School of Obstetrics and Gynaecology

Trainee Induction Booklet

August 2018

Contents Page(s) Key contacts 3

RCOG College Tutors 4-5

Welcome to Health Education England North East 5-8 • How the region works • Hospitals and services • Travel expenses and nominating a base hospital

Introduction to O&G Training Programme 9-12 • Rotation • Trainee Professional Development • Curriculum • ePortfolio

Mandatory Training 13-14

ATSMs (Advanced Training Skills Modules) – ST6/ST7 14-15

ARCP (Annual Review of Competence Progression) 15

Trainee Revalidation 16

OOP (Out of programme) 16

Inter Deanery Transfers (IDTs) 17

Further information for trainees 17

Glossary 18

Key Contacts

Head of School Mr Ian Aird

Training Programme Directors

Mr Paul Moran (Quality Assurance)

Dr Seema Sen (Basic ST1-ST2 course director + curriculum delivery, ARCP)

Dr Sarah Gatiss (Intermediate ST3-ST5 course director + curriculum delivery, ARCP)

Mr Sanjay Rao (Advanced ST6-ST7 course director + curriculum delivery, ATSMs)

Dr Trez Hannon (Recruitment & Selection, trainee placement, rotation)

Academic Advisor Professor Steve Robson

Community Sexual & Reproductive Health Lead Dr Diana Mansour

Specialty Business Manager Ms Julie Khan

School Manager Mr Chris Quinn

Specialty Programme Coordinator (SPC) Miss Helen Taylor

Human Resources Officer (LET) Miss Lucy Turnbull

Payroll Officer (LET) Mrs Paula Peacock

Useful websites:

Health Education England North East (HEE NE): HEE NE

(For School of Obstetrics &Gynaecology go to O&G)

(For Human Resources webpages choose LET)

Royal College of Obstetrics & Gynaecology: RCOG

RCOG College Tutors

The role of the College Tutor is to coordinate obstetrics and gynaecology training and education in an individual trust. The responsibility for delivering that training and education lies with the Trust, on behalf of and resourced by the Postgraduate Dean. The Tutor should oversee the provision of the Specialty Training and Education Programme and should also be involved in assisting the deanery/school in managing the appropriate components of the foundation programme.

Northumbria Healthcare NHS Foundation Trust Dr Nalini Munjuluri (Wansbeck, North Tyneside, Hexham)

Royal Victoria Infirmary – Newcastle upon Tyne Dr Marie Smith Hospitals NHS Trust

Queen Elizabeth Hospital - Gateshead Health NHS Mr Isaac Evbuomwam Foundation Trust

Sunderland Royal Hospital - City Hospitals Sunderland Mr Alex Mortimer NHS Foundation Trust

University Hospital North Durham– County Durham and Dr Velur Sindhu Darlington NHS Foundation Trust

Darlington Memorial Hospital– County Durham and Mr Emmanouil Damigos Darlington NHS Foundation Trust

University Hospital North Tees – North Tees and Mr Atul Nalawade Hartlepool NHS Foundation Trust

South Tees NHS Foundation Trust (James Cook Mr Sanjay Rao University Hospital and Friarage Hospital)

North Cumbria University Hospitals NHS Trust Dr Ayesha Anwar (Cumberland Infirmary and West Cumberland Hospital)

Welcome to Health Education England North East (HEE NE)

Welcome to the North East of England Obstetrics & Gynaecology Specialty Training Programme. The region is a mixture of rural, urban and industrial areas with an ethnically and demographically diverse population. Overall just over 2.5 million people live in the region.

You have chosen to train in an excellent region that will provide you with a wide range of high-quality learning opportunities.

The following is a guide to inform you of some of the practicalities of Obstetrics & Gynaecology training here at HEE NE.

How the region works

Health Education England North East (HEE NE)

HEE NE is not your employer but is the organisation that provides the structure and co-ordination for your training whilst in the region. There is lots of useful information about training days and important contacts available through the website; HEE NE. This is a website that you should consult frequently as relevant and important information that affects your training will be posted here.

Lead Employer Trust (LET)

As a HEE NE trainee you will be employed by the County Durham and Darlington NHS Foundation Trust. This is the Lead Employer Trust (LET) which means that no matter where you are working within the region, this trust will remain your employer, even though you might never actually work in one of their hospitals! The LET provides the Human Resources and Payroll function for all specialty trainees and you should contact them if have concerns or questions regarding these aspects. Their details can be found through the Health Education England North East - LET website.

