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Approval criteria for subspecialty training centres

This page sets out generic and subspecialty-specific criteria for subspecialty training centres.

The subspecialty-specific criteria cover:

Generic criteria

Education and access to training opportunities

  • Subspecialty Training Programme Supervisor (STPS) must be actively involved in clinical work and academic activities
  • STPS must be an Educational Supervisor as defined by the deanery
  • The trainee must have regular dedicated teaching sessions (formal educational activity – minimum 1 per fortnight)
  • The trainee must be engaged in audit or research
  • The trainee must have a named research supervisor with a proven research track record

Research

  • The centre must have a minimum of 10 peer-reviewed papers relevant to the subspecialty over the last 3 years 
  • Trainees admitted into a 3-year programme must have completed two first author peer-reviewed papers within 3 years of their admission
  • Other evidence of research activity as follows:
    • Active research projects – at least one project
    • Other academic evidence may be submitted, e.g. grants, chapters in books, Cochrane reviews, presentations (national or international), centre-run journal review group

Performance of centre

  • There must be no significant concerns about the programme or trainees raised in trainee feedback noted by the Subspecialty Committee
  • There must be no significant concerns raised by the deanery quality management processes (deanery surveys or deanery visits)
  • There must be no significant concerns consistently raised by assessors during trainee reviews noted by the Subspecialty Committee
  • There must be no significant concerns raised about the impact on specialty trainees
  • The centre must meet the standards set out by the Care Quality Commission, Health Improvement Scotland or RQIA in Northern Ireland

Download the checklist for the generic criteria for subspecialty training centres (Word document, 33 kb).

Gynaecological oncology criteria

Workload (caseload per annum and scope)

  • Minimum number of sessions for major surgical procedures = 6 per week
  • Minimum number of gynaecological oncology outpatient clinics = 2 per week
  • Minimum number of new gynaecological oncology referrals = 350 per annum
  • >100 open laparotomies for ovarian cancer(+suspected) (PDS/DDS/IDS)
  • >20 open laparotomies for endometrial cancer*
  • >50 laparoscopic hysterectomies for endometrial cancer
  • >15 laparoscopic pelvic lymphadenectomies
  • >15 radical surgical procedures for cervical cancer (>10 laparoscopic)*
  • >5 fertility-sparing procedures for cervical cancer
  • >15 bowel resections
  • >20 radical procedures for vulval cancer (sentinel nodes can be included)
  • >5 exenterations for advanced or recurrent gynaecological cancer
  • Pre-invasive disease service:
    • >250 new referrals for abnormal cervical cytology
    • >15 new referrals for VIN/VaIN

*There are anticipated changes to both practice and disease incidence which may influence the number of cases, so these numbers need to be carefully monitored.

Service organisation

  • Minimum of two gynaecological oncology consultants (as designated by the Cancer Network Medical Director)
  • Weekly, fully constituted centre multidisciplinary team meeting
  • Easy access (within 30 minutes) to or on-site radiotherapy, chemotherapy, combined/parallel clinics, colorectal surgery, urological oncology, plastic surgery, ITU and pain management
  • Data collection: cancer site breakdown, stage, surgical treatment and perioperative morbidity/mortality
  • Intraoperative frozen section facilities
  • On-call arrangements that don’t interfere with daytime activities or result in lengthening of training

Download the checklist for the gynaecological oncology training centre criteria (Word document, 42 kb).

Maternal and fetal medicine criteria

Please note: for recognition of a centre for a second simultaneous trainee, some multiplier of minimum case load criteria for MM and FM referrals and procedures is required to ensure the centre has the capacity to deliver adequate training to both trainees.

FM = fetal medicine; MFM = maternal and fetal medicine; MM = maternal medicine

Workload

  • Number of MFM sessions (with external referrals):
    • Minimum number of FM sessions per week = 6, AND minimum number of FM consultants accepting referrals with ≥2 sessions per week = 3*
    • Minimum number of MM sessions per week = 4, AND minimum number of MM consultants undertaking (sub)specialist sessions = 2*
  • Major fetal anomaly referrals should:
    • Number ≥150 per annum
    • Come from at least two other referral units
  • MM clinic(s) – or services if more appropriate – should cover ALL of the following disorders:
    • Endocrine (including >20 pregnancies to women with pre-existing diabetes per annum)
    • Cardiac
    • Respiratory
    • Haematology
    • Neurology
    • Obesity/metabolic
    • Renal
    • Hypertension
    • Anaesthetic
    • Infectious diseases
  • Fetal invasive procedures:
    • Minimum number of CVS procedures per annum = 100 AND >30 average per practitioner
    • Minimum number of more complex fetal procedures (e.g. multifetal reduction, fetocide, shunt insertions, vesicocentesis, thoracocentesis, fetal transfusions, laser ablation) >30 per annum
  • Annual delivery rate >5000 per annum

*To allow for adequate holiday cover and access from peripheral units to an opinion within 2 working days where necessary.

