These FAQs are designed to guide you through the details of starting your training in obstetrics and gynaecology. They outline how the programme is structured, what components are included in the programme, how each year within the programme is strucuted and what assessment tools you need to complete as part of the competence sign off process.
We hope that you and your trainers will find this information useful in helping to plan your progress in your training post.
Who is in charge of my training?
Overall responsibility for your training is held within the Deanery or Postgraduate School that you have been appointed to. There is a Deanery Chair for Specialty Training in O&G and sometimes a separate Head of School. Programmes within hospitals in a Deanery are overseen by a number of Training Programme Directors. Within your local hospital, your training is overseen by the College Tutor, who will allocate you an Educational Supervisor to monitor and assess your progress.
Successful progress through training requires the trainee to drive the process and to use all available training opportunities that are offered.
What is the role of the RCOG in my training?
The RCOG sets the standards for the structure and curriculum of training that is required for you to progress through training to be awarded a CCT (or CESR) in order to be entered on the Specialist Register. All curricula are approved by PMETB. The RCOG works closely with PMETB and the Deaneries in assessing applications for CCT or CESR. Both these certifications allow you to join the Specialist Register in the UK. The RCOG also provides registered trainees with an ePortfolio and Pocket Logbook or Training Portfolio required for recording progress through training.
What should happen when I start my post?
If successfully appointed to a run-through training post, you will be allocated a national training number (NTN) by your Deanery or Postgraduate School and will be informed which hospital you will be working at. Some of you will have obtained a shorter-term training post (FTSTA), usually of 1 year in duration.
On starting your post, you will usually meet with your College Tutor and be advised of your Educational Supervisor’s (ES) details.
You must meet your ES within three weeks of commencing your post to set out your training goals for the duration of your post. You should then meet again during your post as per the guidelines set out in the induction and appraisal documentation.
Do I register with the RCOG as a trainee?
Yes. You need to subscribe to the Trainees' Register at the RCOG in order to receive your ePortfolio and Pocket Logbook, Training Portfolio and other materials. At present, this costs £75 annually and includes many benefits; for example a reduction of £50 on the registration fee for the annual trainees’ conference (‘SpROGs’).
I’m in a run through training post - what is my national training number (NTN)?
You will be contacted by your Deanery with details of your training number after commencing your post. Please be aware that this may take several weeks due to the large number of new trainees commencing at any one time. This number is unique to you and will be recorded on all documentation from the Deanery, in your training portfolio, and on your annual assessment documentation (ARCP)
How do I enrol with the RCOG?
All trainees entering specialty training must subscribe to the Trainees’ Register and must renew their subscription each year. Trainees appointed to short-term training (FTSTA) posts or non-training posts are not required to subscribe to the Register but are encouraged to do so as they will then receive benefits including trainee newsletters. Further details of how to subscribe and the benefits of registration are available on the College website.
Once you have passed your Part 2 MRCOG, your registration will continue to be recorded as a trainee but you will become a full Member of the RCOG.
How will my progress during clinical training be assessed?
Local assessment and appraisal will take place regularly during each placement by your Educational Supervisor and College Tutor. This process then feeds into to central review administered by the Deanery (ARCP – ‘Annual Review of Competency Progression’). For further general details, see Section 7 of the Gold Guide. PMETB require that the ARCP process is based on a portfolio of evidence that the trainee submits for review. Specific details about the processes and tools available for appraisal and assessment in O&G are detailed here.
How long will it take me to progress through training?
The Specialty Training Curriculum for O&G is competency-based. It is expected that most trainees starting at ST1 will take seven years to complete their training, subject to satisfactory assessment of progress. The curriculum is based on competency (rather than on ‘numbers of procedures’ or ‘time’) so some trainees may take longer to achieve all competences.
How do I progress from ST2 to ST3?
This is one of several critical steps in your career progression. You will sometimes hear these steps referred to as ‘weigh points’ to emphasise their importance. This particular step is usually where you will progress from ‘1st on-call’ to 2nd on-call’ duties. With progression comes more responsibility, but this should always be within the limits of your competency and with continued support from your seniors. There are some mandatory requirements for progression from ST2 to ST3:
- Attainment of Part 1 of the MRCOG examination
- Completion of a relevant BPS (Basic Practical Skills) course.
- Satisfactory attainment of the relevant competences for independent practice in certain specific skills identified within the logbook (see below).
If you are an ST2 or FTSTA2 trainee, you and your educational supervisor must ensure that specific attention is given to the acquisition of the relevant competences from the start of your post in order to ensure smooth progression into ST3 (or successful application for an ST3 post if you are an FTSTA2).
What are the specific technical competences which I need to achieve to progress into ST3?
A complete list of the specific clinical competences that you need to be signed off as being competent to manage ‘unsupervised’ by the end of ST2 are detailed here:
- Opening and closing the abdomen
- Uncomplicated acute and elective caesarean section
- Non-rotational operative vacuum delivery
- Manual removal of placenta
- **CTG Interpretation
- **Management of shoulder dystocia
- **Management of cord prolapse
- Perineal repair
- Fetal blood scalp sampling
- Uncomplicated surgical uterine evacuation
- Non-rotational forceps delivery
** These skills/procedures detailed above do not have an OSATS assessment form. They can be assessed and signed off using other means; for example, as part of a specific study day or teaching session or via case-based discussion (CbD).
What tools do I use to get specific competences assessed and signed off during my training?
Various tools are available to help you to assess the development of competences. These include: OSATS (Objective Assessment of Technical Skills), CbD (Case-based Discussion) and Mini-CEX (Mini Clinical Evaluation eXercise).
