These FAQs are designed to guide you through the details of starting your training in obstetrics and gynaecology and explain how you should expect to progress through your training post.
Who’s in charge of my training?
The deanery or postgraduate school you’ve been appointed to has overall responsibility for your training. There will be a Deanery Chair for Specialty Training in O&G and sometimes a separate Head of School. Within hospitals in a deanery, a number of Training Programme Directors oversee the training programme. Within your local hospital, the College Tutor will oversee your training and will allocate you an Educational Supervisor to monitor and assess your progress.
Successful progress through training requires you as the trainee to drive the process and to use all available training opportunities that are offered.
What’s the RCOG’s role in my training?
The RCOG sets the standards for the structure of training and the curriculum, which is approved by the General Medical Council (GMC). You need to complete this programme to be awarded a CCT or CESR, which qualify you for entry onto the Specialist Register. The RCOG works closely with the GMC and deaneries to assess CCT and CESR applications.
The RCOG also provides registered trainees with a Training ePortfolio and logbook for recording progress through training.
Do I need to register with the RCOG as a trainee?
All UK trainees entering specialty training need to subscribe to the RCOG Trainees’ Register to receive the ePortfolio and other materials. You must renew your subscription every year. This costs £127 annually and includes many benefits.
Trainees appointed to short-term training (FTSTA) posts or non-training posts are not required to subscribe to the Trainees’ Register, but we encourage them to do so as they will then receive the benefits.
International Trainees and international exam candidates are not eligible to join the Trainees’ Register, but it is strongly recommended that you become an RCOG Associate
How do I register with the RCOG?
If you are a UK Trainee, please visit the Trainees’ Register page and look at the ‘Subscribe to the Trainees’ Register’ section.
If you are an International Trainees and international exam candidates are not eligible to join the Trainees’ Register, but it is strongly recommended that you become an RCOG Associate
I’m in a run-through training post: what’s my national training number (NTN)?
Your deanery will contact you with details of your NTN after you start your post. Please be aware that this may take several weeks owing to the large number of new trainees commencing at any one time.
Your NTN is unique to you and will be recorded on all documentation from your deanery, in your training portfolio and on your annual assessment documentation (ARCP).
What should happen when I start my post?
On starting your post, you’ll usually meet with your College Tutor and be advised of your Educational Supervisor’s details.
You must meet your Educational Supervisor within 3 weeks of commencing your post to set out your training goals for the duration of your post. You should then meet again during your post as per the guidelines set out in the induction and appraisal guidelines.
I haven’t received a contract of employment: what should I do?
You should contact your employing trust’s Medical Staffing or Human Resources department urgently.
How long will it take me to progress through training?
The specialty training curriculum in O&G is competency-based. Most trainees starting at ST1 will take 7 years to complete their training, subject to satisfactory assessment of progress. The curriculum is based on competency (rather than numbers of procedures or time), so some trainees may take longer to achieve all competences.
How will my progress through clinical training be assessed?
Local assessment and appraisal will take place regularly during each placement by your Educational Supervisor and College Tutor. This process then feeds into a central review administered by your deanery (Annual Review of Competence Progression, or ARCP). For further general details, see Section 7 of the Gold Guide. The GMC requires that the ARCP process is based on a portfolio of evidence that you submit for review.
What tools do I use to get specific competences assessed and signed off during my training?
Various tools are available to help you to assess the development of competences. These include OSATS (objective structured assessment of technical skills), CbD (case-based discussion) and mini-CEX (mini clinical evaluation exercise).
Why have the workplace-based assessment (WPBA) forms changed?
The aim of the WPBA tools (mini-CEX, CbD and OSATS) was always to aid trainee learning by providing quality feedback. In addition, for specific procedures there was also a need to provide a judgement of competency. However, the purposes of the assessments were not always clear to those using them, and mini-CEX/CbD were being used to provide judgement whereas the feedback function of OSATS was not being used as well as it should.
The changes are designed to address these problems and make sure the WPBA work as well as possible for trainees. The formative (for learning) assessments (mini-CEX, CbD and formative OSATS) will have a generic form design which emphasises feedback provision. The only summative assessment (of learning) will be the summative OSATS, which will contain a judgment of competence as well as the opportunity for feedback.
How do the workplace-based assessment (WPBA) forms work?
All formative WPBA (supervised learning event, or SLE) forms (CbD, mini-CEX and formative OSATS) have the same design. This reflects their common purpose, which is to deliver quality feedback to the trainee. All forms include:
- Space to identify brief details of the case/procedure
- General feedback guidance points
- Mandatory free-text boxes for quality feedback
- A reflective section for the trainee
The summative OSATS (assessment of performance, or AoP) form has a different design to reflect its different purpose, and includes:
- Space to identify details of the case/procedure
- Anchor statements to frame the judgement of competence
- General guidance points to inform the judgement and provision of feedback
- Free-text boxes to record and justify the judgement with qualitative feedback
What are OSATS and when are they used?
