It is not possible to answer every question that you may have and we are unable to advise individuals with regard to specific medical conditions and methods of treatment. However, please contact us if there is anything you do not understand, or anything more you need to know as we can usually direct you to alternative sources of information.
The following list has been compiled to reflect the questions most frequently put to the College. It does not claim to be exhaustive. This section of the website will be of most help to those living in the UK.
What does the RCOG (Royal College of Obstetricians and Gynaecologists) do?
The RCOG is one of a number of organisations given a Royal Charter.
These organisations include many other Royal Colleges, including the Royal College of Midwives (RCM) and the Royal College of Paediatrics and Child Health (RCPCH). The Colleges work with each other when it's helpful to do so.
The Royal College is an independent membership organisation with more than 11,000 members worldwide. In the UK, it is mostly made up of hospital obstetricians and gynaecologists. They are called "Members" and "Fellows". To become a Member, the doctor has to pass an examination, after a period of training. "Fellows" are generally older "Members" who have shown evidence of good work and who hold a more senior job.
The main role of the RCOG is in the training and the continuing professional development of obstetricians and gynaecologists, and of other health professionals in the same field.
The RCOG works to raise the profile of women's health issues at national level, and Members and Fellows of the College help with informing and developing Government policy on women's health.
A growing part of the College's work is informing the public about women's health and issues related to it.
The College organises an examination for general practitioners (family doctors). Those doctors who succeed in completing the training programme and examination can use the following letters after their name – DRCOG. A summary of RCOG membership categories can be found here.
Further details about the Role of the College and its history can be found here.
What is the difference between an obstetrician and a gynaecologist?
Obstetricians and gynaecologists are specialist doctors certified by the government, who work in women's healthcare.
Obstetrics deals with problems that arise in maternity care, treating any complications of pregnancy and childbirth and any that arise after the birth.
Obstetricians may see some women before conception to plan their pregnancy.
Some obstetricians specialise in a particular aspect of maternity care:
- Fetal medicine – looking after the health of the unborn baby
- Maternal medicine – looking after the mother's health
- Labour care – care during birth
Obstetricians work alongside midwives, whose speciality is usually normal pregnancy and delivery.
Gynaecology is the care of women with problems of the female reproductive system (ovaries, tubes, womb, cervix, vagina). Some gynaecologists specialise in:
- Urogynaecology (bladder incontinence)
- Reproductive medicine (fertility problems and recurrent miscarriage)
- Colposcopy (dealing with abnormal smears)
- Gynae-oncology (cancer of the uterus, Fallopian tubes and ovaries)
- Contraception
- Menopause
Around the world, most specialists work in both obstetrics and gynaecology. However, a growing number work in one particular area.
In most countries, obstetrician/gynaecologists do not undertake breast care. Specialist breast surgeons who have had training in general surgery usually deal this with.
Both obstetricians and gynaecologists care for women who have had a miscarriage.
What are the different grades of a doctor in the UK?
The role of a doctor is really defined by their job title. Again, this varies from country to country. In the United Kingdom the following titles are used:
|
Job title |
Role |
|
Consultant |
Qualified specialist who is leader of a clinical team. |
|
Associate Specialist |
Fully-qualified specialist who works independently but does not lead a clinical team. |
|
Staff Grade |
Doctor who has had some specialist training but is not necessarily fully-qualified. Largely works independently, sometimes in more limited roles than a consultant. |
|
Specialist Trainee Registrar (STR) |
Working in a senior training post. Works both independently and under supervision. Generally called a Registrar. Formerly called Specialist Registrar (SpR) |
|
Specialist Trainee (1/2) |
Working in a junior training post. Will work independently but has more supervision than an STR. Formerly called Senior House Officer (SHO). |
|
F1/F2 |
Foundation trainee (year one or two). Most junior trainee doctors, just after qualification. Highly supervised whilst undergoing general training in medicine and surgery. Formerly called House Officer. |
How can I tell from the title and letters after the doctor's name what sort of doctor I'm seeing?
This is not straightforward, as it differs around the world and even with individual countries (Scotland and England differ for example).
In addition, some doctors do not follow the common pattern.
All medical practitioners are doctors. Traditionally, fully-qualified surgeons (including obstetricians and gynaecologists) title themselves Mr, Mrs, Ms or Miss, because originally surgeons were barbers and not doctors. That is why the barber shop pole was red and white stripes – white for the bandages and red for blood!
The title Mr, Mrs, Ms or Miss does not mean the person is a consultant but simply that they have passed their Royal College examination.
Some medical doctors have the title "Professor". This means that they have specialised in research as well as working as a doctor.
