.org.nice.net: Gynaecological Oncology e-tutorials ¾ The Obstetrician & Gynaecologist ¾ Palliative care course or sessions (including in hospice) ¾ Breaking bad news course ¾ Basic colposcopy course ¾ Colposcopy sessions ¾ Useful websites: • • • www.scot.JMedit/16-11-2006 Curriculum Module 17: Gynaecological oncology Learning outcomes: • To understand and demonstrate appropriate knowledge.ac.show.uk/sp cerh Evidence/assessment ¾ Logbook ¾ Reflective diary ¾ RITA ¾ MRCOG Part 2 ¾ Case reports ¾ Audit projects ¾ Meetings attended Knowledge criteria ¾ Epidemiology. chemoand radiotherapy in language appropriate for the patient ¾ Deals sensitively with issues regarding palliative care and death ¾ Is aware of the ‘End of Life’ policy ¾ Demonstrates effectiveness in liaising with colleagues in other disciplines. counsel and plan initial management of carcinoma of: • • • • cervix endometrium ovary vulva . skills and attitudes in relation to gynaecological oncology Clinical competency ¾ Perform cervical smear and counsel about cervical cytology reports ¾ Perform cervical colposcopy under direct supervision ¾ Recognise. screening. prognosis.org. diagnosis. counsel and plan initial management of premalignant conditions of: • • • cervix endometrium vulva Professional skills and attitudes ¾ Shows empathy with patients ¾ Recognises the importance of psychological factors for women and their families ¾ Demonstrates respect for the patient’s dignity and confidentiality ¾ Hasthe ability to explain clearly and openly treatments.uk www.

complications and outcomes of: • • • oncological surgery radiotherapy chemotherapy . techniques.JMedit/16-11-2006 ¾ Diagnostic imaging ¾ Indications.

aetiology. vaginal and peritoneal) colposcopy: o cervix o vagina o vulva ¾ Uterus: intraendometrial adenocarcinoma adenocarcinoma adenosquamous carcinoma sarcoma leiomyosarcoma haemangiopericytomata trophoblastic disease. invasive) ¾ Minor procedures: • • • • directed cervical biopsy cone biopsy of cervix endocervical curettage ¾ Diagnostic imaging: radiography: o standard plain film evaluation of heart. screening. diagnosis. prevention. prognosis. complications and anatomical considerations of premalignant and malignant conditions of: ¾ Vulva: • • • • • • • • • • • • • • • • • • • • • • • • preclinical phase of invasive carcinoma Paget’s disease basal cell carcinoma squamous cell carcinoma malignant melanoma sarcoma • • mesonephroma metatastic carcinoma ¾ Palliative and terminal care: • • • • relief of symptoms pharmacological alternative therapies community support roles: o general practitioner o district nurse o family o religion o community services ¾ Cervix: human papillomavirus screening preclinical phase of invasive squamous cell carcinoma adenocarcinoma in situ squamous cell carcinoma adenocarcinoma sarcoma metastatic tumours ¾ Hospice care ¾ Indications and limitations of screening and investigative techniques: • • cytology: o cervical o other (endometrial. partial. hydatiform mole (complete. management. abdomen and skeletal system o urography (intravenous.JMedit/16-11-2006 Appendix to Curriculum Module 17: Details of knowledge criteria Epidemiology. retrograde) o gastrointestinal imaging o lymphangiography ¾ Ovary: epithelial tumours germ cell tumours sex chord stromal tumours gonadoblastoma .

other) o nodal biopsies (pelvic. other) o open biopsies gastrointestinal: o resection o reanastomosis o colostomy • • .JMedit/16-11-2006 o o angiography (pulmonary. transabdominal. abdominal. techniques. body) • ultrasonography: o pelvis o abdomen o retroperitoneal masses o peripheral vascular thrombosis magnetic resonance imaging: o pelvis o abdomen o other • ¾ Indications. complications. renal. live. pelvic) computerised tomography (head. transverse colon. and outcomes of: • oncological surgery: o gynaecological o radical hysterectomy o pelvic lymphadenectomy o radical vulvectomy o vaginal reconstruction o pelvic exenteration o feeding jejunostomy/gastrotomy urinary tract: o ureter (ureteroneocystostomy. lung. end-to-end ureteral anastomosis) o conduits (ileum. sigmoid colon) o repair of vesicovaginal fistulae o hysteroscopy o endometrial curettage o vulval biopsy o needle biopsies (transvaginal.

