The College’s mission is to set standards to improve women’s health and the clinical practice of obstetrics and gynaecology both in the UK and across the world. One of the principal means of achieving this aim is through the College’s provision of education, training, assessment and professional development.
The College, through the Educational and International departments is embarking on a new and exciting venture. Traditionally the majority of the college’s educational work is related to UK and overseas doctors who are either preparing for or who have gained the membership qualification and their subsequent professional development. The international activities of the college have to a large extent been aimed towards doctors largely conducted through the International Executive Board. This new venture is aimed at a different group, who go by different titles across the world, but who can be classed as mid-level service providers. They do not hold a medical qualification.
It is estimated that there are 500,000 maternal deaths worldwide per year. A key causal factor is the lack of local expertise – put simply, there are no skilled carers locally who can assess life threatening complications of pregnancy and labour and provide appropriate clinical interventions.
The lack of appropriate emergency obstetric care in developing countries is a worldwide concern. Governments around the world are looking at and implementing new ways of providing this vital service, including training non-clinicians to carry out assisted vaginal deliveries and caesarean sections. There is a lack of doctors in developing countries. For example, in Africa 5,000 doctors complete their medical courses per year, compared with 175,000 in Europe. For economic and other reasons, many African doctors leave their home country to work in Europe, North America and Australasia.
Over 50% of African countries have established non-clinician physicians, medical assistants, technical officers – they go by many titles.
These people, trained in specific procedures are operating in many African countries, including Ethiopia, Malawi, Mozambique, Tanzania and Zambia. This is not a stop-gap solution. It is going to become accepted practice in many more countries.
Local education programs have been in place, in some cases for many years. The RCOG recognizes the enormous amount of local training that is in place to produce fit for purpose local carers with appropriate technical skills. The College will be producing a series of training modules that can be accessed by trainees and those who have completed their training.
We hope that these will enhance local training and that in time will help to engender continuing career development that is evidence based. We are looking at novel ways of presenting key technical information, so that it is easily absorbed and remembered. In time we would like to see procedure-specific assessments that would be available for personal and peer-to-peer use.
This venture is in its early stages. Nigel Bickerton, recently awarded a Sims Black Travelling Professorship, will be leading the project and is keen for ideas and points of views from everyone who might be affected by this Project.
“This is going to be a big and exciting task. It will be a bit of a moving target too. We have ideas, - lots of them, but we would value yours too. A lot of agencies worldwide are providing training material. We don’t want to replace any of this and we are certainly not in competition. We want to help by providing modules and other resources that will enhance what is already there.”
If you have experience of working with this section within international healthcare or any ideas of how any package may be best produced the College would love to hear from you.
Please send any comments directly to education@rcog.org.uk