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Obstetrics and gynaecology

Obstetrics and gynaecology is the amalgamation of two disciplines, both involved in the healthcare of women.

Obstetrics revolves around the care given to a woman before, during and after pregnancy. Gynaecology is the care of women specific to the disorders and problems unique to the female reproductive organs.

The specialty includes varied surgical work and involves close co-operation with other specialties such as urology, colorectal surgery and oncology.

Most doctors train as generalists and undertake further training in one of the following subspecialties: gynaecological oncology, maternal and fetal medicine, reproductive medicine, sexual and reproductive health, community gynaecology and urogynaecology.

  • Skills, rewards and challenges

    Skills

    • Adaptability
    • Decisiveness
    • Leadership skills
    • Good communication skills
    • Ability to sympathise and be non-judgmental
    • Work effectively as part of a team

    Rewards

    • Breadth of medicine covered
    • Involvement in deliveries
    • Scope for development of strong doctor-patient relationships
    • Varied and challenging

    Challenges

    • Long and unpredictable hours, heavy on-call duties
    • Demanding and stressful at times but enjoyable at the end
  • Training

    Specialty training in obstetrics and gynaecology comprises three levels of training - basic, intermediary and advanced training, completed over seven years.

    During basic level training, trainees gain generic skills, knowledge, understanding and competences in obstetric and gynaecological practice. During the next three years of intermediary training, trainees will be expected to build further on the skills and knowledge acquired during basic specialist training.

    Advanced training years encompass the continuation of core training and the acquisition of specialist skills through the Advanced Skills Training Modules (ATSM).

  • Inside look: consultant in obstetrics and gynaecology 1

    What factors influenced your decision to choose this branch of medicine?

    Obs and gynae excited me as a medical student where there was very much a practical hands on experience (now sadly lacking!)

     

    What are the hours like? How intensive is your work schedule?

    Compared to when I was a trainee and a new consultant the hours are fine, but there is quite a bit of night work however the compensation is less work during the day!

     

    Is there scope for flexibility, for example part-time work?

    Certainly in training and for some at consultant level. Job shares are the norm for flexible trainees.

     

    What are the highlights and advantages of working in this specialty?

    Bringing the next generation(s) safely into the world. Suits both men and women and particularly those who wish a surgical component to their work. Plenty of adrenaline and sense of achievement.

     

    … and the challenges and disadvantages?

    Dealing with unexpected bereavements when expectations are of normality remains a challenge. It’s not 9-5 but Medicine is not 9-5, I knew that when I started.

     

    What are the routine aspects, if any, of your role?

    Antenatal clinics, gynae clinics, ward rounds and labour ward cover. Being on call, the paper work and admin and attending meetings.

     

    … and the more unusual experiences to date?

    Unexpected rarities, like finding a rare uterine abnormality during Caesarean section. Dealing with the media after a press release from the Trust. Meeting Princess Diana in association with a medical charity.

     

    Please describe your duties in a typical day.

    Gynae clinic in the morning and a dedicated teaching clinic with medical students in the afternoon. Alternatively a whole day 8.30 -5.30 on labour ward and a combination of meetings, discussion of previous days emergencies, elective Caesarean sections with trainees and supervising emergency Caesarean sections, plus the occasional laparoscopic ectopic. Added to this are numerous requests for advice about patients on the wards.

     

    What are the necessary personality characteristics for this career?

    Ability to be calm but also enthusiastic. Dedicated, quick thinking and perhaps an adrenaline junkie…that wears off!

     

    What advice would you give to someone interested in pursuing a career in this branch of medicine?

    Do it! It’s a real combination of acute medicine and surgery and no day is exactly the same. It has enormous opportunities to sub specialise and for the right person at the right time to undertake cutting edge research.

     

    How competitive is this specialty?

    Entry is getting more competitive and I feel that the entry level has increased especially this year.

     

    Additional comments…

    Obstetrics and gynaecology is probably the specialty with the widest options from a single point entry.

  • Inside look: consultant in obstetrics and gynaecology 2

    What factors influenced your decision to choose this branch of medicine?

    I enjoyed the student experience of normal deliveries. I had the opportunity early in my career to do a short supernumerary attachment where I shadowed registrars and enjoyed it enormously.

     

    What are the hours like? How intensive is your work schedule?

    There is still a significant out-of-hours commitment but having always done this it isn’t that bad. Most units have increased their consultant numbers in recent years and so one is usually on-call less than once a week. Doing significant out-of-hours work means that I have free time during the week for other interests. In the future many large units are likely to move to having consultants resident for night shifts. This is likely to be compensated for with time off during the days.

     

    Is there scope for flexibility, for example part-time work?

    Being a popular choice of specialty for women, there are often opportunities for job shares as well as part-time working.

     

    What are the highlights and advantages of working in this specialty?

    It is a great mixture of medicine and surgery. The majority of patients have a good outcome.

     

    … and the challenges and disadvantages?

    Obstetrics requires effective team working with midwifery and anaesthetic colleagues, a skill that does not come naturally to all trainees. Obstetric emergencies require decisive and effective leadership but bad outcomes can be particularly heartbreaking.

     

    What are the routine aspects, if any, of your role?

    Antenatal clinics can be repetitive particularly as a trainee when the consultant sees more of the interesting cases.

     

    … and the more unusual experiences to date?

    Conducting reconstructive surgery after a pelvic exenteration for gynaecological cancer. The work is varied, mothers to be can have almost any medical condition you can think of.

     

    Please describe your duties in a typical day.

    I would start with a ward round of any emergency admissions on my take and any in-patients from elective operating. This would be followed by office work reviewing results and correspondence. Then a pre-operative ward round seeing patients admitted for surgery.

    There will be pre-theatre meetings with the anaesthetist and scrub staff to finalise arrangements for list. Operating lists could include laparoscopic hysterectomy for endometrial cancer, a diagnostic laparoscopy for pelvic pain and an endometrial ablation procedure for heavy menstrual bleeding.

     

    What are the necessary personality characteristics for this career?

    A good team worker and must be calm in a crisis.

     

    What advice would you give to someone interested in pursuing a career in this branch of medicine?

    Try it! Take any opportunity to gain some experience in it during your student career or foundation jobs.

     

    How competitive is this specialty?

    Not bad.

     

    Additional comments…

    The birth rate and the amount of involvement of consultants has steadily risen over the last decade so prospects for consultant employment are good in the longer term.