Induction

This handbook forms part of the induction package developed by the School of Obstetrics & Gynaecology. This document does not replace your Trust Induction which is mandatory.

Hospitals and services

The region provides an exciting and diverse range of training opportunities based in numerous centres throughout the North-east and Cumbria. The hospitals that you may work in during your time in the region are listed below.

Cumberland Infirmary – North Cumbria University Hospitals NHS Trust Newtown Road Carlisle CA2 7HY Telephone: 01228 523444

Darlington Memorial Hospital – County Durham and Darlington NHS Foundation Trust Hollyhurst Road Darlington DL3 6HX Telephone: 01325 380100

University Hospital North Durham – County Durham and Darlington NHS Foundation Trust North Road Durham DH1 5TW Telephone: 0191 3332333

James Cook University Hospital – South Tees Hospitals NHS Foundation Trust Marton Road Middlesbrough TS4 3BW Telephone: 01642 850850

Friarage Hospital, Northallerton – South Tees Hospitals NHS Foundation Trust Northallerton North Yorkshire DL6 1JG Telephone: 01609 779911

The Royal Victoria Infirmary – Newcastle upon Tyne Hospitals NHS Foundation Trust Queen Victoria Road Newcastle upon Tyne NE1 4LP Telephone: 0191 2336161

Queen Elizabeth Hospital – Gateshead Health NHS Foundation Trust Queen Elizabeth Avenue Gateshead NE9 6SX Telephone: 0191 4820000

Sunderland Royal Hospital – City Hospitals Sunderland NHS Foundation Trust Kayll Road Sunderland SR4 7TP Telephone: 0191 5656256

University Hospital North Tees – North Tees and Hartlepool NHS Foundation Trust Hardwick Road Stockton on Tees Cleveland TS19 8PE Telephone: 01642 617 617

Northumbria Specialist Emergency Care Hospital – Northumbria Healthcare NHS Foundation Trust Northumbria Specialist Emergency Care Hospital Northumbria Way Cramlington Northumberland NE23 6NZ 0344 811 8111 North Tyneside General Hospital – Northumbria Healthcare NHS Foundation Trust Rake Lane North Shields Tyne and Wear NE29 8NH Telephone: 0344 811 8111

Travel expenses and nominating a base hospital

HEE NE covers a large geographical area. You will have to travel to a relatively distant hospital at some point during your training. Not only would you lose out on some fantastic learning opportunities if you only applied for hospitals near to where you live, you are also unlikely to always get what you want.

When you start your training you will be asked to nominate your “base hospital”. This is simply the hospital nearest your home address which remains the same throughout your training unless you let us know. If you are placed in another part of the region you may claim travel expenses for the distance from your base hospital to your place of work. You cannot claim travel expenses from your home to your base hospital.

For example, if you decide to live in Newcastle and buy a house in Jesmond then you would nominate the RVI as your base hospital. If your next post was in Middlesbrough, you could then claim return travel expenses from the RVI to James Cook Hospital minus the distance from your home address to the RVI. The distance from your home to your base hospital is classified as your normal commute to work and is not eligible for expenses claims. It is the extra distance that you are travelling away from your base hospital that is reimbursable.

However, when considering long-distance commuting on a daily basis you should perhaps remember that the region’s roads are busy and an hour’s commute back from Middlesbrough after a night shift is neither pleasant nor probably that sensible. You may therefore choose to stay in hospital accommodation. In this case you could claim for accommodation costs in-lieu of travel expenses. Both claim forms are available from the HR Officer (LET).

Introduction to Obstetrics & Gynaecology Training Programme

The School of Obstetrics and Gynaecology provides comprehensive training covering the full RCOG core curriculum, advanced training skill modules (ATSMs) as well as opportunities for sub-specialty training and academic training through competitive selection processes.

To complement the hospital based clinical training, the School provides a formal taught programme for each level of specialty training mapped to the relevant curriculum requirements as well as providing support for MRCOG exam preparation.

Training is provided by 11 individual units which are managed by the School and HEE NE.

As a School we ask that all our trainers and trainees read and adhere to our School Charter of Appropriate Behaviour in Training to ensure a better working environment for everyone.

