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Gynaecology training

Conclusions

The perception of sufficient opportunities was lowest for major gynaecology operating, across all training grades. Opportunities in gynaecology operating tend to increase with seniority of trainee with the exception of ST3-5. The BSGE survey identifies that despite the requirements of the RCOG curriculum, many trainees are not confident to perform the laparoscopic procedures independently at the level they are expected to, which is most pronounced for ST5 trainees. 

Supervision of trainees for gynaecological procedures appears adequate.

Opportunities to attend gynaecology and specialist gynaecology clinics are proportional to seniority of training grade. 

Approximately half of trainees have access to laparoscopic box trainer or virtual reality simulator. However, most of these trainees have no access to formal simulation training programme (66-94%). This is likely to explain why there is no clear relationship between the access to the use of a box trainer or simulator and the overall perceived opportunities in gynaecological training.

Northern Ireland LETB appears to consistently outperform others in terms of perceived opportunities in gynaecological training and also with the lowest proportion of trainees being taken out of scheduled daytime activities to cover service provision.

Overall there appears to be a significant problem with rota gaps with over 50% of O&G trainees reporting that their rotas are not full at their training level.

 

Recommendations

  1. Explore in depth the training delivered in Northern Ireland, to establish measures taken for adequate training and how they manage rota gaps?  Is it because it is a smaller deanery and easier to manage or do innovative rota management/team-based approach mean they can deliver excellent training.  If there is a unique model that exists this can be shared with other deaneries.
  2. It is apparent from the analysis that focus of training should be more directed towards ST3-5 trainees (where opportunities appear to be less than at other grades).
  3. A standardised laparoscopic simulation-training programme for gynaecology should be developed. The acquired skills are likely to improve the opportunities trainees get as trainees will become more useful and trainers will be more confident to allow trainees to operate. We suggest the RCOG work with the BSGE to develop this training programme.