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Knowledge Area 12 – Sexual and reproductive health

Capability in practice (CiP)

  • 1: The doctor is able to apply medical knowledge, clinical skills and professional values for the provision of high-quality and safe patient-centred care
  • 6: The doctor takes an active role in helping self and others to develop
  • 11: The doctor is competent in recognising, assessing and managing non-emergency gynaecology and early pregnancy care

 

Summary Knowledge Requirements

PART 1 MRCOG

  • Physiology, endocrinology, epidemiology and pharmacology of contraception
  • Epidemiology and serology of sexually transmitted infections (STIs), the microorganisms involved, the drugs used in their treatment and the pathological features of STIs
  • Termination of pregnancy, including assessment, Fraser competency, surgical management and the drugs used in medical termination of pregnancy

PART 2 MRCOG

  • Demonstrate appropriate knowledge, skills and attitudes in relation to fertility control, the diagnosis and management of sexually transmitted infections (including HIV) and sexual dysfunction
  • Be familiar with irreversible and emergency contraception and abortion, their modes of action, efficacy, indications, contraindications and complications
  • Be familiar with the laws relating to abortion, sexually transmitted disease, infection, consent and child protection
  • Demonstrate broad-based recognition of management techniques relating to the sexual health of vulnerable groups, such as young people, asylum seekers, commercial sex workers, drug users and prisoners
  • Know the basis of national screening programmes and their implementation through local care pathways

PART 3 MRCOG

  • Demonstrate appropriate knowledge, skills and attitudes in relation to fertility control, the diagnosis and management of sexually transmitted infections (including HIV) and sexual dysfunction
  • Be familiar with irreversible and emergency contraception and abortion, their modes of action, efficacy, indications, contraindications and complications
  • Be familiar with the laws relating to abortion, sexually transmitted disease, infection, consent and child protection
  • Demonstrate broad-based recognition of management techniques relating to the sexual health of vulnerable groups, such as young people, asylum seekers, commercial sex workers, drug users and prisoners
  • Know the basis of national screening programmes and their implementation through local care pathways

 

Detailed Knowledge Requirements

  • Reversible, irreversible and emergency contraception and termination of pregnancy: mode of action and efficacy, methods, indications, contraindications and complications
  • The laws relating to termination of pregnancy, sexually transmitted infections, (STIs), consent, child protection and the Sexual Offences Act 2003
  • Recognise and manage the sexual healthcare needs of vulnerable groups, e.g. young people, asylum seekers, commercial sex workers, drug users, and prisoners.
  • Recall the effect of addictive and self-harming behaviours, especially substance misuse and gambling, on personal and community health and poverty
  • Sexually transmitted infections including HIV/AIDS: transmission, clinical features, management, transmission and prevention, National Chlamydia Screening Programme and local implementation, Understand local care pathways for multi-agency working and cross referrals for individuals with sexual health needs
  • Sexual problems: anatomy and physiology of the human sexual response, epidemiology, aetiology, pathogenesis, clinical features and prognosis of psychosexual / sexual problems
  • Fertility control methods: Natural family planning (physical, Persona®), Barrier (condom: male and female), diaphragm, caps], Chemical, Hormonal methods (including pharmacodynamics and metabolic effects) oral, transdermal, subdermal, intramuscular, intrauterine, Male and female sterilisation, Intrauterine contraception, (copper-containing, progesterone-containing), Reversal of sterilisation, Postcoital methods (progestogen, intrauterine contraceptive devices), Advances in contraception (including male reversible)
  • Contraceptive failure: method, iatrogenic, User
  • Non-use of contraception due to e.g. social factors, cultural factors, sexual/ domestic abuse, poor service access/delivery
  • Termination of pregnancy: Pre-procedure consultation/assessment, Estimation of maturity, Method options/choice, STI screen and prophylaxis, Counselling and support, Methods (manual vacuum aspiration, suction evacuation of uterus, dilatation and evacuation, medical termination), Complications of procedures, Contraceptive supplies on discharge
  • Aftercare for termination of pregnancy: Contraception, Sexual health, Counselling and support
  • Other issues related to termination of pregnancy: Age, Consent, Confidentiality, Legality, Special needs and vulnerable groups, Service organisation, High risk groups for sexual poor health, ‘Hard to reach’ groups (asylum seekers, homeless and rootless, commercial sex worker, substance abusers, mental illness), Adolescents, Vulnerable adults, Learning disability, Socio-economic deprivation, Negative psychosocial impact of STIs, in particular HIV/AIDS, Importance of networks and multi-agency working
  • Gender dysphoria
  • Socio-economic consequences: Cycle of deprivation, Population trends
  • Management options: Abortion, Adoption, Keep baby
  • Sexually Transmitted Infections including HIV/ AIDS: Transmission, Clinical features, Detection, Prevention, Treatments, Test of cure, Contact tracing, Health advisors, Genitourinary medicine services, Screening programmes, Specific conditions, Chlamydia, HIV, Parasitic infections, Fungal infections, Bacterial infections, Protozoal infections, Viral infections
  • Sexual problems: The anatomy and physiology of human sexual response, The psychogenic aetiology and presentation of common sexual problems such as loss of sexual interest and arousal, vaginismus, anorgasmia, The effect of age, cultural influences, illness and drugs on sexual behaviour and performance, The principles of psychosexual counselling, Sexual problems in special needs groups such as physical and learning disability, Covert presentations of psychosexual problems and childhood sexual abuse
  • Referral pathways to local expertise in the field of psychosexual medicine and sexual dysfunction