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Monthly blog from RCOG President

Blog 12 February 2021

Dr Eddie Morris writes to the membership…

Dr Eddie MorrisOver the past few weeks, in the usual Chief Medical Officer and National Medical Director briefings that I attend there has been a very definite improvement in the mood because we are seeing a fall in new infections and hospital admissions.

Sadly, deaths are still very high, but we are told by the epidemiologists briefing us that they too will reduce soon, typically following by 2-3 weeks. Our friends at UKOSS, who have been doing such a marvellous job of keeping us informed and keeping ahead of the data so we can warn you of upcoming issues through our guidance, have also seen a reduction in new cases of pregnant women with COVID-19.

This is still a very scary situation, no matter how reassuring the data are that we see daily and weekly in terms of numbers. We are all still waiting to find out more about new variants and the effects on us, the women we look after and vaccine effectiveness. What is clear from everything that I have seen in the past 2 weeks is that these new variants are just as transmissible, if not more so, than previous variants. 

On the topic of vaccination, earlier this week we heard about a study looking at administering a different vaccine as the second dose to see if this enhances the immune response. At this week’s call with Chris Whitty, he confirmed that this is a research study that is just starting and is unrelated to current vaccine administration practices. The intention is that in the UK all second doses will be of the same type as the first received vaccine.

Bringing this all together and with advice we were given by Steve Powis, Medical Director for NHS England, it is clear that most of us are at greatest risk at work. I know I have written about this before but whilst we are all compliant with PPE in the presence of our patients it is in admin, office and rest spaces where we let our guard down. Susan Hopkins, senior medical advisor to PHE, told us this week that needing enhanced respiratory precautions, PPE and social distancing within the NHS would need to continue for many more months.

One fact I heard last week that really got my attention was that the UK has been performing genomic sequencing on between 20-30,000 samples per week in its detection and monitoring of outbreaks. This is part of the UK strategy to contain outbreaks in the future. What is particularly interesting is that the UK performs half of the global need for sequencing, demonstrating the expertise and knowledge we have in this ever more important area of medicine and healthcare. 

Some of you may know that in May 2019, an RCOG Genomics Taskforce, chaired by Peter Braude, was established to assist and advise the RCOG in establishing genomics expertise within the discipline of obstetrics and gynaecology and develop a programme that can impart the understanding of genomics across the RCOG membership. In 2020, Council agreed to develop a strategy for the College, to embed genomics expertise within the profession by embracing an understanding of the new genomic technologies and by becoming involved in the discussions and decisions about their implementation. 

From my example above you can see that the pandemic has highlighted the extraordinary power of modern genomics. The College is acutely aware of the importance of genomics to our specialty and the profession must be at the forefront and centre of embracing its progress. Besides the complexity of genetic diagnoses in prenatal, preimplantation and postnatal genetic testing, genomics is changing how we diagnose and treat gynaecological cancer and is being explored for its applications in benign gynaecology such as fibroids and endometriosis. The relevance of genomics to clinical medicine is exponentially growing. 

It is my intention to continue to build on our efforts to provide educational resources both for practising generalists and those in general training in the subspecialties which have special needs. We have approached this by launching in the past few days a Genomics Hub on the RCOG website. The hub has a resources and learning plan and is divided into three parts. It is aimed at all levels of knowledge from the beginner to the more advanced. In the future we hope to encourage a new cadre of our profession for whom genomics will be their specialism and who will be there to support the implementation of the NHS Genomic Strategy for the College. I have done the beginners modules which I greatly enjoyed (and of course added to my CPD diary!)

Another major impact of the pandemic globally, as you will be aware, is that regrettably we were unable to run the MRCOG Part 3 exam in 2020. This was hugely frustrating to so many, and most of all to those of you who had studied so hard and were ready to sit the exam. The global restrictions have caused huge delays for the progression and education of candidates across the world and in every specialty. It is a big priority for us this year to put this right and ensure that we can still deliver the exam despite the pandemic. I am delighted to say that we successfully ran the first ever digitally enabled, fully remote Part 3 diet for a small cohort of UK candidates in January. We have now commenced work to scale this up both in the UK and also for our overseas candidates. To update colleagues outside of the UK on our plans, the team has recorded a short video.

I don’t normally stray into politics in these missives but as you know reproductive rights, including the right of women globally to have access to high quality contraception and abortion care, are one of my high priority issues. I was therefore delighted when, in his first few days in office, President Biden repealed the Global Gag Rule. This policy, first introduced by President Reagan, overturned by Democrat Presidents, and successively reintroduced by Republican Presidents, limited organisations in receipt of US funding from providing safe abortion services around the world. You can read more about how the Global Gag Rule negatively affected women’s health in an op-ed written by myself and Asha Kasliwal, President of the Faculty of Sexual and Reproductive Healthcare, published in the Telegraph.  

Over the coming weeks I hope things become easier for you in the workplace and you are able to get some time to rest.