Even the word "doctor" can be confusing. To most of us, doctor means somebody who looks after us when we are unwell but it is also the title of somebody who has done a research degree at university. It doesn"t necessarily mean they are medically qualified. They have passed the scientific qualification of PhD (Doctor of Philosophy). It gets really confusing when you have a surgeon who also has a PhD but they still call themselves Mr, Mrs, Ms or Miss.
The important thing is not to feel embarrassed if you call a Mr, Mrs, Ms or Miss a doctor, or a doctor, a Ms, Mrs, Ms or Miss. It doesn"t matter. You can ask what they prefer to be called, if you like.
The letters after a doctor's name are usually qualifications, though a small number will have honours such as the MBE.
Each country has it own system. The ones below are those seen most frequently amongst obstetrician/gynaecologists and general practitioners in the UK.
|
Letters |
What they mean |
|
MB ChB, or MB BCh, or MB BS |
They stand for Bachelor of Medicine and Bachelor of Surgery. This is the basic medical qualification a medical student gains at the end of five years in medical school. It allows the student to enter supervised medical practice as a foundation doctor. |
|
BSc/MSc |
They stand for Bachelor of Science / Master of Science. Many doctors have some pure science training as well training in clinical science. |
|
MD |
Doctor of Medicine. In the UK and many Commonwealth countries, this stands for a research qualification. This is a higher degree than MB but it does not mean the doctor is more clinically trained. It simply means they have had research training. In the USA and some other countries it is the basic medical degree, and the equivalent of the UK MB. |
|
MRCOG / FRCOG |
This stands for Member / Fellow of Royal College of Obstetricians and Gynaecologists. A Member has usually passed an examination after a period of training in Obstetrics and Gynaecology. Members usually become Fellows after about eight years as a consultant. |
|
CCT |
This stands for Certificate of Completion of Training. This is the Government license to practise a particular speciality of medicine. |
|
DRCOG |
This stands for Diploma of RCOG. It means the doctor has passed this College's examination specially designed for general practitioners. |
|
FRCS |
This stands for Fellow of Royal College of Surgeons. It may have the place where the examination was taken in brackets. So you might see: (Lond) for London |
|
MRCP |
This stands for Member of Royal College of Physicians. (UK) for United Kingdom (I) for Ireland |
How do I know if my doctor is properly qualified and up-to-date?
In the UK, every medical practitioner has to be registered with the General Medical Council (GMC).
The GMC's main responsibility is to regulate doctors to ensure good medical practice. The GMC decides if a doctor is allowed to see patients or not. If a doctor behaves unprofessionally or is technically poor, the GMC can warn the doctor, advise more supervised training or remove her/him from the Medical Register (known as "being struck off").
The GMC keeps an up-to-date register of all doctors licensed to practice and aims to ensure they maintain the standards the public and the medical profession expect. You can check a doctor's credentials on the online database called the List of Registered Medical Practitioners at the GMC website www.gmc-uk.org.
The website tells you whether a doctor is allowed to practice or not, but at present it does not say whether the doctor is keeping up-to-date.
Within a short time, the UK will have a process of revalidation, which will address the issue of a doctor being up-to-date.
Currently, the RCOG runs a scheme called CPD (Continuing Professional Development). For this, a doctor has to do 250 hours of training every five years to maintain Membership of the College. You can check your specialist is still a Member by contacting the RCOG.
What does it mean to be on the CPD roll?
CPD = Continuing Professional Development
Continuing professional development (CPD) is commonly used as an all-encompassing term to describe professional lifelong learning. In medicine, it can be considered to incorporate continuing medical education (CME), relating to the core skills and knowledge in a specialty, and professional education, relating to the skills and knowledge in terms of the wider role of the professional doctor.
Following a CPD programme enables doctors to remain up to date in a changing medical environment. Professional expertise demands a continuing awareness of new concepts, values and technologies, as well as the appreciation of many other new influences. It is important for doctors to update themselves not only on facts but also on opinion and consensus.
All doctors practising obstetrics and gynaecology in a career grade post in the UK are required to register on the RCOG CPD programme.
The CPD roll, published on the RCOG website, relates only to those who have successfully completed the CPD programme, i.e. have participated for five years and have acquired the required number of credits and spread of activity.
Note that completion of the programme does not necessarily confirm clinical competence.
If you are looking for the name of your doctor in the CPD roll, please also read the text preceding the roll which gives important information about the CPD programme.
What if my doctor's not on the CPD roll?
CPD = Continuing Professional Development
The CPD programme was designed for doctors who have completed their formal training as obstetricians and gynaecologists, so that they can remain updated in a changing medical environment.
Doctors who are still training as obstetricians and gynaecologists are neither required nor eligible to follow the CPD programme and their name will not be listed on the CPD roll.
When doctors complete their formal training as obstetricians and gynaecologists, they are registered on the five-year CPD programme and their name is added to the CPD roll only after the five-year cycle has been successfully completed. Note that completion of the programme does not necessarily confirm clinical competence.