A small number of procedures are so fundamental to the practice of O&G that we have developed an objective assessment tool to aid the review process. The objective structured assessmenr of technical skills (OSATS) is a validated assessment tool used to assess competency in a particular technique.
What are the differences between formative OSATS (SLEs) and summative OSATS (AoPs)?
OSATS can be formative (supervised learning events, or SLEs) or summative (assessments of performance, or AoPs). Formative OSATS give you the opportunity to practise and get feedback for a given procedure. Summative OSATS allow you to demonstrate your competence in a procedure and progress in your training.
You should take as many formative OSATS (SLEs) as necessary until you feel you are sufficiently competent in a procedure to request a summative OSATS (AoP). You should complete OSATS throughout training until you are competent to practise independently. When you feel ready to take an OSATS, you will meet with your clinical trainer, who will assess the procedure and complete the relevant OSATS form on your ePortfolio.
For more information, please visit the workplace-based assessment (WPBA) webpage.
When using OSATS to define competence in a procedure, we recommend the following approach:
- You must have successfully completed an OSATS in all areas (i.e. every section ticked for ‘independent practice’) on at least three separate occasions
- At least two different assessors must be involved in signing off the three OSATS
- At least one assessment must be completed by a consultant
You must retain all OSATS forms in your ePortfolio, whether they were completed satisfactorily or not – this allows your Educational Supervisor to review your progress. Once you’ve been signed off as fully competent for independent practice (minimum of three satisfactorily completed summative OSATS per procedure), you should undergo an annual OSATS assessment (one per procedure) to demonstrated continued competence until you achieve CCT.
Who can assess me for a summative OSATS (AoP)?
Any consultant, senior specialty trainee or, in appropriate situations, a co-professional may assess you as a ‘clinical supervisor’. One example would be an experienced midwife supervising a basic perineal repair.
When you feel ready to undertake the relevant OSATS, you’ll meet with your clinical supervisor, who will assess the procedure and complete the OSATS form. Remember that a consultant should complete at least one of the three OSATS which we require as evidence that you’re competent for ‘independent practice’ (some deaneries or schools may request you collect more than three).
How many assessments do I need to complete before I can be signed off as competent for a particular skill in my logbook?
Both the GMC and the RCOG have confirmed that in a ‘competency-based’ curriculum like O&G, it’s not always appropriate to expect a fixed minimum number of assessments to be deemed competent as this approach doesn’t allow for individuals who may progress at different rates.
To be signed off as competent for independent practice in a particular skill/procedure, you need to have successfully completed the relevant OSATS on at least three separate occasions. You should also have a minimum of three CbD and mini-CEX per year (i.e. for each ARCP).
How do I progress from ST2 to ST3?
This is one of several critical steps in your career progression: you’ll sometimes hear these steps referred to as ‘way points’ to emphasise their importance.
This particular step is usually where you’ll progress from 1st on-call to 2nd on-call duties. With progression comes more responsibility, but this should always be within the limits of your competency and with continued support from your seniors.
There are some mandatory requirements for progression from ST2 to ST3:
If you’re an ST2 or FTSTA2 trainee, you and your Educational Supervisor must ensure that specific attention is given to the acquisition of the relevant competences from the start of your post in order to ensure smooth progression into ST3 (or successful application for an ST3 post if you are an FTSTA2).
What are the specific technical competences I need to achieve to progress into ST3?
The specific clinical competences you need to be signed off as being competent to manage ‘unsupervised’ by the end of ST2 are:
- Opening and closing the abdomen
- Uncomplicated acute and elective caesarean section
- Non-rotational operative vacuum delivery
- Manual removal of placenta
- CTG interpretation*
- Management of shoulder dystocia*
- Management of cord prolapse*
- Perineal repair
- Fetal blood scalp sampling
- Uncomplicated surgical uterine evacuation
- Non-rotational forceps delivery
*There are no specific OSATS for these procedures. You can use other tools such as CbD or mini-CEX.
How do I apply for less than full-time (flexible) training?
Please read our guidance on applying for less than full-time training.
Am I allowed to keep case notes within my training portfolio or ePortfolio?
Patient-identifiable information mustn’t be used or disclosed for purposes other than the individual’s health care without the subject’s explicit consent. The NHS Code of Practice on Confidentiality provides general guidance on how patient information should be handled. Most healthcare organisations have also produced local policies which you must adhere to. For training purposes, any patient-identifying information must not be kept on paper or in an ePortfolio.
Find out more
For more information:
To contact the RCOG, please email the Trainees’ Coordinator or call +44 20 7772 6348.