HEALTH EDUCATION THAMES VALLEY - SPECIALTY
TRAINING PROGRAMME IN OBSTETRICS AND
GYNAECOLOGY
About Health Education Thames Valley
We are the Local Education and Training Board (LETB) for Thames Valley covering
Berkshire, Buckinghamshire and Oxfordshire. Our vision is to ensure the delivery of
effective workforce planning and excellent education and training to develop a highly
capable, flexible and motivated workforce that delivers improvements in health for
the population of Thames Valley. Thames Valley LETB is responsible for the training
of around 2000 Foundation and Specialty trainees.
Health Education Thames Valley is a relatively small organisation with a defined
geographical area which serves as a single unit of application. In the majority of
cases successful candidates will be asked to preference their choice of location for
either one or two years. Some programmes will require successful candidates to
indicate a location and specialty. Future placements will usually be based on
individual training and educational needs. Please note that applications are to the
Health Education Thames Valley as a whole. This may mean that you may be
allocated to any geographic location within the deanery depending on training
needs.
The Obstetric and Gynaecology Training Programme
The Obstetrics and Gynaecology training programme is a 7 year programme,
starting at ST1. During the training, the trainee’s work will be monitored for
satisfactory progress and subject to annual reviews in the form of ARCPs.
Progression up the programme will be dependent upon these reviews.
The posts on this rotation have been approved for Specialist Training by the
Postgraduate Dean, GMC and Royal College of Obstetricians and Gynaecologists.
The posts attract National Training Numbers and provide training towards a
Certificate of Completion of Training (CCT) when commenced at ST1.
The Postgraduate Dean has confirmed that these posts have the necessary
educational and staffing approvals.
1
The programme is based in several different Trusts throughout Health Education
Thames Valley so trainees may find themselves employed by any of the following
Trusts and placed in any of the following hospitals:
Trust
Hospitals and Locations
Buckinghamshire Healthcare Stoke Mandeville Hospital, Aylesbury
NHS Trust
http://www.buckshealthcare.nhs.uk/
Wycombe Hospital, High Wycombe
http://www.buckshealthcare.nhs.uk/
Heatherwood and Wexham Wexham Park Hospital, Slough
Park Hospitals NHS
http://www.heatherwoodandwexham.nhs.uk/location/wexhamFoundation Trust
park-hospital-slough
Milton Keynes Hospital NHS Milton Keynes Hospital
Foundation Trust
http://www.mkgeneral.nhs.uk/
Oxford University Hospitals John Radcliffe Hospital, Oxford
NHS Trust
http://www.ouh.nhs.uk/
Horton Hospital, Banbury
http://www.ouh.nhs.uk/
Royal Berkshire NHS
Royal Berkshire Hospital, Reading
Foundation Trust
http://www.royalberkshire.nhs.uk/
Programme Description
The Oxford Deanery comprises 1 University Hospital and 5 District Hospitals.
The programmes have been designed to give a wide variety of exposure to general
Obstetrics and Gynaecology in the first five years, rotating through all / most of the
hospitals, with special interests in the final two years.
The first 2 years introduce the trainee to basic Obstetrics and Gynaecology at the
end of which Part 1 MRCOG must be passed. There is a strong Deanery teaching
programme for ST1 – 5 which prepares trainees for the Part 2 MRCOG examination
and addresses the requirements of the basic and intermediate curriculum. ST6 and 7
programmes have been carefully designed to provide ATSM training. Allocation to a
particular programme at senior level will be determined by the interests of the trainee
and in open competition with their colleagues.
Less than full time training is available if job shares can be organised with another
trainee at a similar level of training.
Academic training in Obstetrics and Gynaecology is available through academic
clinical fellowships and clinical lecturer posts. These are appointed separately.
The Head of School is Mrs Rebecca Black who is based in Oxford. The Deputy Head
of School is Miss Jill Ablett who is based in Reading.
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The School Board has the responsibility of ensuring excellent training in O&G
throughout the seven years of run through training. There are enthusiastic
Educational Supervisors available to direct and support the training in each Trust.
We are a small LETB but can provide all the necessary training with options for
research later (as well as the ACF, Academic Clinical Fellowship scheme) and
subspecialty training.
The training programme rotates around the 6 acute hospitals in the Oxford Deanery.
Most placements are for a year and trainees must be able to travel between the
different units.
The Thames Valley scheme has an intake of 8 trainees at ST1 per year, and in some
years an academic clinical fellow. At a senior level, all advanced training special
interest modules can be offered apart from paediatric gynaecology. There is
subspecialty training in all areas of interest (urogynaecology, gynaecological
oncology, maternal and fetal medicine and reproductive medicine).
The training scheme is divided into 3 parts, ST1-2, ST3-5 and ST6-7 based on the
RCOG curriculum and competencies have to be achieved before progression, as
determined each year by the ARCP process.
ST1 and ST2
These posts are paired and allocation is decided following interview when trainees
can give their preferences. The person who scores highest at interview is placed in
their first choice etc. All posts will allow the trainee to develop the skills of the basic
curriculum and ST2 competencies have to be achieved before progressing to ST3.
