How to become a physician in obstetrics and gynaecologyBMJ 2019; 367 doi: https://doi.org/10.1136/bmj.l6129 (Published 14 November 2019) Cite this as: BMJ 2019;367:l6129
Although there is an option to choose one or the other, most consultants in obstetrics and gynaecology work in both areas. Obstetrics revolves around the care given to mothers and their babies before, during, and after birth. Gynaecology is concerned with the management of diseases specific to women and includes reproductive and fertility medicine as well as sexual and reproductive health. The specialty is attractive as it allows doctors to combine medicine and surgery.
After completing a medical degree, trainees will need to complete the two year foundation programme before applying for obstetrics and gynaecology specialty training which normally takes seven years.
There are no specific additional undergraduate requirements for a career in obstetrics and gynaecology. However, if students can undertake a special study module or project in the specialty it will demonstrate interest and enthusiasm. It may also help to undertake an elective in obstetrics and gynaecology—perhaps in the developing world.
The British Undergraduate Society of Obstetrics and Gynaecology1 has representatives in all UK medical schools and can provide information to students about what a career in the specialty has to offer. Students can also register free with the Royal College of Obstetrics and Gynaecology (RCOG)2 which provides a range of information and support.
Foundation training takes two years. Trainees should aim to undertake a rotation in obstetrics and gynaecology if possible and ensure their e-portfolio is kept properly up to date.
Getting first hand experience can help trainees decide if they want to pursue a career in the specialty, as well as demonstrating their commitment. However, undertaking an obstetrics and gynaecology placement is not required as part of foundation training and trainees won’t be disadvantaged if they haven’t done such a placement.
Towards the end of the foundation period, doctors who want to become obstetricians and gynaecologists must apply for selection on to the national training programme through the Oriel website.3 The application process is managed by Health Education England - North West. In 2018 there were 270 applicants for 95 posts in the UK. More information can be found on the Health Education England website.4
Trainees can sit the Part 1 Member of the Royal College of Obstetricians and Gynaecology (MRCOG) examination during the foundation training period although this isn’t required before applying for specialty training. In fact, the exam has recently become more clinically focused, so it may be better to wait in order to gain more direct clinical experience in managing problems on the ward.
Specialty training in obstetrics and gynaecology normally takes seven years and is divided into basic, intermediate, and advanced training. All specialty trainees need to complete 19 core modules and two basic ultrasound modules.5
The core modules include antenatal care, management of labour, management of delivery, postpartum problems, and gynaecological problems. Each module contains various competencies which need to be signed off by a clinical trainer in the eLogbook.
At the end of each year a trainee’s progression is reviewed at an Annual Review of Competence Progression. More information about how progress through training is monitored and assessed can be found on the RCOG website.6
In the last two years of the programme, trainees take advanced training skills modules or undertake subspecialty training depending on their interests and abilities. There are 20 advanced training skills modules to choose from, including high risk pregnancy, subfertility and reproductive health, urogynaecology and vaginal surgery, oncology, and fetal medicine.7 Subspecialty training is a minimum three year programme with two years of clinical training and 12 months of dedicated research. There are four subspecialties available: gynaecological oncology, maternal and fetal medicine, reproductive medicine, and urogynaecology.8
Trainees need to pass three examinations in order to progress through training. Part 1 of the MRCOG is usually taken by the end of the second year of specialist training (ST2) and Parts 2 and 3 examinations at the end of ST5 before progressing to year 6.
Part 1 is a written examination to evaluate basic and clinical sciences relevant to the subject. Part 2 is a written examination that assesses the application of knowledge, and Part 3 is a stand alone clinical skills examination. More information can be found on the RCOG website.9
Once doctors have completed the full General Medical Council approved training programme they can apply for their Certificate of Completion of Training—a legal requirement before taking up a consultant post in the NHS.
Trainees will also need to hold an Advanced Life Support Certificate from the Resuscitation Council which involves attending a two day course covering resuscitation guidelines and skills.10