Intended for healthcare professionals

Rapid response to:


Maternal mortality in the UK and the need for obstetric physicians

BMJ 2011; 343 doi: (Published 09 August 2011) Cite this as: BMJ 2011;343:d4993

Rapid Response:

Lets improve the training already in place


Concerns have been expressed regarding the quality of obstetric
training to GP trainees for several years. Many of us have seen this
coming for some time, with the increasing monopoly that our midwifery
colleagues have achieved in pre and postnatal care. There has been a
frustrating lack of action by "those at the top", including co-ordinators
of GP training within obstetric units.

Ask any GP who has recently completed obstetric training: I
understand that the majority will report persistent difficulties in
accessing quality learning opportunities. On many units, GP trainees are
utilised mainly to prepare IV antibiotics, write out discharge scripts
which are monotonously similar, check paper results and in the process
face unhelpful levels of institutional division between obstetric/medical
and midwifery teams. Enthusiasm and attempts to challenge this culture as
a GP trainee are simply ineffectual - many of us have tried and failed.

Having been told by a senior midwife "you don't need to do obstetrics
any more as we do it all now", I think there needs to be a closer look at
the culture of obstetric training already provided to GP trainees.

Many of us had a lot of useful experience throughout our GP training,
however frustratingly this was far less so in obstetrics. We all share
the same motivation to provide quality medical care to our pregnant
patients - and we try to fill the gaps through book work and courses.

Before calling for increased training, we should look at the training
already in place. There would appear to be plenty of room for

Competing interests: No competing interests

10 August 2011
David R Hogg
West of Scotland