ST3 – ST5
At present, we organise fixed 3 year rotations and allocation is made to rotate the
trainees through most of the Units. We now aim for ST3 to be in the same Unit as
ST2. All the posts will allow trainees to gain their intermediate competencies and
Part 2 MRCOG must be passed before moving into ST6. We have good success
rates at Part 2 MRCOG.
ST6 and ST7
These posts allow trainees to develop their areas of special interest whilst
completing their advanced curriculum. The programmes are altered depending on
trainee and workforce requirements. Allocation is by competitive interview and posts
are in all the Units. A preceptor for the appropriate ATSM will be in each Unit and we
have a Director of ATSMs in the Deanery, currently Miss Jill Ablett at Reading. Two
ATSMs must be completed before CCT can be awarded and the total intensity score
cannot be more than 3.
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CURRENT ST6 & 7 PROGRAMMES
Rotation letter and
locations
ATSMs available on each site for the trainee in this rotation,
with work intensity score in brackets
A
Milton Keynes and
Oxford
(mixed)
Milton Keynes
Benign abdominal surgery (2) or ALWP (1) or Med Ed after
ALWP complete (1), maternal medicine, colposcopy
Oxford:
Support benign abdo surgery and Med Ed/ ALWP
Or offer Acute gynae and early pregnancy (2)
Or Subfertility & Reproductive Medicine (2) but both must
complete at Oxford if started
C
Reading ALWP (1) or medical education (1)
Reading and Oxford
Oxford: Acute gynae & early pregnancy (2)
(mixed)
D
Wexham: ALWP (1) or colposcopy (1). Support benign
Wexham and Reading abdominal surgery
(mixed)
Reading: Benign abdominal surgery (2)
E
Reading Urogynaecology and vaginal surgery (2) or oncology (2)
Reading 2 years (mixed)
ALWP (1) or med education (1) or colposcopy (1)
F
Bucks ALWP (1) and Labour ward lead (1) or Fetal medicine (2),
Bucks and Oxford
or ALWP alone (1)
(Obstetric ATSMs only) Oxford: support fetal medicine if commenced with ALWP (1) or
Maternal medicine (2) or Advanced antenatal practice (2)
G
Reading and Oxford.
Reading and Oxford
Maternal medicine (2) or Fetal Medicine (2) or Advanced
(Obstetric ATSMS only) antenatal practice (2) plus ALWP (1)
H
Bucks Colposcopy (1) and vulval disease (1) or vaginal surgery
Bucks and Oxford
& urogynaecology (2)
(Gynae ATSMs only)
Oxford:
Benign vaginal surgery & urogynaecology (2) or menopause (1)
I
Wexham: Benign abdominal surgery (2) or ALWP (1). Oncology
Wexham and Oxford
(2) is available for suitable applicants
(mixed)
Oxford: Gynae oncology (2) Labour ward lead (1) and ALWP (1)
or med ed(1)
Each post will offer general obstetric and gynae training to ensure completion of the
advanced parts of the logbook/curriculum. The ST6/7 trainees will be expected to
lead the more junior trainees, organise rotas, lead departmental meetings and join in
appropriate management meetings. Involvement in at least one audit project per
year is required. (All ARCP requirements are explained in the RCOG Training Matrix,
which is available online and updated annually).
The posts have allocated ATSMs which fit in with the development of special
interests for future consultant posts. Most trainees should complete advanced
labour ward practice unless intending to apply for gynae only consultant posts. The
ATSM trainer will be allocated at each unit by the College Tutor who acts as local
preceptor.
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Advanced laparoscopic training is available and we can preceptor this ATSM but this
is centrally appointed by the RCOG.
SUBSPECIALITY TRAINING:
There is recognition for subspecialty training in maternal and fetal medicine (2),
gynaecological oncology, reproductive medicine (2) and urogynaecology.
EDUCATIONAL SUPERVISION
Trainees will be allocated an educational supervisor in the Trust at the beginning of
each year and this person will give educational support and organise the regular
appraisals according to the RCOG curriculum. All trainees must be registered with
the RCOG. The training will be reviewed annually at the ARCP to agree progress to
the next year.
There is an annual interview at HETV to discuss this outcome and plan the next year
of training.
At each hospital, trainees will be allocated to one or more clinical supervisors who
will provide clinical training and perform many of the workplace based assessments.
The trainee is responsible for requesting and arranging these as necessary.
TEACHING
ST1 – ST2: There is an alternate month, whole day training organised centrally for
these trainees which is based on the basic modules of the curriculum. This is
protected time and trainees will be released from their Units – although there may be
rare occasions when this is not possible. Further teaching sessions are held in each
Unit and focus on the basic practical skills which are required.
ST3 – ST5: At present, there is a protected weekly half day of teaching on a Friday
afternoon (for thirty weeks of the year) which all trainees are expected to attend. This
covers the intermediate curriculum and syllabus for Part 2 MRCOG. There may be
occasions when Units cannot release all the trainees to attend because of rota
commitments. There is also an alternate month, whole day central teaching which
covers the training courses of each module. These sessions account for the majority
of the annual study leave allocation.
