Differences in Specialty Training O&G vs cSRH January 2013 Dr 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?

SRH Training Modules

KEY MESSAGE-1 Basic ST1,2&3 Int ST 4&5 Adv ST6 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

Basic ST1&2 Int ST 3,4&5 Adv ST6&7 Basic ST1,2&3 Int ST 4&5 Adv ST6

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 each module can be accessed individually and this easier to utilisewww.fsrh.org

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 each module can be accessed individually and this easier to utilisewww.fsrh.org cSRH trainees are VERY SMALL in number Currently n=20 in UK CfWP has authorised 15 more over the next 3yrs

15 modules Module 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 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 Modules Module 1 Clinical skills Module 2 Teaching, appraisal and assessment Module 3 IT clinical governance and research Module 4 Ethics and legal issues Module 5 Core surgical skills Module 6 Postoperative care Module 7 Surgical procedures Module 8 Antenatal care Module 9 Maternal medicine Module 10 Management of labour Module 11 Management of delivery Module 12 Postpartum Problems Module 13 Gynaecological problems Module 14 Subfertility Module 15 Sexual and reproductive health Module 16 Early pregnancy care Module 17 Gynaecological oncology Module 18 Urogynaecology and pelvic floor problems Module 19 Developing professionalism

15 modules Module 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 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 Sub-fertility Gynae oncology Urogynaecology + pelvic floor problems Community-based Mx

KEY MESSAGE-2 Basic ST1,2&3 Int ST 4&5 Adv ST6 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 modules Module 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 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 5 Gynae oncology Level 2 basic colposcopy + Mx of CIN Urogynaecology + pelvic floor problems Level 3 Interpret urodynamics

15 modules Module 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 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 4 Level 3 Marsupialisation of Bartholin’s Endometrial ablation Level 2 Diagnostic Laparosopy

15 modules Module 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 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 19 th ) 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 SMALL Currently 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