Yorkshire Humber Deanery School of Obstetrics Gynaecology

1. Yorkshire & Humber DeanerySchool of Obstetrics & Gynaecology Induction for Trainees September 2010

2. Introduction 1 Who is in charge of my training? What should happen when I start my post? E-portfolio How will my progress during clinical training be assessed? How do I feedback on training? What tools do I use to get specific competencies assessed and signed off during my training? How do I organise workplace based assessment WPBA?

3. Introduction 2 YMTP & Study Leave Ultrasound training ATSMs Rotations Bullying Serious untoward incidents SUI Trainee support Out of programme experience OOP Flexible training

4. Who is in charge of my training? You � Trainee driven process Educational supervisor will review training but you have to collect training documents, attend training sessions and make appointments to see ES. Your responsibility to submit required documents on time for ARCP Deanery: Head of School: Dr Diana Fothergill Training Programme Director: Dr Jackie Tay Deputy TPD: Mr John Jolly RCOG College Tutors: Miss K Graham, Miss P Munjuluri, Dr J Bodle, Mr J Jolly, Miss L Rogerson, Mr N Simpson, Mr D Nugent, Mr J Campbell Yorkshire and Humber Deanery: Jemma Leckenby Joanne Aisthorpe

5. Do I register with the RCOG as a trainee? You MUST subscribe to the Trainees Register (NTN) Optional for FTSTA�s but advised �75 includes benefits Obtain training portfolio (e-portfolio) N.B. Must maintain annual subscription or you will be denied access to the eportfolio!

6. E-portfolio All ST1 - 4 trainees should now be using this Mandatory, however can print off paper based portfolio Pocket log book to carry with you No additional charge TPD and HOS access it to check up on your progress

7. PORTFOLIOS Do not include any patient identification DOB Name hospital number Anonymise scans, operation notes Organise and keep up to date Plastic folders to group OSATs CBDs, etc Regular review of competences to be signed off

8. What should happen when I start my post? Meet your College Tutor Allocated an Educational Supervisor Meet your educational supervisor within 3 weeks and set out your training goals and arrange your next meeting Deanery will contact you with your training number NUMBERS ENDING /E DO NOT LEAD TO CCT but CESR(CP) ST3 starters and LATs must meet with TPD to discuss level at which they are to be assessed as working

9. How will my progress during clinical training be assessed? ST 1 � 2: Core ST 3 � 5: Intermediate ST 6 � 7: Advanced Regular local Assessment and appraisal with ES & College Tutor Start, mid, end of placement Annual Review of Competency Progression (ARCP) ARCP based on portfolio evidence � evidence is reviewed in absence of trainee and outcome given

10. ST1 minimum OSAT requirements Demonstrate the following competences: Open and close abdomen Fetal blood sampling

11. ST2 minimum OSAT requirements Demonstrate the following competences: Perineal repair Uncomplicated and acute CS Non-rotational vacuum delivery Manual removal of placenta Evacuation of uterus

12. Mandatory requirements for progression from ST2 to ST3 MRCOG part 1 Basic practical skills course (BSS course) Completion of all basic training (white boxes in core logbook) ARCP 1 Will be asked to attend ARCP panel from 2011

13. Additional evidence for ARCP Annual audit Satisfactory TO2 Completion of STRAT OG modules and attendance at regional teaching Progressive acquisition of competences in log book

14. ARCP outcomes ARCP 1 no concerns ARCP 2 development of specific competences required but not adding to training time ARCP3 inadequate progress additional training time required ARCP 5 inadequate evidence may need extra training time ARCP 7 for LAT posts lists specific competences Cannot have IDT or OOP unless ARCP 1

15. ARCP 2 or 3 ARCP 2 and 3 not �BAD� it puts onus on trainers to provide specific training but repeated or prolonged ARCP 3 can lead to exiting programme

16. How do I feedback on training PMETB annual trainees survey TEF collated annually at ARCP Hours monitoring Trainees rep on STC � Dr Hlupe Chipeta Speak to local tutor if concerns, contact TPD

17. What tools do I use to get specific competencies assessed and signed off during my training? OSATS � minimum of 3 completed successfully, at least ONE MUST BE BY A CONSULTANT, more showing progression, don�t just ask for them when you feel confident. Check grid. CBDs � minimum of 6 completed satisfactorily (3obs+3gyn) which should be used as evidence to sign off log book competences MiniCex � minimum of 6 completed satisfactorily (3obs+3gyn) which should be used as evidence to sign off log book competences Reflective practice � at least 2 episodes which should be discussed with your ES. If involved in a clinical incident, this should be recorded as Reflective log and discussed.