STRATOG is used to support this teaching.
ST6 - ST7: There is a requirement to attend three regional days a year, one being
OXSFOG and the other two being specifically for ST6-7 trainees. The requirements
of individual ATSMs will be addressed in the Units and RCOG organised essential
courses have to be attended. It is expected that senior trainees will participate in the
delivery of teaching, as invited, to the more junior trainees.
OXSFOG: (Oxford Scientific Forum for Obstetrics and Gynaecology) is an annual
Deanery study day which all trainees and Consultants attend where trainees present
their audits and there is a scientific programme.
All the centralised teaching is within study leave allocation.
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Ultrasound Training
Mr Mark Selinger from Reading, is the Deanery Ultrasound Co-ordinator. Training
takes place within each Trust to ensure that the basic ultrasound modules are
completed before the end of ST5, preferably earlier. Intermediate modules are
available at certain Trusts on discussion with the Co-ordinator.
Academic Clinical Fellows
These are appointed jointly between the Deanery and University by separate
advertisement. We currently have 3 ACFs and 4 academic clinical lecturers.
Research
The Nuffield Department of Obstetrics and Gynaecology (NDOG) supervises the
ACFs and ACLs. There is access to research projects for other trainees which may
lead to an MD or DPhil. The academic lead and Head of Department of NDOG is
Professor Stephen Kennedy.
Less than full time training
We can arrange slot shares for trainees to work less than full time – subject to
appropriate rotations. Dr. Rebecca Mather is the Associate Dean responsible for this
training.
LEAVE
Annual leave must be arranged at least 6 weeks in advance and individual Units will
have their own guidance. At most Units, there will be a maximum number of trainees
who can be away at once.
Study leave is determined by each local Unit under the guidance of the Trust’s
Director of Medical Education and Deanery guidelines. The fixed Deanery teaching
sessions will count within the study leave allocation. Personal study will usually only
be given before examinations or completing research work.
Pay Banding: Please check with the relevant Trust.
All posts include prospective cover for annual and study leave of colleagues.
Transport:
It is expected that trainees can provide their own transport between Trusts
particularly for the Friday teaching.
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BOARD OF THE POSTGRADUATE SCHOOL OF OBSTETRICS &
GYNAECOLOGY
Head of School
Board Members Deputy HOS
TPD for ST1/2
TPD for ST3-5
Rebecca Black
Jill Ablett
Nandini Gupta
Lee Lim
TPD ST6/7/Director ATSMs
College Tutor from each Trust:
Reading
Oxford
Jill Ablett
Jill Ablett/Rajee
Vijayanand
Debbie Harrington /Jane
Moore
Abdul Wagley
Jonathan Nicholls
Nandini Gupta
Aparna Reddy
Wexham
Banbury
Milton Keynes
Bucks (Stoke Mandeville and
Wycombe)
University Representative
Stephen Kennedy
Director Ultrasound Training
Mark Selinger
Teaching Co-ordinator ST1/2
Jane Moore
Teaching Co-ordinator ST3-5
Lee Lim
Simulation Lead
Jill Ablett
Local
Workforce
Behaviours Felicity Ashworth
Champion
Trainee Representatives
- Senior Liv Knutzen
- ST1/2 Prasanna Subramanian
Lay Representatives
Deanery Programme Manager
Sue Varley & Mary Legge
Jane Exell
Responsibilities:
Trainees Placements/Recruitment
ARCP
Quality assurance
ST1/2 trainees (include teaching &
ARCP)
ST6/7 Trainees
ST1/2 Teaching
Rebecca Black
Rebecca Black
Rebecca Black
Nandini Gupta
Jill Ablett
Nandini Gupta
7
ST3-5 teaching
- Local
Lee Lim (lead)/Aparna Reddy/Jill Ablett
- Deanery-wide Lee Lim
ATSM
Jill Ablett
Academic/University
Stephen Kennedy
Local Workforce Behaviours
TBA
champion
Academic Clinical Fellows
Joint responsibility with University Medical
Academic Board
Stephen Kennedy
The Hospitals
Milton Keynes General Hospital.
Departmental Staff:
Nine Consultants
Mr Ghaly Hanna
Mr Kailash Nakade
Ms Maryam Pezheski (Locum Consultant)
Mr Anthony Stock ( Clinical Service Unit Lead)
Ms Premila Thampi
Miss Naomi Whitelaw
Ms Nandini Gupta (College Tutor)
Milton Keynes General Hospital it situated in the north of Buckinghamshire and there
are approximately 4000 deliveries (2009). The Obs & Gynae department is staffed
by 9 Consultants. Mr Anthony Stock has an interest in pre-natal diagnosis and is
the Deputy Cancer Lead. Mr Nakade is the Cancer lead for gynae oncology and has
an interest in minimal access surgery. Ms Whitelaw, Mr Agboola, Mr Nakade and
Miss Gupta run Colposcopy clinics. Miss Gupta is the College Tutor and has an
interest in early pregnancy scanning. Mr Hanna has an interest in Fetal Medicine
and outpatient Hysteroscopy. Mr Hanna and Mr Nakade are preceptors for the
benign gynaecology module.