JMedit/16-11-2006 ¾ Radiotherapy: • therapeutic methods: o interstitial o intracavity o external complications: o gastrointestinal tract o urinary tract o skin o bone marrow o kidneys o liver o central nervous system • ¾ Chemotherapy: • • • drug agents adverse effects monitoring .

JMedit/16-11-2006 MODULE 17 TOPIC: Gynaecological oncology Competence level: Basic Training Intermediate Training Advanced Training Independent Practice Date Signature Skill Observation Date Cervical cytology: Counsel about cytology reports Perform basic colposcopy examination Management cervical intraepithelial neoplasia Manage premalignant conditions: Cervical Endometrial Lower genital tract Recognise. counsel and plan initial management of carcinoma of: Cervix Endometrium Ovary Vulva Choriocarcinoma Rapid access clinic Signature Direct Supervision Date Signature .

JMedit/16-11-2006 Training courses or sessions Title Basic colposcopy training Signature of educational supervisor Date Authorisation of signatures – please print your name and sign: Name (please print) Signature Completion of Module 17 I confirm that all components of the module have been satisfactorily completed Date Signature of Educational Superviser Name of Educational Superviser .

JMedit/16-11-2006 Curriculum Module 18: Urogynaecology and pelvic floor problems Learning outcomes: • To understand and demonstrate appropriate knowledge.nhs.ac.org.rcog. physiology and pathophysiology of: • • pelvic floor urinary tract ¾ Epidemiology.org. aetiology.sign. complications and adverse effects of drug and surgical treatments ¾ Demonstrates the need to deal sensitively with issues regarding incontinence ¾ Has the skills to liaise effectively with colleagues in other disciplines.uk www. characteristics and prognosis of: • • • • • urinary and faecal incontinence urogenital prolapse urinary infection lower urinary tract disorders urinary disorders associated with other conditions ¾ Indications and limitations of investigations: • • • • • • microbiological examination of urine quantification of urine loss urodynamic investigations videocystourethrography urethrocystoscopy imaging ¾ Be aware of the National Continence Policy ¾ Observe procedure: • minimally invasive slings .uk www.net: Urogynaecology and Pelvic Floor Problems etutorials ¾ The Obstetrician & Gynaecologist ¾ Urodynamic sessions • • • • • Useful websites: www.uk/sp cerh Evidence/assessment ¾ Logbook ¾ Reflective diary ¾ RITA ¾ MRCOG Part 2 ¾ Case reports ¾ Meetings attended ¾ Audit projects Knowledge criteria ¾ Anatomy.nice.uk www. skills and attitudes in relation to urogynaecology and pelvic floor problems Clinical competence ¾ Take a urogynaecological history ¾ Interpret investigations ¾ Assessment and nonsurgical management of uterovaginal prolapseTreatment of acute bladder voiding disorder ¾ Counsel and plan initial management of overactive bladder symptoms and stress urinary incontinence ¾ Direct supervision: • • Primary repair of anterior and posterior prolapse vaginal hysterectomy Professional skills and attitudes ¾ Shows empathy with patients ¾ Appreciate the importance of psychological factors for patients ¾ Demonstrates respect for patient’s dignity and confidentiality ¾ Has the ability to explain clearly and openly treatments.show. clinical and nonclinical Training support ¾ Local and regional courses ¾ Multidisciplinary and clinical team meetings ¾ StratOG.scot.

limitations and complications of treatment: • • • non-surgical drug surgical .JMedit/16-11-2006 ¾ Indications. techniques.