18. What tools do I use to get specific competencies assessed and signed off during my training? All assessments to be done by at least 2 different assessors. At least 1 assessor to be a consultant for each WPBA (2 for some OSATs) These can only be completed by another trainee if they are at least 2 years your senior Senior midwives as assessors - only for procedures like perineal suturing and hand hygiene/aseptic techniques

19. How do I organise WPBA? Ask assessor at start of procedure and bring forms with you- not retrospectively CBD takes time - better at start of a clinic rather than at the end! Discuss the case and complete paperwork later Do not continue to complete OSATs for the same procedure once 3 satisfactory obtained, unless more complex cases Ensure all parts of forms are completed

20. YMTP & Study Leave Be organised! Sima Raw - co-ordinator Year 1 - 5 (less structured in Year 5) Courses cover the log-book requirements Co-ordinate study leave Meetings and presentations - funding etc Regional Trainees Day � 28th January 2011

21. Ultrasound training All trainees should be competent at basic early pregnancy and biometry scanning ST1-ST3 (up to ST5 for current trainees) Ad hoc training � clinics, LW Local units are responsible- phantoms may be available ST4 and above � sessions based on ATSMs

22. ST3-5 (intermediate training) MUST provide evidence of WBAs relevant to stage of training (OSATS, 6 minicex, 6 CBDs, 2 reflective practice) Include diagnostic & operative laparoscopy, diagnostic hysteroscopy, CS with increasing difficulty (OSATS) MRCOG part 2 in ST 4 (second sitting) so if you fail can resit March/May in ST 5 year you cannot progress to yr 6 until passed Completion of all core log book intermediate training (pink boxes) Start to consider which ATSMs and discuss with TPD- Look at pre-requisite skills, and consider undertaking mandatory courses ATSMs may require interview, evidence of suitability e.g laparoscopy

23. ST6-7 (advanced training) MUST provide evidence of WPBAs relevant to stage of training/ATSM (OSATS, 6 CBDs, 2 reflective practice) Maintain log of experience Need to complete 2 ATSMs (unless sub-speciality training) Career objectives � seek advice regarding choice/suitability Must be thinking about these in year 4 and 5 Priority will be to complete the ATSMs at expense of other aspects of training - LW training v hysterectomies May be able to do more than 2, but not normally 4 LW lead can be combined with Adv LW but mainly for those undertaking only obstetric ATSMs

24. Log book competencies Core curriculum updated � RCOG website New OSAT: laparoscopic mgt of ectopic pregnancy (module 7) Core Module 15: Sexual & Reproductive Health Medical Leadership Framework Generic Competency Framework Health Inequalities Framework

25. Log book competencies Level 1 � not the same as �Observation� Level 2 � direct supervision Level 3 � independent practice

26. ATSMs Director of ATSMs Kevin Phillips (Hull), Emma Ferriman (Leeds) leads on Obstetric topics There are 21 in total Not all modules always available Must apply prospectively to register Check RCOG website as content is evolving Difficult to achieve all competences within timescale, need to be very focussed and seek out rarer cases Some competences have to be based on theoretical discussions

27. Recommended study leave for ST 6-7

28. Rotations Usually annually Annual leave cannot be carried over (different employing Trusts) Cannot be fixed due to differing needs of trainees

29. Bullying Who to report this too: First instance educational supervisor Then College Tutor (some Units also the Director of PGME) Then TPD Then Deanery

30. Serious untoward incidents Must be reported to Deanery and the Director of PGME in employing Trust Discuss with educational supervisor ASAP Need for any additional training or assessment and support Statements - ASAP while events are clear

31. Trainee support Deanery funded confidential counselling services Self referral Workplace Wellbeing30 Wilkinson StreetSheffield, S10 2GB Telephone: 0114 226 1810 e-mail: workplace.wellbeing@sct.nhs.uk website: www.phs-sheffield.nhs.uk/wwb/

32. Out of programme experience Training, Experience, Research, Career break Must discuss with educational supervisor and TPD before applying 3 years maximum in training programme Application forms on Deanery website Subspecialty training in another deanery is OOP and will not be allowed if you have already had time out of programme DO NOT APPLY FOR ANY POST OUTSIDE PROGRAMME UNTIL DISCUSSED WITH TPD

33. Flexible training Well founded reasons Usually slot sharing 50% Treated as full timers and will rotate Still require annual assessments

34. The Future Workforce in Obstetrics and Gynaecology 2007 - 107 consultants appointed - there are 200+ NTNs annually Obstetric posts 60 Gynae onc 18 Rep med 7 Urogyn 6 Other 16

35. Finally- Welcome! We hope you enjoy your year We want to help you be excellent doctors We do try to listen to your feedback We are all learning as well!