The Department is a very busy department, with a wide variety of experience. The
unit is able to provide the labour ward advanced module, the maternal medicine
module, colposcopy ,benign gynaecology and basic ultrasound training.
Trainees: At present there are nine SHO (2 ST1/2) and five StR posts (4 at ST 3-5
and 1 ST6). There are also four non-career grade doctors on the middle-grade rota.
Gynaecology: About 3,000 operations per year (1999). Twenty-five+ beds. The
department also has access to about five day unit beds on a daily basis.
Each week there are three colposcopy clinics, one combined medical and ante-natal
clinic and one urogynaecology clinic. There is also an out-patient hysteroscopy
clinic. There is a pre-assessment clinic staffed by nurses.
8
Pregnancy related services: An Early Pregnancy Assessment Unit is currently
located on the outpatient clinic area.
Antenatal Care: Virtually all initial assessments and serum screenings are done by
midwives in the community. There are six hospital-based antenatal clinics per week.
Some hospital-staffed ante-natal clinics are held in different community health
centres or surgeries.
Day Assessment Unit: This is run by Midwives with medical input where necessary.
Labour Ward Beds: 12
Maternity Beds: 32
Births: About 4000 per year
Medical Students: from University of Oxford.
Rota: Full shift.
OXFORD – The Women’s Centre, John Radcliffe Hospital
The Nuffield Department of Obstetrics and Gynaecology (NDOG) is the academic
unit of the University of Oxford:Professor Stephen Kennedy is Head of Department.
Oxford Reproductive Medicine
Mr Enda McVeigh
Mr Tim Child
Miss Jane Moore
Mr Christian Becker
Miss Ingrid Granne
Senior Fellow, Reproductive Medicine
Senior Fellow, Reproductive Medicine
Senior Fellow, Reproductive Medicine
Senior Fellow, Reproductive Medicine
Senior Fellow, Reproductive Medicine
Mr Manu Vatish
Senior Lecturer and Consultant Obstetrician
There are 3 clinical lecturer posts (0.5 WTE) employed by the University
The NHS consultant staff, giving their main interests comprise:
Mr Simon Jackson
Miss Natalia Price
Mr Lawrence Impey
Miss Catherine Greenwood
Mrs Rebecca Black
Miss Deborah Harrington
(Urogynaecology)
(Urogynaecology)
(Maternal Fetal Medicine)
(Maternal Fetal Medicine)
(Maternal Fetal Medicine)
(Maternal Fetal Medicine)
Mr Vic Rai
Dr Lucy Mackillop
Miss Lee Lim
Miss Veronica Miller
Mr Sujay Chakravarti
Miss Brenda Kelly
(Emergency Gynaecology, Benign Gynaecology)
(Obstetric Physician)
(Obstetrics and Gynaecology)
(Obstetrics)
(Obstetrics)
(Maternal Fetal Medicine)
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There are 5 subspecialty trainees, 2 in Fetal Maternal Medicine, 1 in Reproductive
Medicine, 1 in Gynaecological Oncology and 1 in urogynaecology.
There are 18 StR posts at the John Radcliffe, 5 at ST1/2, 6 at ST3-5 and 7 at ST6/7.
In addition there are GP VTS trainees and foundation (FY2) doctors. There are also
clinical fellows who perform a mixture of clinical and academic work. There is an
Associate Specialist in Fetal Cardiac Scanning (Dr Nicky Manning).
The pattern of emergency duties is a full shift with periods of night duty. The rota is
EWTD compliant.
Trainees at ST 3-5 level rotate to the Horton Hospital, Banbury to gain experience in
gynaecology and outpatient clinics, and to the Cancer Centre, located at the
Churchill Hospital, Oxford.
All services are located within the Women’s Centre.
Deliveries per year:
7200 (2012), Caesarean Section Rate 21%
Obstetric beds:
81+ 16 Delivery Suite beds
10 Observation area beds
Midwifery led Unit (The Spires) opened 2008
2 natural birthing rooms including 1 pool within the 16
delivery rooms
Obstetric Ultrasound:
Total Scans – > 9,000
Gynaecology beds:
16-20 beds; 70 inpatients per week
Gynaecological referrals:
230 outpatient appointments per week
Gynaecological operations:
Two lists / day. 3 diagnostic suite sessions / week
Neonatal Facilities:
Level 3 unit
Facilities:
All the major subspecialty interests are represented within the Women’s Centre.
Delivery Suite: There are 2 dedicated obstetric theatres and modern monitoring
facilities, including central monitoring, ultrasound and fetal blood sampling
Gynaecology Facilities: There is a single gynaecological ward plus a diagnostic
suite and 2 dedicated theatres with laser facilities.