If you are looking for the name of your doctor in the CPD Roll, please also read the text preceding the Roll which gives important information about the CPD programme.
There may be a variety of reasons why a doctor is not yet on the CPD roll and, if you have any queries regarding this, it is a good idea to discuss it with your doctor.
Can I request someone else to be present when the doctor is examining me?
Yes. It is part of good practice for a woman to have someone with her during physical examination. This might be a nurse, or a companion of the woman, or both. A woman can also chose to be accompanied by a relative or friend when speaking with the doctor. A chaperone is usually made available. However, if there is no chaperone present don't feel uncomfortable about requesting one.
What happens if I ask to be seen/treated by a female doctor only?
Any Obstetrics & Gynaecology Department will do their best to provide a woman doctor for you if you state a preference, and it helps if you ask in advance and to ensure your request is included with the referral letter from your general practitioner.
If it's not possible, and the situation isn't urgent, then it may be possible to arrange a further appointment at a time when a female doctor is available for you.
How do I see a private gynaecologist or obstetrician?
Your general practitioner will usually know the name of specialists who undertake private care and be able to refer you to one in your area. The specialist will usually prefer to receive a referral letter from your general practitioner.
If you wish to research this for yourself, you can ring the local private hospitals, which are in the Yellow Pages. The Dr Foster independent, website provides information on practising consultants including whether they work privately - http://www.drfosterhealth.co.uk/consultant-guide/
Your general practitioner will often know if a specialist offers the treatment locally or else make enquiries by writing to the clinical director of the department of obstetrics and gynaecology at a hospital. Even if the treatment is not provided locally, the clinical director often knows of departments within the region or nationally who offer the treatment.
The NHS provides information about services which hospitals offer at www.nhs.uk.
The Dr Foster independent website also provides information on services provided by local and regional hospitals www.drfoster.co.uk.
If these are not helpful, you can try searching on the internet further by putting the name of the treatment and hospital into a search engine.
How do I find out about doctors/centres offering help with fertility problems?
Your general practitioner will know of local help. Most hospital obstetrics and gynaecology departments offer fertility care.
The local fertility specialist will usually have links with the larger centres that will be able to refer you for more advanced investigation and treatment if needed.
If you wish to search for yourself, the Human Fertilisation and Embryology Authority publish a list of licensed centres, which provide assisted conception techniques, including their success rates. Once you find a centre which interests you, many have websites which provide detailed information. The majority of these are private clinics, but there are a number of NHS centres too.
You have a number of options.
First of all you could deal with this informally. You could discuss this with the doctor directly or you could also approach the ward nurse if you are an in-patient.
If it's a trainee doctor you are not happy with, you could write to the consultant or ask to see her/him to discuss things. If you want some support to do this, you can approach the hospital Public Advice and Liaison Service (PALS). They meet to understand patients" concerns and can pass information to the doctor or arrange a joint meeting. They work to negotiate good relationships, but they act in your interest.
Understandably, because they feel it is a serious matter, some women wish to deal with things more formally. You can then contact the Quality Assurance Officer in the Hospital who deals with complaints. The NHS Choices website provides information on how to make a complaint.
Complaints are willingly received and dealt with professionally. The matter will be investigated and you will receive a letter from the chief executive of the hospital. The chief executive will provide a factual account of events, an apology if appropriate, and the offer of a meeting to resolve things. A key part of the exercise is for the hospital to learn lessons, so that it should not happen again.
If you remain concerned after the investigation, you can request an independent review, which involves external assessors. Ultimately, you can make application to the health ombudsman, but that is rare.
Two helpful websites with more detailed information are:
If my family doctor or midwife refers me to a gynaecologist or obstetrician, can I choose who I see?
Yes. Choice is a key component of healthcare and that includes who you see. Your general practitioner or midwife should provide information on the choices available for your condition and allow you to request who you would prefer to see.
The NHS Choices website describes your choices and how you can make them - www.nhs.uk/aboutNHSChoices
What happens about medical students or other doctors being present?
Observing senior doctors at work is an essential part of training for medical students and trainee doctors. It's one way that you can help ensure good quality medical care in the future, and doctors are aware of how important it is.
However, it is your decision whether or not to allow this, and whether you want the student or trainee to stay for part of the consultation and not others.
If you feel uncomfortable with somebody being present, you should tell the nurse or doctor. You don"t have to explain why you feel that way, and asking for a trainee to leave will not affect your care.
If I have seen a doctor privately, can I switch back to non-private treatment at a later time?
Yes. You never lose your right to NHS care. Your general practitioner or specialist will be able to help you with this.
The NHS is working towards providing more information on the results for individual doctors, but at present, this is still not published in many specialities.
