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Core Curriculum: CiP 11

Capability in Practice 11: The doctor is competent in recognising, assessing and managing non-emergency gynaecology and early pregnancy.

This CiP is grouped under Professional Identity 3: Clinical Expert

 

Key Skills

Descriptors

Manages abnormal vaginal bleeding

 

  • Performs focused history, appropriate examination and orders appropriate investigations.
  • Formulates a differential diagnosis.
  • Discusses diagnosis in a sensitive manner.
  • Formulates an appropriate and individualised management plan taking into account patient preferences and the urgency required.
  • Recognises limitations and escalates care to senior colleagues and other specialities when appropriate.
  • Performs surgery where appropriate.
  • Ensures appropriate follow up. 
  • Demonstrates awareness of the quality of patient experience.

Manages pelvic and vulval pain

 

Manages pelvic masses

Manages the abnormal cervical smear

  • Demonstrates ability to counsel about cytology reports and HPV testing.
  • Refers to colposcopy services in accordance with national guidelines.

Manages suspected gynaecological cancer symptoms

 

  • Performs focused history, appropriate examination and order appropriate investigations
  • Discusses diagnosis and prognosis in a sensitive manner.
  • Demonstrates knowledge of when referral to a tertiary gynaecological oncology centre will be required.
  • Can counsel about surgical and non-surgical treatment options, taking into account the individual woman’s background health and preferences.
  • Ensures appropriate follow up in line with national guidance.

Manages urogynaecological symptoms

 

  • Performs focused history, appropriate examination and orders appropriate investigations.
  • Formulates a differential diagnosis.
  • Discusses diagnosis in a sensitive manner.
  • Can counsel about surgical and non-surgical treatment options, taking into account the individual woman’s background health and preferences.
  • Ensures appropriate follow up.  
  • Demonstrates awareness of the quality of patient experience.

Manages vulval symptoms

  • Performs focused history, appropriate examination and orders appropriate investigations.
  • Recognise common vulval disorders
  • Formulates a differential diagnosis.
  • Discusses diagnosis in a sensitive manner and recognise the psychological impact of vulval disease
  • Formulates an appropriate and individualised management plan taking into account patient preferences and the urgency required.
  • Recognise when to refer to allied specialties and the importance of the multidisciplinary team

Manages menopause and postmenopausal care

  • Performs focused history, appropriate examination and orders appropriate investigations.
  • Formulates an appropriate and individualised management plan taking into account patient preferences including complimentary therapies and lifestyle modifications.
  • Appreciates the impact that the menopause may have on other aspects of wellbeing.

Manages subfertility

  • Performs focused history, appropriate examination and orders appropriate investigations.
  • Is able to interpret results in order to plan effective care and counsel about management options, including local referral pathways and alternatives for conceiving.
  • Understands the ethical issues surrounding IVF treatment.

Manages sexual wellbeing

  • Performs focused history, appropriate examination and orders appropriate investigations.
  • Offers advice regarding all contraceptive methods and understands the factors affecting choice of contraception, including comorbidities, patient preference, failure rates, etc.
  • Demonstrates ability to administer/fit different contraceptive methods
  • Demonstrates the ability to manage unplanned pregnancies (including medical and surgical abortion*
  • Is aware of alternative sources of support and follow-up for patients, particularly in cases of unplanned pregnancy and termination of pregnancy.
  • Offers sexual health screening advice and provides appropriate referral to genitourinary medicine (GUM) services for management of sexually transmitted infections.
  • Identifies psychosexual problems, explores and can initiate referral to specialist services where available.
  • Recognises the interactions between gynaecological problems and psychosexual problems.

 

* Trainees who have personal beliefs that conflict with provision of abortion or for those undertaking training in a region where there are legal restrictions to provision of abortion, see Section 10 of this Definitive Document.

 

 

Evidence to inform decision

  • OSAT
  • CbD
  • Mini-CEX
  • MRCOG
  • Reflective practice    
  • TO2 (including SO)
  • NOTSS
  • Local and Deanery Teaching
  • RCOG eLearning
  • IPM training certificate
  • MRCOG Part 2

 

Mapping to GPCs

Domain 1: Professional values and behaviours

Domain 2: Professional skills

  • Practical skills
  • Communication and interpersonal skills
  • Dealing with complexity and uncertainty
  • Clinical skills (history taking, diagnosis and management, consent; humane interventions; prescribing medicines safely; using medical devices safely; infection control and communicable diseases)

Domain 3: Professional knowledge

  • Professional requirements
  • National legislative structure
  • The health service and healthcare systems in the four countries

Domain 4: Capabilities in health promotion and illness prevention

Domain 5: Capabilities in leadership and teamworking

Domain 6: Capabilities in patient safety and quality improvement

  • Patient safety

Quality improvement