The Outpatient Department: Housed within the centre is solely for the use of the
Women’s Centre and neonatal unit.
10
The Feto-Maternal Medicine Unit incorporates the Fetal Medicine Unit, the Silver
Star High Risk Pregnancy Unit, the Prenatal Diagnosis and the Obstetric Diabetic
Clinic. Alongside these services are the Day Assessment Unit and Ultrasound anomaly and nuchal scanning is offered as a routine.
Specialist Clinics covering all aspects of the specialty are provided including,
colposcopy, out-patient hysteroscopy, urodynamics, infertility, the menopause,
gynaecological oncology, recurrent miscarriage, high risk maternal medicine,
obstetric cardiac clinic and pre-conception counselling.
An Early Pregnancy/rapid access gynaecology clinic runs every morning during
the week, with a dedicated emergency gynaecology list 3 days per week. The aim is
that there will be no out of hours surgery.
ATSM
Year 6/7 Programmes are offered in: - Urogynaecology, Subfertility, Oncology,
Maternal Fetal Medicine, Gynaecological Ultrasound and Gynaecological operating
including Minimal access surgery.
Medical Students: Oxford and Cambridge
Undergraduates from Oxford Brookes University.
Universities
plus
Midwifery
Horton General (Banbury)
This hospital is part of Oxford University Hospitals NHS Trust. The department
comprises:
5 Consultants:
Mr Stuart Canty
Mr Jonathan Nicholls (District College Tutor)
Mr Hikmet Naoum
Mr Mohamed Raheem (Locum)
Miss Wing Han Cheung (Locum)
Ms S Doshi (Staff Grade)
The hospital is a District General Hospital providing an acute maternity and
gynaecological service.
All consultants share the general obstetric and
gynaecological workload of the department. The-out-of-hours rota is staffed by
Clinical Fellows.
Trainees from the John Radcliffe rotate to the Horton for a 4 week block to work in
the elective gynaecology service. This provides opportunities for extensive operating
and out-patient experience as well as in the specialist urogynaecology, O/P
diagnostic and colposcopy services.
Buckinghamshire Hospitals: Stoke Mandeville (Aylesbury) and Wycombe
Hospital:
The department has fourteen Consultants:
Mr Yemi Akinsola
(Maternal medicine)
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Miss Felicity Ashworth
Mr Ian Currie
Mr Tunde Dada
Mr Damian Eustace
Miss Jacqueline Hall
Miss S. Suri
Miss Nutan Mishra
Miss Geraldine Tasker
Miss Aparna Reddy
Miss Deborah Sumner
Mr Chris Wayne
Miss A. Patil
Miss S. Iyengar
(Former Head of School, Maternal
Medicine, Fertility)
(Urogynaecology, Hon Secretary RCOG)
(MAS)
(Oncology)
(Fetal medicine and Clinical Governance)
(Labour ward lead)
(DAU)
(Clinical Director, oncology, colposcopy)
(College Tutor, Maternal Fetal medicine)
(Colposcopy, urogynaecology)
(Emergency gynae and EPU)
(urogynaecology)
(emergency gynae)
There are 7 ST3-5, 4 ST6, 2 Trust Doctors and 2 Staff Grades. Two Consultants
work nights within the on call rota.
There are 2 middle grade staff on call out of hours. The middle grade rota is a full
shift pattern (1 in 8 ) with blocks of nights split 3 / 4.
SHO rota (14):
2 ST1/2,
8 Vocational Training Scheme Doctors
4 F2
The banding is 1b for ST1/2 and 1a for ST3-7 at present.
Stoke Mandeville is renowned for its spinal injuries unit and therefore has a large
radiology department with MRI and CT scan facilities. Travel time from Oxford is
approximately 30-40 minutes.
The unit has combined obstetrics and gynaecology facilities. The labour wards
merged on to one site (at SMH) in October 2009, with a MLU at Wycombe Hospital.
There are 52 obstetric beds, 20 gynaecological beds and approximately 5,800
deliveries per year. Neonatal facilities include 20 cots and 2 with designated
intensive care. The labour ward has 2 dedicated theatres and water birth facilities.
Specialist interests within the department include colposcopy, infertility, outpatient
hysteroscopy, minimal access surgery, fetal medicine and urogynaecology. One ST6
specialises in urogynaecology, one in benign gynaeoncology, one in advanced
antenatal care / Fetal Medicine and advanced labour ward practice. Most ATSMs
could be taught at the Unit. Mr Dada is a preceptor in minimal access surgery. Ms
Reddy is local ultrasound coordinator and supports USS training and the fetal
medicine ATSM .
There are several multidisciplinary meetings within the department. (MDT, risk
management, perinatal morbidity/mortality, clinical audit). Teleconferencing links are
available.
Medical students: five Oxford medical students have their attachments at the unit.
The Royal Berkshire (Reading)
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The Royal Berkshire Hospital in Reading serves a catchment population of
approximately 500,000. In 2011 there were approximately 6000 deliveries and 4060
gynaecological outpatient episodes; in addition there were 867 Colposcopy sessions.