If the information is not on the website of the hospital you are interested in, you could write to the general manager of the department of Obstetrics and Gynaecology.
Alternatively, if this doesn"t get you the information you want, you can make a request to an NHS Hospital under the Freedom of Information Act (FOI). The FOI entitles you to ask your local hospital for such information and they have to provide it within a certain time. There maybe a small charge for this.
How do I get a second opinion after I have seen one specialist?
It is your right to ask for a second opinion, and it's not an uncommon request. You can either ask the specialist directly, or you can ask your general practitioner to arrange it.
A second opinion could be in the same hospital or at a different unit. Sometimes women are happy with the first specialist, but just want to check things out and then return to the first. That is possible with many doctors.
Yes. According to the Good Medical Practice guideline (confidentiality paragraph 37) you have the right to ask your hospital doctor not to inform your general practitioner or other healthcare professional about your treatment, condition or medical history.
Can I keep the same consultant if I go into hospital?
You are free to request for the same consultant or to change to another. However, remember that in the NHS, doctors work in teams and you might be cared for by a number of different doctors within the consultant's team. In addition, in an emergency you would probably be cared for by the on–call team.
Do I have a choice of hospitals?
Yes, your general practitioner should be able to supply you with a list of hospitals to choose from. You can get more information about the hospitals you are considering from the internet. This includes the NHS Choices website.
Do I have a choice of treatments?
Yes. Your doctor should explain the full range of treatments that are suitable for you. This should include the advantages (success rates, simplicity, and speed of recovery) and disadvantages (complications, side-effects and complexity) of each treatment. You then have the right to choose what you feel is the most appropriate treatment for you.
The doctor can"t make you do anything you do not wish to do, but equally, patients cannot force a doctor to do something she/he feels is unsuitable.
Unless there is an emergency, you do not need to decide in front of the doctor. You can go away and think things over. There may be leaflets and other written information to help you with this.
Finally, if you do make a decision, you are free to change your mind.
Will I see the letters written to my doctor after a consultation?
Yes. The NHS is promoting Copying Correspondence which says that patients have the right to get a copy of all letters sent to their GP (unless in exceptional circumstances the doctor feels that would not be in the interest of the patient). It's a good way of keeping you informed of the doctor's diagnosis and treatment.
This should happen automatically, but to be sure, you can mention this at the time of your consultation.
Where can I get more information about my condition or my treatment?
Your specialist will often have information leaflets.
Local libraries have sections on health matters with books and articles.
The RCOG website has many leaflets on conditions and treatments especially written for the public.
The NHS Choices website site has detailed information on more than 850 conditions.
NICE has a website for publication of its guidance including information notes for patients -
The BBC website has a section on health issues, including a section on pregnancy.
Another good source of information is NHS Direct, which you can call on 0845 4647. Their website is www.nhsdirect.nhs.uk
Dipex is another website which has a lot of information on women's health and healthcare http://www.dipex.org.uk
Scientific information is on websites such as the RCOG (for guidelines), pubmed (for individual scientific articles) www.ukpmc.ac.uk, and Cochrane (for systematic reviews) www.cochrane.co.uk
Where can I find support groups to get more information about my condition or treatment?
You can find support groups on the internet from sites like www.patient.co.uk/selfhelp.asp and www.netdoctor.co.uk
Women's Health Concern is a charity which runs an information website on women's health issues - www.womens-health-concern.org
Dipex has links to support groups www.dipex.org.uk.
Yes. You"ll be aware that not all information on the internet is helpful, or applicable to your own situation, but if you find something you think may be useful, then do share it with your general practitioner or the hospital doctor during the consultation. Doctors are normally keen to help patients to understand information they have found themselves. It is extremely difficult to know of every new development, and occasionally patients find information that the doctor was not aware of and that can be very helpful.
If I am told there is nowhere in my area I can get treatment, what can I do?
Your general practitioner may be able to refer you to the nearest available centre for the treatment. She/he can search on the NHS Choose and Book system .
If your GP and specialist do not know, the NHS Choices website has a list of hospitals offering clinical services.
Are language translators available if necessary?
It is important to let the hospital know well in advance of your appointment if you have limited English and require translation services for your consultation with the doctor. Whilst some people prefer to rely on a family member or friend, alternatively you can ask the Trust for a professional translator or interpreter. Sometimes a spoken language, telephone-based, translation service may be provided. If you use British Sign Language as your first and preferred language, you should ask the Trust for a qualified interpreter, who should be supplied, given adequate notice.
Is there any way to let the RCOG know of my experience?
The RCOG sets standards for clinical care and training. If you have any comments on how you have been treated you need to contact the consultant in charge of your case, and/or the hospital Trust, and or the hospital PALS service. The RCOG does not have a role in the management of individual patients.