Gynaecology Training for Higher Specialist Trainees in Obstetrics and Gynaecology, a Personal View.

Sir, As a specialist trainee in Obstetrics and Gynaecology in Ireland, I wish to add some supportive information to reinforce the suggestion that the minimum time spent training in gynaecology be one year. An important issue for all trainees in Obstetrics and Gynaecology in this country, and indeed globally, is the struggle to acquire a good standard of surgical competency in gynaecology. The total number of years spent on the higher specialist training programme equates to approximately 5 years. Rotations between hospitals/regions on the specialist register are typically changed over on a yearly basis, with a few exceptions. This means that theoretically if a trainee is employed in the one institution for a period of 12 months that the system would allow for the trainee to remain operating with the same trainer for that time period. As the scheme encompasses both obstetrics and gynaecology training, at least one year with a designated gynaecology theatre list should not infringe upon obstetrics experience. I am including an anecdotal synopsis of my own exposure to gynaecology in theatre and cases performed while working as a Specialist Registrar in the National Maternity Hospital. While working here I also had a full time clinical involvement in obstetrics, including antenatal clinics and covering labour ward sessions. Favouring the argument for at least one year of operating in one centre, with one trainer for higher specialist trainees, is my experience as a 3rd year higher specialist trainee in obstetrics and gynaecology. Over a consecutive 12 month period at the National Maternity Hospital, 2013-2014, only 50% of theatre sessions were attended by me due to annual leave (consultant and my own) EWTD, having time off pre and post call (which was avoided if at all possible)and also where there was no unscheduled leave of absence. Attending one operating list a week the cases included 7 abdominal major cases, 8 vaginal hysterectomies and 14 vaginal repairs. This is a very basic and probably inadequate number of major procedures for a specialist trainee. In our view (myself and my trainer) the minimum amount of time for attachment to a unit should be one year, not forgetting that the trainer needs to establish a rapport with the trainee. N Maher, M Foley Department of Obstetrics & Gynaecology, National Maternity Hospital, Holles St, Dublin 2 Email: [email protected] Gynaecology Training for Higher Specialist Trainees in Obstetrics and Gynaecology, a Personal View 1