There are about 300 hysterectomies performed annually, and 700 laparoscopic
procedures.
The medical staffing establishment at 2011 is:
Miss Jill Ablett FRCOG
Miss Helen Allott, MA, FRCOG
Consultant in Feto-Maternal Medicine
College Tutor
Consultant in Feto-Maternal Medicine
Mr Alan Crystal, FRCS, FRCOG
Consultant Gynaecologist
Mr Bill Kuteesa MRCOG
Miss Samantha Low MRCOG
Mr Brian Reid FRCOG
Consultant Gynaecologist
Consultant Obstetrician
Consultant Obstetrician and Clinical
Director
Consultant in Feto-Maternal Medicine
Consultant in Feto-Maternal Medicine
Associate Dean for Education
Consultant Gynaecologist
Consultant in Feto-Maternal Medicine and
Clinical Lead
Mr Mark Selinger, MD, FRCOG
Miss Jane Siddall, FRCOG
Mr Kevin Smith, MRCOG
Miss Patricia Street, FRCOG
Mr. Alex Swanton MRCOG
Miss Rajee Vijayanand MRCOG
Consultant Gynaecologist
Consultant Gynaecologist and College Tutor
Dr. Suruchi Arora
Associate Specialist in O&G
Ultrasound
There are seven posts recognised for Specialist Registrar training, two at ST3-5 and
five at ST6/7. Nine other doctors are also in post: one or two are post CCT fellows
and the remainder are specialty doctors.
Two middle grade doctors are on call out of hours, 1 in 8
There are 3 ST1/2 posts.4 VTS and 3 F2 doctors who rotate every 4 months within
the Trust.
All trainees will receive training and provide service in both obstetrics and
gynaecology. The ST6/7 trainees on rotations C, D, E and G will have
proportionately more day time duties in Obstetrics or Gynaecology depending on
special interest.
All consultant gynaecologists offer a wide training in gynaecological surgery,
including minimal access work, and conduct both general and PMB outpatient
services. Mr Swanton has a special interest in sub-fertility, with designated clinic
facilities, Mr Crystal undertakes gynaecological cancer cases as does Ms Vijayanand
and Mr Smith and Mr Kuteesa have subspecialty expertise in urogynaecological
services. There is an Early Pregnancy Assessment Service.
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Training in all of these areas is available; junior trainees will normally access two of
these firms during the year, while senior trainees will work with consultants relevant
to their ATSMs.
All obstetricians offer a broad training in the management of medium to high risk
pregnancy, with six on-site and two satellite outpatient clinics. In addition, Miss
Street runs a diabetic ANC in conjunction with the consultant endocrinologists and
Miss Ablett runs a monthly clinic with the Cardiologists. Miss Allott has an interest in
HIV, Miss Siddall in drug and alcohol misuse and Miss Low in haematological
disorders. There is a Day Assessment Unit for monitoring hypertensive disease etc.
Mr Selinger offers training in invasive prenatal diagnostic techniques and imaging to
senior trainees. Miss Allott runs a clinic for bereaved parents and also one for
women with previous traumatic birth experiences. Access to these clinics is for the
senior trainee who is pursuing training in fetomaternal medicine.
The Delivery Suite has a designated consultant for >60 hours each week who will
supervise ward rounds and teach obstetric skills as necessary to any trainee.
All trainees are required to participate in the perinatal morbidity and mortality
meetings, and the gynae pathology meetings, each held monthly. Junior trainees are
expected to attend specialty teaching and training every Friday afternoon, and to
undertake an audit project whilst in post. In addition, senior trainees are invited to
attend policy and clinical governance meetings, and are encouraged to help draft
guidelines, care pathways etc. Audit projects must also be undertaken as required.
Rota: Full shift.
Heatherwood and Wexham Park Hospitals
East Berkshire has a population of 380,000 and covers the Boroughs of Slough,
Windsor & Maidenhead and Bracknell, but together with an overlap zone in South
Buckinghamshire; the true catchment area of the Trust is nearer to 430,000. This is a
large and diverse population and includes affluent areas such as Ascot, Windsor and
Maidenhead, and also the larger urban area of Slough. The towns of Bracknell,
Maidenhead, Slough and Windsor house two-thirds of the total population, the
remainder living in rural areas or small towns. Much of the District lies within
designated Green Belt areas.
The Trust is an Acute Hospital Trust, which provides inpatient services on two sites:
Heatherwood in Ascot and Wexham Park, north of Slough - essentially, one hospital
on two sites. Wexham Park Hospital, Slough is the centre for acute services and all
obstetric and the major part of gynaecological services. Other satellite hospitals in
the Trust are Heatherwood Hospital in Ascot where some elective work is
undertaken, King Edward’s Hospital, Windsor and St Marks Hospital, Maidenhead,
both units with outpatient facilities only.
