About your doctor

• There are 33 undergraduate medical schools in the UK producing approximately 7000 graduates per year. Most medical students spend 5 or 6 years at university. 
• All students are taught in the university classroom and through contact with patients in hospitals and in general practice surgeries. Medical students have no responsibility for the care of patients and every student meeting patients will always be closely supervised. If a patient doesn’t want to have contact with a medical student or doesn’t want one present when they speak to the qualified doctor, that choice will always be respected. 
• The university is responsible for the content and delivery of medical school education. However, the General Medical Council (GMC) – the body overseeing the professional status and standards of doctors in the UK – provides guidance, sets standards which all medical schools must follow and ensures that these are being met by the universities.

• After graduating, doctors spend two years working in various areas of medicine and surgery, both in hospital and community practice. This is known as foundation training. During this time they build on their clinical and professional skills but are closely supervised and assessed.
• Foundation year 1 doctors work only under very close supervision. They are often based on wards, outpatient clinics or operating theatres. Occasionally, they might take care of a pregnant woman or a woman in labour.
• Foundation year 2 doctors have more responsibility for patients and may see pregnant women with problems, but they would always refer to a more senior colleague about their assessments and before making recommendations about treatment.

• After graduating, doctors spend two years working in various areas of medicine and surgery, both in hospital and community practice. This is known as foundation training. During this time they build on their clinical and professional skills but are closely supervised and assessed.
• Foundation year 1 doctors work only under very close supervision. They are often based on wards, outpatient clinics or operating theatres. Occasionally, they might take care of a pregnant woman or a woman in labour.
• Foundation year 2 doctors have more responsibility for patients and may see pregnant women with problems, but they would always refer to a more senior colleague about their assessments and before making recommendations about treatment.

Specialty trainees in O&G

• After the two-year foundation programme, doctors enter a training programme in the area of medicine in which they wish to specialise.
• Doctors wanting to specialise in O&G must compete nationally for a training place and undergo a rigorous selection process. There are about three applicants for each training place.
• Specialty training in O&G takes at least 7 years to complete, but some doctors can take up to 10 years before completing training and becoming a consultant. This can be for various personal and professional reasons, such as maternity leave or working less than full-time for family reasons or to undertake a period of research.
• Specialty training in O&G is divided into three distinct stages, set out below. As they progress through their training, doctors gain more experience, knowledge and competence. During their training they’re a key part of the clinical team, seeing patients in clinics and performing procedures under the supervision of senior doctors.

Specialty trainees years 1 and 2 (ST1 and ST2)

• During the first two years of specialty training, doctors build up their knowledge, clinical skills and professional approach. They become increasingly skilled at taking a medical history and focus on both O&G. They enhance their ability to examine pregnant women, labouring women and women with gynaecological problems and they learn how to do procedures under supervision.
• By the end of ST2, doctors will be able to carry out an uncomplicated caesarean section and be able to use special instruments (forceps or ventouse) to help a woman give birth. Although they are fully qualified in the general care of patients, they will always refer to a more senior doctor for advice and assistance in the more complicated areas of O&G.
• Trainees must past the MRCOG Part Part 1 to progress from ST2 to ST3.

Specialty trainees years 3 to 5 (ST3, ST4 and ST5)

• By specialty training years 3–5, doctors in speciality training in O&G are skilled to provide immediate care but will always have support from more senior doctors. By the end of ST5 they can deal with all common problems and quite a few less common ones. They will be able to do more difficult caesarean sections and will be able to work independently to carry out a range of gynaecological procedures, but they will still receive support and supervision from their senior doctors. They will also be involved in teaching junior colleagues.
• By the end of ST5 they are required to complete the Part 2 MRCOG exam, after which they gain membership of RCOG.
• These doctors work on delivery suites providing hands-on care to women in labour, see women with urgent and emergency gynaecology problems and work in antenatal and gynaecology clinics alongside consultants, and also in O&G operating theatres.

Specialty trainees years 6 and 7 (ST6 and ST7)

• During these last two years, doctors choose areas that they are interested in and spend time doing extra training in those areas. These are called Advanced Training Skills Modules (ATSMs) and each module takes on average 6 months. Examples of the modules include extra experience in gynaecological surgery or dealing with more complicated medical problems in pregnancy. These are the specialist skills that they will offer when they are consultants.
• Some hospitals call these doctors senior registrars, but that term is heard less often. Although they oversee the more junior trainees, these doctors still ask advice from their consultants.
• When their training is finished, each doctor has a final assessment to make sure that all aspects have been completed successfully. The RCOG then recommends to the GMC that the successful doctor is awarded a Certificate of Completion of Training (CCT). They are then qualified to work as a specialist/consultant.

Subspecialty training

• A small number of doctors undertake subspecialist training in their final two years. They are trained to work exclusively in one of four areas: gynaecological cancer, urogynaecology, reproductive medicine (including IVF treatment) and maternal and fetal medicine. These doctors are usually involved in medical research and will work in the hospitals which provide these specialised services.

Doctors undertaking research posts

• Some doctors will take time out of their clinical training to undertake research projects. You may be approached to enter into research studies and these would be carefully explained to you. It is vitally important that women are given the chance to participate in these studies which will lead to better care in the future. Doctors undertaking research will often follow a more ‘academic’ career. This means that they will still look after patients as a consultant, but will spend a significant part of their time teaching, lecturing and leading research projects.

• Not every doctor becomes a specialist/consultant. Even though they have undertaken the training and are experienced clinicians, some do not achieve the formal accreditation. This may be because they were unable to complete the formal UK training programme, particularly if some of their training took place overseas, or because they simply chose not to become consultants. They often have a particular area of expertise and experience, like colposcopy, infertility or urogynaecology. They work independently alongside consultants but the consultant is responsible for the overall care of an individual patient.

• As well as O&G trainees, there may be doctors training in other areas of medicine who spend some time working in O&G. Most commonly these are doctors who are training to be General Practitioners (GPs), who often do placements in O&G, usually 4 to 6 months, as part of their GP training. They work alongside the ST1 and ST2 doctors and are skilled to provide general care to women, but will always refer to senior doctors regarding more complex obstetric or gynaecological problems.
• Hospitals may also employ doctors to work at various levels equivalent to doctors in specialty training posts. They are often called Clinical Fellows, although some hospitals may use different titles, for example specialty doctors

• When all their training has been completed, doctors apply competitively to become a consultant (a permanent position in a hospital). Consultants are sometimes called specialists. One named consultant has overall responsibility for the care of each patient. Consultants often lead a team of trainee doctors and are responsible for their training, as well as managing the patients that the trainee doctors see. They also have managerial, educational and organisational roles and usually have a special area of interest.
• Consultants work in teams so, if your named consultant isn’t on duty, another consultant will be always be available.