JMedit/16-11-2006 Appendix to Curriculum Module 18: Details of knowledge criteria ¾ Imaging: Epidemiology. techniques. aetiology. limitations and complications of treatment: ¾ Non-surgical: • • • • • • • • • • • • • • • • • • • • • • pads and garments bladder retraining pelvic floor exercises self-catheterisation long-term indwelling catheterisation community care ¾ Lower urinary tract disorders: • • • • • urethral disorders pain fistulae effects of radical pelvic surgery effects of irradiation ¾ Drug: anticholinergics anti-muscarinic alpha blockers antidepressants estrogens ¾ Urinary disorders associated with other conditions: • • • • pregnancy gynaecological pathology elderly patients neurological conditions ¾ Surgical: urethral dilatation urethrocystoscopy suprapubic catheterisation periurethral injectables anterior repair vaginal hysterectomy vaginal repair of genital tract prolapse sling procedures colposuspension repair of recurrent prolapse fistula repair Indications and limitations of investigations: ¾ Urodynamic investigations: • • • • • voiding charts ambulatory monitoring urodynamic equipment uroflowmetry standard subtracted cystometry . characteristics and prognosis of: ¾ Urinary and faecal incontinence: • • • • urodynamic stress incontinence detrusor overactivity voiding disorders and urinary retention urinary frequency and urgency • • • upper urinary tract lower urinary tract pelvic floor Indications.

JMedit/16-11-2006 • urinary diversion • Injectables MODULE 18 TOPIC : Urogynaecology and pelvic floor problems Competence level: Basic Training Skill Observation Date Take urogynaecological history Cystoscopy Interpret: Urinary frequency volume charts Uroflowmetry profiles Cystometric investigations Residual volume measurement Manage non-surgically: Bladder voiding disorders Urgency of micturition Signature Date Intermediate Training Direct Supervision Signature Date Advanced Training Independent Practice Signature .

JMedit/16-11-2006 Uterovaginal prolapse: Assess Manage non-surgically Repair of anterior prolapse Repair of posterior prolapse Vaginal hysterectomy Stress urinary problems: Minimally invasive slings/bladder neck procedures Authorisation of signatures – please print your name and sign: Name (please print) Signature Completion of Module 18 I confirm that all components of the module have been satisfactorily completed: Date Signature of Educational Superviser Name of Educational Superviser .

To demonstrate good working relationships with colleagues. To demonstrate the ability to work in clinical teams and have the necessary leadership skills.JMedit/16-11-2006 Module 19: Professional development 1. Clinical competency ¾ Be able to communicate both verbally and in writing with patients and relatives ¾ Be able to break bad news ¾ Be able to use interpreters appropriately ¾ Be able to communicate both verbally and in writing with colleagues ¾ Be able to work effectively within a specialty team ¾ Be able to respect others’ opinions ¾ Deal with problems and difficult colleagues Professional skills and attitudes ¾ Demonstrates the ability to communicate effectively with: • • colleagues patients and relatives Training support ¾ Observation of and discussion with senior medical staff ¾ Experiential learning in the workplace ¾ Leadership course ¾ StratOG.net: The Obstetrician and Gynaecologist as a Teacher and Researcher and The Obstetrician and Gynaecologist as a Professional e-tutorials Evidence/assessment ¾ MSF ¾ Mini CEX ¾ Logbook ¾ Reflective Diary Knowledge criteria ¾ Roles and responsibilities of team members involved in delivering care ¾ How a team works effectively and ways of improving teamworking: • • • objective setting and planning motivation and organisation respect ¾ Demonstrates the ability to break bad news appropriately and support patients in distress ¾ Has the ability to work in a clinical team ¾ Understand the contribution that mentoring and supervision make to professional and personal development ¾ Theories of motivation and demotivation . team working and leadership skills Learning outcomes: • • • To demonstrate effective communication with patients and colleagues. To understand ‘Good Medical Practice’ and professionalism. 2. Communication. The process of becoming a consultant Learning outcomes: • • To ensure a smooth transition and effective start to professional life as a consultant.