Service and capacity in the department of Obstetrics and Gynaecology are as
follows:
Deliveries per year
5300
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Obstetric beds:
69 plus 11 delivery rooms and 2 obstetric theatres
Gynaecology beds:
24
Gynaecological admissions:
200 per month
Services:
Obstetric service comprises of 9 antenatal clinics per week over the 4 sites, inpatient
antenatal and postnatal care, routine obstetric scanning and labour ward. Down’s
syndrome screening is by combined testing supported by a very sound prenatal
screening team.
Prenatal diagnosis is by high resolution scanning, and invasive tests like chorionic
villus sampling and amniocentesis. Therapeutic procedures like amnioreduction and
amnio-infusion are done when indicated. This service is provided by Miss Kalla and
Miss Sarkar, who is the local ultrasound co-ordinator and offers training for both
basic and intermediate ultrasound. We are also able to offer the ATSM in fetal
medicine.
The Day assessment Unit, called FAU is very busy and supports both outpatient and
antenatal patients. A dedicated Triage area assesses all acute obstetric
attendances. Specialist antenatal clinics include weekly diabetic clinic with Dr Moji
Akinsola, diabetic physician and fortnightly joint haematology clinics with Dr Nikki
Philpott, Consultant haematologist. A vulnerable women clinic is running under the
care of Mr Vathanan. Monthly meetings are held with the GUM team to discuss
antenatal women with positive screening results. Mr Pilsniak is Lead for HIV and
infectious diseases. Miss Loudon is the labour ward lead, and Mr Raafat the
obstetric clinical governance lead.
A broad spectrum of gynaecological surgery is carried out regularly at both Wexham
Park and Heatherwood sites. Besides general open surgery, minimally invasive
surgery is also undertaken. Fibroid/endometrial resection is performed regularly, as
are the current second generation endometrial ablative techniques.
The
gynaecology service is embarking on shared use of the da Vinci robot, with the
urology department; this is under the care of Mr Raafat.
Six colposcopy clinics run each week across both sites offering diagnosis, treatment
and follow-up of cervical lesions. There is opportunity to undertake accreditation for
BSCCP and also the ATSM for colposcopy. Monthly Colposcopy MDT meetings are
held. Mr Wagley leads this service and is a BSCCP registered trainer.
There are regular urodynamic clinics and urogynaecology surgery, with opportunities
to undertake ATSM in Urogynaecology. Mr Furtado is the lead for this service.
Rapid access clinics are held twice weekly. Combined oncology clinics are held on
alternate weeks. Mr Philip Reginald is the lead for the oncology service. Weekly
MDT meetings are held for suspected gynaecological cancers. Other core members
include Mr Wagley and Mr Raafat.
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Secondary care fertility services are offered. This falls under the remit of Mr Dimitry
and Miss Husain.
The unit has Obstetrics simulation training opportunities’ and laparoscopic trainer
access. Simulation training is under the care of the practice development midwifery
team and Mr Eniola.
The unit offers undergraduate training to medical students from Southampton
University and American University of the Caribbean.
ATSMs are available in:






ALWP
Advanced Antenatal Practice
Maternal medicine
Fetal medicine
Colposcopy
Benign gynae surgery

•
•
Oncology
Early Pregnancy
Urogynaecology
Miss Shaku Kalla, Miss Husain, Mr Wagley
Mr Pilsniak
Mr O E Eniola
Miss P Sarkar
Mr P W Reginald, Mr Wagley
Mr P W Reginald, Mr E S Dimitry, Mr
Gordon, Mr Raafat
Mr P W Reginald
Mr Vathanan
Mr Furtado
Staffing:
The unit is recognised for training for 8 StRs; 3 at ST1/2, 3 at ST3-5 and 2 at ST6/7.
There are currently 13 consultants, with 3 further Consultant posts to be advertised
in 2013/14.
The current team comprises:
Mr Alasdair Gordon, MRCOG FRCS(Ed) MFFP (Clinical Director)
Mr P W Reginald MD FRCOG
Mr E S Dimitry FRCOG MPhil
Miss S Kalla FRCOG
Miss P Sarkar MD FRCOG Specialty Tutor
Mr A Pilsniak MD, PhD
Mr O Eniola, MRCOG
Miss F Husain MRCOG MRCGP DIPM
Mr A Wagley MRCOG
Mr A Raafat MRCOG MSc
Mr V Vathanan
Mr G Furtado
Ms J. Loudon MRCOG, MD
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Besides the consultants and trainees, both career and VTS, there are 6 Staff Grade
(SAS) doctors. Some of the SAS doctors are trained as educational supervisors and
mentors, a number teach in Foundation programme.
The middle grade at night is in 2 tiers, the 1st-on-call being primarily for Labour Ward,
and the 2nd on call covering primarily gynaecology including emergencies, antenatal
and postnatal wards, and help in Labour Ward whenever required. The rota is in 9
weeks blocks, and the 1st on call and 2nd on calls interchange after each 9 week
block.
There are 6 VTS trainees at SHO level, 2FY2 and 4 career ST1 and2. There is one
trainee at SHO level at night.
Rota: Full shift.
