Differences in Specialty Training

O&G vs cSRH

January 2013Dr Tracey Masters

Chair of CSRH Curriculum Committee

NEW specialty – BIG challenges.

We are working to a vision - preparing leaders for Sexual Health services of the future.

Community Sexual & Reproductive

Health

What will future services be like?

Obstetrics &

Gynaecology

What will future services be like?

SR

H T

raining Modules

KEY MESSAGE-1

BasicST1,2&3

IntST 4&5

AdvST6

• Whilst the cSRH trainee is only on the O&G dept on-call rota for 18 months

- their gynae training continues all the way through the 6 years

BasicST1&2

IntST 3,4&5

AdvST6&7

BasicST1,2&3

IntST 4&5

AdvST6

NEW specialty – BIG challenges.

We are working to a vision - preparing leaders for Sexual Health services of the future.

Where is cSRH curriculum? on GMC website as a single document +

Faculty website under “specialty”. at www.fsrh.org each module can be accessed individually and this easier to utilise

NEW specialty – BIG challenges.

We are working to a vision - preparing leaders for Sexual Health services of the future.

Where is cSRH curriculum? on GMC website as a single document +

Faculty website under “specialty”. at www.fsrh.org each module can be accessed individually and this easier to utilise

cSRH trainees are VERY SMALL in number Currently n=20 in UK CfWP has authorised 15 more over the next 3yrs

15 modulesModule 1 Clinical Skills

Module 2 Contraception Module 3 Abortion care Module 4 Gynaecology

Module 5 Specialist Gynae Module 6 Pregnancy (Obs)

Module 7 Menopause/PMSModule 8 GUM

Module 9 Public Health Module 10 Teaching, appraisal and assessment

Module 11 Ethics and legal issues Module 12 Leadership, governance and management

Module 13 Research Methodology, Audit and IT Module 14 Sexual Assault

Module 15 Sexual Problems

19 ModulesModule 1 Clinical skills

Module 2 Teaching, appraisal and assessmentModule 3 IT clinical governance and research

Module 4 Ethics and legal issuesModule 5 Core surgical skillsModule 6 Postoperative careModule 7 Surgical procedures

Module 8 Antenatal careModule 9 Maternal medicine

Module 10 Management of labourModule 11 Management of delivery

Module 12 Postpartum ProblemsModule 13 Gynaecological problems

Module 14 SubfertilityModule 15 Sexual and reproductive health

Module 16 Early pregnancy careModule 17 Gynaecological oncology

Module 18 Urogynaecology and pelvic floor problemsModule 19 Developing professionalism

15 modulesModule 1 Clinical Skills

Module 2 Contraception Module 3 Abortion care Module 4 Gynaecology

Module 5 Specialist Gynae

Module 6 Pregnancy (Obs)Module 7 Menopause/PMS

Module 8 GUMModule 9 Public Health

Module 10 Teaching, appraisal and assessmentModule 11 Ethics and legal issues

Module 12 Leadership, governance and managementModule 13 Research Methodology, Audit and IT

Module 14 Sexual AssaultModule 15 Sexual Problems

•Sub-fertility•Gynae oncology•Urogynaecology + pelvic floor problems

Community-based Mx

KEY MESSAGE-2

BasicST1,2&3

IntST 4&5

AdvST6

• This is training for clinicians who will be mostly based in community settings

What is level 3? - Anchor statement: ‘To be deemed competent, the majority of cases are managed with no direct supervision or assistance (senior support will be requested in certain complex cases/complications).’

15 modulesModule 1 Clinical Skills

Module 2 Contraception Module 3 Abortion care Module 4 Gynaecology

Module 5 Specialist Gynae

Module 6 Pregnancy (Obs)Module 7 Menopause/PMS

Module 8 GUMModule 9 Public Health

Module 10 Teaching, appraisal and assessmentModule 11 Ethics and legal issues

Module 12 Leadership, governance and managementModule 13 Research Methodology, Audit and IT

Module 14 Sexual AssaultModule 15 Sexual Problems

Areas of concern in Module 5

•Gynae oncologyLevel 2 basic colposcopy + Mx of CIN

• Urogynaecology + pelvic floor problemsLevel 3 Interpret urodynamics

15 modulesModule 1 Clinical Skills

Module 2 Contraception Module 3 Abortion care

Module 4 Gynaecology Module 5 Specialist Gynae Module 6 Pregnancy (Obs)

Module 7 Menopause/PMSModule 8 GUM

Module 9 Public Health Module 10 Teaching, appraisal and assessment

Module 11 Ethics and legal issues Module 12 Leadership, governance and management

Module 13 Research Methodology, Audit and IT Module 14 Sexual Assault

Module 15 Sexual Problems

Areas of concern in Module 4Level 3 Marsupialisation of Bartholin’sEndometrial ablation

Level 2Diagnostic Laparosopy

15 modulesModule 1 Clinical Skills

Module 2 Contraception Module 3 Abortion care

Module 4 Gynaecology Module 5 Specialist Gynae Module 6 Pregnancy (Obs)

Module 7 Menopause/PMSModule 8 GUM

Module 9 Public Health Module 10 Teaching, appraisal and assessment

Module 11 Ethics and legal issues Module 12 Leadership, governance and management

Module 13 Research Methodology, Audit and IT Module 14 Sexual Assault

Module 15 Sexual Problems

Areas of concern Gynae ultrasound (lev 3)•Measure endometrial thickness•Diagnose fibroids + polyps•Diagnose ov cysts + PCOS(in other modules)•Dating early pregnancy•Localise IUD/ deep implant

(lev2) T/A scan of pelvis

Requests to GMC for cSRH curriculum changes (Oct 2012)

• Removal of Marsupialisation of Bartholin’s

• Change “Excision” of vulval lesion to “Biopsy of vulval lesion” and “Interpret urodynamic investigations” to “Understand urodynamic investigations”

• Laparoscopic procedures to be Lev 1 final competence - not Lev 2

• Endometrial ablation competency (Lev 3) to be achieved by end of Intermediate Training/ST 5 - not Basic Training/ST3

• Ultrasound competencies (Lev 3) to be achieved by end of Intermediate Training/ST 5 - not Basic Training/ST3

GMC answer (received Dec 19th)

GMC approved all the changes

requested!

Key Messages• NEW specialty

BIG challenges

• Working to a vision

• Where is cSRH curriculum? GMC website as a single document +

Faculty website under “specialty”.

• Trainee numbers SMALLCurrently n=20 in UK CfWP has authorised 15 more over the next 3yrs

• This is training for clinicians who will be mostly based in community settings

• Whilst the cSRH trainee is only on the O&G dept oncall rota for 18 months - gynae training continues all the way through the programme

Thank you for the opportunity to share / discuss

Please pass on this info to your colleagues who may work as cSRH Clinical Supervisors