Defined as a joint obstetrics/medical clinic run by an obstetrician and a physician OR a dedicated pregnancy clinic run by a consultant physician/anaesthetist OR a dedicated clinic run by a (sub)specialist in MFM with access to a named relevant physician.

Organisation of services

  • Multidisciplinary MFM meetings with evidence of regular MFM consultant attendance
  • Evidence of robust audit/multidisciplinary team meeting with MFM learning outcomes
  • On-site regional neonatal intensive care facility with >10 beds
  • Ready access within a <50-mile radius to ALL of the following regional services:
    • Paediatric surgery
    • Fetal echocardiography/paediatric cardiology
    • Fetal MRI
    • Genetics: ALL cytogenetics, molecular genetics and clinical genetics sessions
  • On-call arrangements that don’t interfere with daytime activities or result in lengthening of training

Download the checklist for the maternal and fetal medicine training centre criteria (Word document, 44 kb).

Reproductive medicine

Workload and scope

  • Workload of training centre:
    • Minimum number of new fertility referrals = 400 per annum
    • Minimum number of sessions for general fertility = 8 per week
    • Minimum number of IVF clinic sessions = 8 per week
    • Minimum number of IVF treatment cycles = 500 per annum
  • Number of procedures to be available to trainee per annum:
    • >100 laparoscopies
    • >100 hysteroscopies
    • >100 HSG/ HYCOSY
    • >20 egg donation cycles
    • >50 IUI cycles
    • >50 OI cycles
    • >50 DI cycles
    • >20 reproductive surgery
    • >20 surgical sperm retrieval
    • >50 reproductive endocrinology
    • >50 recurrent miscarriage

Service organisation

  • HFEA-licensed centre with comprehensive portfolio of specialist services and:
    • Minimum of two fertility consultants
    • Weekly multidisciplinary team meeting
    • On-site facility to manage OHSS
    • On-site laboratory for semenology and embryology
  • Data collection: HFEA
  • On-call arrangements that don’t interfere with daytime activities or result in lengthening of training

Download the checklist for the reproductive medicine training centre criteria (Word document, 39 kb).

Urogynaecology

Unit workload

  • Referrals:
    • Minimum number of theatre lists undertaken by designated consultant urogynaecologists = 3 per week
    • Minimum number of urogynaecology outpatient clinics = 2 per week
    • Minimum number of urodynamics clinics = 4 per week (mix of consultant- and nurse-led clinics)
    • Minimum number of new urodynamic referrals >400 per annum
    • Minimum number of new urogynaecology referrals >750 per annum
    • Referrals should come from at least three other units (demonstration of tertiary practice)

Number of operations per annum

  • Surgical procedures:
    • >80 mid-urethral tapes/colposuspension for stress urinary incontinence
    • >20 procedures for recurrent/failed stress incontinence surgery, with a range of procedures such as autologous slings or injectables (>5 procedures should be a type other than mid-urethral sling)
    • Approximately 20 cases of intradetrusor botulinum toxin A injections
    • >150 cases undergoing one or more vaginal operation for pelvic organ prolapse
    • >30 procedures for vault prolapse (mix of sacrocolopopexy and sacrospinous fixation)
    • >10 procedures for recurrent/failed prolapse surgery
    • >50 diagnostic cystoscopies including flexible and rigid cystoscopy (non-tape cystoscopies)
    • Exposure to laparoscopic surgery to support vaginal vault
  • Conservative therapies on-site or easily accessed within the same service organisation:
    • Nurse-led urodynamics clinics = at least 2 per week
    • Women’s health physiotherapist with range of physical therapies for pelvic floor dysfunction
    • Bladder training clinic = 1 per week
    • Nurse-led ISC available for outpatients
  • Other clinics:
    • Perineal clinic/management of third-degree tears at specific clinic (1 per month)
    • Availability to perform video urodynamics
    • Availability for ambulatory urodynamics

Service organisation

  • Minimum two urogynaecology consultants (two consultants have at least six urogynaecology clinical sessions/week)
  • Regular multidisciplinary team meetings
  • Monthly audit meetings and/or risk management meetings
  • Easy access to (<30 minutes) within the same service organisation for ALL of the following:
    • Urology
    • Coloproctology
    • Medical physics
    • Care of the elderly
    • Physiotherapy
    • Anorectal physiology including anorectal ultrasound
    • Neurology including MS clinics and neurophysiology
  • On-call arrangements that don’t interfere with daytime activities or result in lengthening of training

Download the checklist for the urogynaecology training centre criteria (Word document, 37 kb).

Contact us

For more information, or if you have any questions, please email the Advanced Training Assistant or call +44 20 7772 6271.

Elsewhere on the site

Specialty training programme
Overview of the specialty training programme in O&G, including assessment and certification of training
Curriculum
The full specialty training curriculum in O&G – core modules, ultrasound, ATSMs, subspecialty and academic