Main Conditions of Service
Appointments to this programme are subject to the Terms and Conditions of Service
(TCS) for Hospital Medical and Dental Staff (England and Wales). In addition
appointments are subject to:
 Applicants having the right to work and be a doctor or dentist in training in the
UK
 Registration with the General Medical Council
 Pre-employment checks carried out by the Trust HR department in line with
the NHS employment check standards, including CRB checks and
occupational health clearance.
The employing Trust’s offer of employment is expected to be on the following
nationally agreed terms:
Hours – The working hours for junior doctors in training are now 48-hours (or 52hours if working on a derogated rota) averaged over 26 weeks (six months). Doctors
in training also have an individual right to opt-out if they choose to do so, but they
cannot opt-out of rest break or leave requirements. However, the contracts for
doctors in training make clear that overall hours must not exceed 56 hours in a
week (New Deal Contract requirements) across all their employments and any
locum work they do.
http://www.nhsemployers.org/your-workforce/need-to-know/european-working-timedirective
Pay – you should be paid monthly at the rates set out in the national terms and
conditions of service for hospital medical and dental staff and doctors in public health
medicine and the community health service (England and Wales), “the TCS”, as
amended from time to time. The payscales are reviewed annually. Current rates of
pay may be viewed at
http://www.nhsemployers.org/your-workforce/pay-and-reward/pay/pay-andconditions-circulars/medical-and-dental-pay-and-conditions-circulars Part time posts
will be paid pro-rata
Pay supplement –depending upon the working pattern and hours of duty you are
contracted to undertake by the employer you should be paid a monthly additional
pay supplement at the rates set out in paragraph 22 of the TCS. The current
payscales may be viewed at
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http://www.nhsemployers.org/your-workforce/pay-and-reward/pay/pay-andconditions-circulars/medical-and-dental-pay-and-conditions-circulars
The pay supplement is not reckonable for NHS pension purposes. The pay
supplement will be determined by the employer and should be made clear in their
offer of employment and subject to monitoring.
Pension – you will be entitled to join or continue as a member of the NHS Pension
Scheme, subject to its terms and rules, which may be amended from time to time. If
you leave the programme for out of programme experience you may have a gap in
your pension contributions. More information can be found at
http://www.nhsbsa.nhs.uk/pensions
Annual Leave – your entitlement to annual leave will be five or six weeks per annum
depending on your previous service/incremental point, as set out in paragraphs 205206 of the TCS. The TCS may be viewed at
http://www.nhsemployers.org/your-workforce/pay-and-reward/nhs-terms-andconditions/junior-doctors-dentists-gp-registrars/junior-doctors-terms-and-conditionsof-service-and-associated-documents
Sick pay – entitlements are outlined in paragraph 225 of the TCS.
Notice –you will be required to give your employer and entitled to receive from them
notice in accordance with paragraphs 195-196 of the TCS.
Study Leave –the employer is expected to offer study leave in accordance with
paragraphs 250-254 of the TCS. Local policy and procedure will be explained at
induction.
Travel Expenses – the employer is expected to offer travel expenses in accordance
with paragraphs 277-308 of the TCS for journeys incurred in performing your duties.
Local policy and procedure should be explained at induction.
Subsistence expenses – the employer is expected to offer subsistence expenses in
accordance with paragraph 311 of the TCS. Local policy and procedure should be
explained at induction.
Relocation expenses – the employer will have a local policy for relocation expenses
based on paragraphs 314 – 315 of the TCS and national guidance at
http://www.nhsemployers.org/PayAndContracts/MedicalandDentalContracts/JuniorD
octorsDentistsGPReg/Pages/DoctorsInTrainingJuniorDoctorsTermsAndConditions150908.aspx
You are advised to check eligibility and confirm any entitlement with the employer
before incurring any expenditure.
Pre-employment checks – all NHS employers are required to undertake preemployment checks. The employer will confirm their local arrangements, which are
expected to be in line with national guidance at
http://www.nhsemployers.org/your-workforce/recruit/employment-checks/nhsemployment-check-standards
Professional registration – it will be a requirement of employment that you have
professional registration with the GMC/GDC for the duration of your employment.
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Though the post is covered by NHS Indemnity, you are strongly advised to register
with the MPS for professional indemnity.
Health and Safety – all employers have a duty to protect their workers from harm.
You should be advised by the employer of local policies and procedures intended to
protect your health and safety and expected to comply with these.
Disciplinary and grievance procedures – the employer will have local policies and
procedures for dealing with any disciplinary concerns or grievances you may have.
They should advise you how to access these, not later than eight weeks after
commencement of employment.
Educational Supervisor – the employer or a nominated deputy (usually the Director
of Medical Education) will confirm your supervisor on commencement.
General information on the LETB’s management of Specialty Training
programmes, including issues such as taking time out of programme and dealing
with concerns or complaints, is available at www.oxforddeanery.nhs.uk and in the
national ‘Gold guide’ to Specialty Training at http://specialtytraining.hee.nhs.uk/.
Please ensure that you inform Health Education Thames Valley of any changes to
your contact details.
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