and managing time effectively. Managing self and others. To understanding of the appraisal system. how conflict arises and the principles for resolution ¾ Becoming a consultant 4. managing and developing trainees Learning outcomes: • • • To develop skills in prioritising work.JMedit/16-11-2006 ¾ Factors that influence and inhibit team development ¾ Leadership skills 3. Negotiating and influencing skills Learning outcomes: • • To develop principles of effective negotiation. To understand the responsibilities for trainees. To enhance competence in formal and informal situations that require assertive responses.net: The Obstetrician and Gynaecologist as a Teacher and Researcher and The Obstetrician and Gynaecologist as a Professional e-tutorials Evidence/assessment ¾ MSF ¾ CBD ¾ Career guidance Knowledge criteria ¾ Principles of effective negotiation ¾ Characteristics and phase of negotiation ¾ Tips and tactics for influencing others and arriving at win-win situation ¾ Techniques in assertion and persuasion ¾ Understanding yourself. . Clinical competency ¾ Identify and improve skills to prepare effectively for negotiations and discussions that require ability to influence colleagues ¾ Understanding other styles and making the most of difficulties ¾ Choosing the right job ¾ Application interview process ¾ Professional role of a consultant Professional skills and attitudes ¾ Has the ability to be able to assess competence of SpRs in formal negotiations and informal situations that require assertive responses ¾ Has developed the skills to accessing appropriate career guidance ¾ Understands job planning and negotiating a contract Training support ¾ Management course ¾ StratOG.

living wills . Defence Unions. skills and attitudes to act in a professional manner at all times. Good Medical Practice and maintaining trust Learning outcomes: • • To inculcate the habit of lifelong learning and continuing professional development. Clinical competency ¾ Be able to recognise and use learning opportunities ¾ Be able to deal appropriately with challenging behaviour ¾ Recognise own limitations ¾ Recognise when personal health takes priority over work pressure ¾ Be able to gain informed consent ¾ Understand ethical issues relevant to subspecialty ¾ Understand legal responsibilities Professional skills and attitudes ¾ Demonstrate the ability to learn from: • • colleagues experience Training support ¾ Observation of and discussion with senior medical staff ¾ Management course ¾ NHS appraisal ¾ StratOG. BMA specialist societies STC and postgraduate dean Defence unions ethical principles respect for autonomy beneficence and non maleficence justice ¾ Demonstrate the ability to work towards independent practice but seek advice appropriately ¾ Show competence in gaining informed consent for: • • patient care and procedures research ¾ Informed consent ¾ Confidentiality ¾ Legal issues: • • • death certification mental illness advance directives.JMedit/16-11-2006 5. To ensure that trainee has the knowledge.net: The Obstetrician and Gynaecologist as a Teacher and Researcher and The Obstetrician and Gynaecologist as a Professional e-tutorials Evidence/assessment ¾ MSF ¾ Logbook ¾ Reflective diary Knowledge criteria ¾ Continuing professional development ¾ Doctor–patient relationship ¾ Personal health ¾ Understand relevance of: • • • • • • • • • RCOG GMC.

JMedit/16-11-2006 .

developing skills in: • • • team building appointments procedures disciplinary procedures ¾ Develop interviewing techniques and those required for performance review ¾ Write a simple business case ¾ Financial resource management . clinical director. To understand and demonstrate appropriate skills and attitudes in relation to administration and management. SHA Commission for Health Improvement educational inspection visits ¾ Be able to participate in recruitment: • • job specification interview and selection ¾ Workings within organisations ¾ Role of medical director. trust PCT.JMedit/16-11-2006 6. chief executive ¾ Health and safety ¾ Management: • • • strategy development business planning project management ¾ Work effectively with human resources departments. Administration and service management Learning outcomes: • • To display knowledge of the structure and organisation of the NHS nationally and locally. Clinical competency ¾ Develop and implement organisational change: • • • development of strategy formulate a business plan manage project Professional skills and attitudes ¾ Initiate and implement organisational change ¾ Demonstrate collaboration with: • • other professions other agencies Training support ¾ Observation of and discussion with senior medical and management staff ¾ Attendance at directorate management meetings ¾ Management course ¾ Equal opportunity course Evidence/assessment ¾ Management course certificate ¾ Logbook ¾ Reflective diary Knowledge criteria ¾ Organisation of NHS services: • • • • directorate.

JMedit/16-11-2006 MODULE 19 TOPIC : Professional development Competence level: Basic Training Skill Observation Date Demonstrate effective teamworking Show evidence of team leadership Verbal communication with patients Verbal communication with colleagues Written communication Signing perinatal death certificates Signature Date Direct Supervision Signature Independent Practice Date Signature Intermediate Training Advanced Training Authorisation of signatures – please print your name and sign: Name (please print) Signature .

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