What are OSATS and when are they used?
OSATS are the tool which trainers will use to assess your progress towards attaining competency in specific technical skills. They can be used to confirm parts of the skill that you are performing competently and highlight those areas that require further practice. When you are ready to perform a particular procedure competently in all areas, the same OSATS form will be used by your trainers to confirm that you can perform the particular skill independently.
To count towards overall competency in the logbook, all sections on the front of an OSATS form must be ticked in the ‘Performed independently’ box. In the ‘Generic technical skills assessment’ on the reverse of the form, the majority of competences should be ringed in the middle or to right of the list. However, for the generic skill ‘insight/attitude’, the right hand box indicating ‘fully understands areas of weakness’ must be consistently ringed.
Your educational supervisor cannot sign off completion of the relevant module in your logbook, until adequate numbers of OSATS have been signed off as described above (the number of OSATS required to confirm competency is discussed below)
- OSATS are designed to demonstrate your progression through the year. Your portfolio should contain all OSATS that you have completed to show that you are working towards competence (whether or not all sections are ‘ticked’ in the ‘Performed independently’ box). This will allow your educational supervisor to assess your progress. Individual trainers can peruse your most recent OSATS and know which parts of the skill to concentrate on when providing supervision. Remember that the ARCP reviews your progressions so you must have evidence.
- Completing an OSATS form should take no longer than 5-10 minutes of your trainer’s time. Detailed guidance on completing an OSATS is available here. Once you have been signed up as competent for ‘independent practice’ in your logbook, we recommend that you continue to demonstrate competency in this area by completing an annual OSATS assessment- however this is only a recommendation.
The logbook contains summary pages in the relevant modules to detail each time you have successfully completed an OSATS for independent practice. These can be signed either by the assessor or by your educational supervisor.
A few competences are detailed in more than one area of the logbook (e.g. manual removal of the placenta). Each section of the logbook relating to that skill can be signed off contemporaneously once competence is achieved.
Please note that OSATS exist for competences which must be attained both prior to progression into ST3, as well as during ‘intermediate training’ in ST3 and beyond. There is no restriction of when you can start collecting these competences. Some trainees may be signed off for intermediate training competences whilst still in ST1-2.
Who can assess me for an OSATS?
Any consultant, senior specialty trainee (or in appropriate situations, a co-professional) may assess you as a ‘clinical supervisor’. One example would be an experienced midwife supervising a basic perineal repair. 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. Remember that a consultant should complete at least one of the three OSATS which we require to have as evidence that you are competent for ‘independent practice’ (some Deaneries of Schools may request you collect more than three).
How does the OSATS form work?
There are two parts to the OSATS form. The first is a checklist which breaks down the procedure into steps, all of which must be successfully completed. The second is a generic technical skills assessment. The generic technical skills, not all of which will be relevant to every OSATS, will form an important part of the assessment process. It is anticipated that as you develop skills in a particular procedure, you will have increasing numbers of competences ringed in the middle or right of the generic skills assessment list. However, in order to be signed off for independent practice, you must also have the generic skill ‘fully understands areas of weakness’ within the insight/attitude section consistently ringed.
OSATS are formative assessment tools and you may have many showing that you are working towards competence. The feedback on an OSATS should be constructive so that each time you perform a procedure you learn something new and your progress is then clear in your portfolio and clinical and educational supervisors can see how you are doing.
How do I indicate the type of case that is being assessed?
The OSATS form may be used to assess technical skills at differing levels of complexity e.g. the caesarean section OSATS may be used to assess competency for a simple caesarean section or a complex caesarean section. The level of complexity should be indicated on the assessment form and you should aim to move from ‘simple’ to ‘complex’ as your training progresses.
How many OSATS, mini-CEX or CbDs do I need completed before I can be ‘signed off’ as competent for a particular skill in my logbook?
When using OSATS to define competence, the following approach is recommended in the portfolio:
a. an OSATS must have been completed successfully in all areas (i.e. every section ticked for ‘independent practice’) on at least three separate occasions
b. at least two different assessors must be involved in signing off the three OSATS
c. at least one assessment must be completed by a consultant.
Case-based discussions and Mini CEX are also formative assessments and inform supervisors of your progress, but we do state that you have a minimum of three per year (i.e. for each ARCP)
Both PMETB and the RCOG have confirmed that in a ‘competency-based’ curriculum, it is not always appropriate to expect a fixed minimum numbers of assessments in order to be deemed competent. This does not allow for individuals who may progress at different rates. The same principle can be applied when reviewing the number of completed CbDs or mini-CEX required to confirm competency for managing a particular clinical problem.
Please watch the online presentations to give you more information about the assessments, number requirements and how to use the tools to your advantage educationally.
How do I access further information about Specialty Training in general?
Overall guidance regarding the overarching principles of specialty training are contained with 'The Gold Guide'.
How do I apply for ‘Less than Full Time’ (Flexible) Training?
The RCOG has a 'Less than Full Time Training' Advisor who approves programmes and who can be contacted via the RCOG website . Further guidance can usually be found via Deanery websites.
I have not received a contract of employment. What should I do?
You should contact your employing Trust’s Medical Staffing or Human Resources department urgently.
Am I allowed to keep case notes within my training portfolio or ePortfolio?
Patient identifiable information must not be used or disclosed for purposes other than the individual’s healthcare without the subject’s explicit consent. The NHS Code of Conduct on Confidentiality provides general guidance on how patient information should be handled. Most healthcare organisations have also produced local policies which must be adhered to. For training purposes, any patient identifying information must not be kept on paper on in an ePortfolio.