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ATSM/APM training


It is apparent that there are three popular ATSMs – advanced labour ward practice is seen almost as a pre-requisite for all trainees which begs the question why it has been considered an ATSM when so many trainees undertake it. Current plans approved by the GMC for Obstetric ATSMs are due for roll out in October and will provide welcome change which better reflect its advanced status.

It would seem that some trainees (15-20% are keen to ensure they have either benign gynaecological operating skills or skills to manage acute gynaecology and early pregnancy complications. There is a third group of ATSMs which 5% of trainees are undertaking in order to gain subspecialist skills in a variety of avenues perhaps setting themselves up to undertake subspecialist training. There are very few trainees undertaking ATSM training in colposcopy (this may reflect that many trainees undertake this training outside ATSM training with BSCCP), vulval disease (1%), menopause (1%) and sexual health (<1%) indicating that the majority of new CCT holders will not have specialist knowledge of these areas resulting in a potential gap in not only knowledge but also future service provision. These numbers do not match the numbers of consultants with interests in these areas as revealed in the RCOG census (6.2%, 5.9% & 1.7% respectively)

Induction meetings happen with sufficient assessment of skills and knowledge at these meetings. The majority of trainees do not have their two sessions per week well protected in any ATSM module other than in advanced labour ward ATSM. If, however, the competencies are being acquired it may be that not all ATSMs require the 2 sessions a week as they all have differing workload intensity scores and the sessions may be split between the 2 modules being undertaken.



  1. There needs to be consideration of promoting and improving the take up of the less popular modules so we have a workforce that has the expertise required to meet the current and future service requirements. This is an issue for Heads of School and School Boards led by the RCOG.
  2. There are some units that get negative feedback across the board for all ATSMs and this should be highlighted to the Heads of School so that the provision in each HEE area can be reviewed. Given the small numbers of respondents, longitudinal data on this negative feedback may be helpful rather than relying on one year’s data. Similarly, high achieving units should be encouraged to share good practice.