This is a 7 year run-through programme which is split into 3 levels:

Basic: ST1-ST2 Intermediate: ST3-ST5 Advanced: ST6-ST7

Rotation

As an Obstetrics and Gynaecology trainee you could rotate through any of the following hospitals during your training:

• Northumbria Healthcare Trust which includes NSEC, North Tyneside and Hexham hospitals • Royal Victoria Infirmary, Newcastle • Queen Elizabeth Hospital Gateshead • Sunderland Royal Hospital • North Tees and Hartlepool NHS Foundation Trust which includes University Hospital North Tees and Hartlepool General Hospital • South Tees Hospital NHS Trust which includes James Cook University Hospital and Friarage Hospital Northallerton • County Durham and Darlington Acute Hospitals NHS Foundation Trust which includes University Hospital North Durham, Darlington Memorial Hospital and Bishop Auckland General Hospital • North Cumbria University Hospitals NHS Trust which includes Cumberland Infirmary Carlisle and West Cumberland Hospital Whitehaven

Allocations are made primarily based on the training need of trainees and other factors are taken into account. The rotation is structured so that all trainees will spend time in one of the bigger units. Dr Trez Hannon is the Training Programme Director for Rotations and Placement and is a member of the School Board.

Trainee Professional Development

The School of Obstetrics and Gynaecology offer trainees the opportunity to present papers, audits etc. at various events throughout the training year.

These are all excellent opportunities to enhance your CV!!

Curriculum

The RCOG curriculum is approved by the GMC (General Medical Council) and all modules are presented in the same format. Modules outline the:

• Knowledge criteria • Clinical competences • Professional skills and attitudes • Training support options • Evidence and assessment requirements.

The curriculum consists of the:

• Core specialty training modules • Basic and intermediate ultrasound modules • Advanced training skills modules (ATSMs) • Subspecialty training modules • Academic curricula • Foundation programme women's health module

The curriculum is available on the RCOG website. You are advised to regularly check for changes and updates to the curriculum and logbooks.

Eportfolio

The RCOG provides all new trainees with an ePortfolio which enables more practical, portable recording of competency development. The electronic format also improves the process for quickly locating and accessing information within the curriculum or logbooks. In addition, the ePortfolio provides opportunities for trainees to reflect on their learning experiences and identify future learning needs. Reflective entries can be typed with associated logs of clinical experiences and the electronic format is proven to encourage organisation of reflective entries more so than in a paper format. Reflective Practice forms an important part of Trainee Revalidation.

The curriculum is also listed on ePortfolio. Your SPC at HEE NE is your local administrator and there is a dedicated team at RCOG to assist. There are demonstration videos on how to use the system available on the RCOG website. The RCOG will enter your first training post on e-portfolio for ST1. Thereafter, it will your responsibility to enter your new training post at each level. If you have any problems with this, please contact your SPC or Alex Baker at the RCOG. It is important that you keep your ePortfolio up to date on a weekly basis. Workplace based assessments, reflective practice logs and other evidence must be collected throughout the year from the day you begin your training. It is an RCOG requirement for ARCP (Annual Assessment Competence Progression) that evidence collection should not be left to the last couple of months prior to ARCP. Your ePortfolio must demonstrate progress made throughout the whole duration of a training year.

Mandatory Training

As a School we run a mandatory training programme which covers key areas of the curriculum for basic, intermediate and advanced training. All trainees are required to attend the level relevant to their grade. Trainees will receive an email at the start of the training year with the dates and topics of the training days.

• ST1-2 trainees should attend the basic training sessions, ST3-5 trainees should attend the intermediate training sessions and ST6-7 trainees should attend the advanced training sessions. • In August 2018 ST1’s will attend a boot camp which will incorporate most of their training for the year. • Each trainee should ensure they sign the register at each teaching session. Failure to sign will be recorded as a non-attendance. • Ideally all trainees should attend all 6 sessions in a 12 month period. In order to achieve ARCP 1 Satisfactory progress, the trainee must ensure they attend a minimum of 4 out of the 6 sessions and non-attendance forms must be complete for any missed sessions and emailed to the SPC. Legitimate reasons for non-attendance are because of night shift or on call commitments (including if you are about to start or are finishing a set of night duties on that day), annual or study leave (Inc. attendance at examinations) and sickness (providing it is reported to your College Tutor and HR officer-LET). • Any trainee who is experiencing recurrent difficulties in attending should discuss their difficulties with their local College Tutor. • If the trainee is having difficulty attending because the local unit cannot release them from “routine day time clinical duties” or they are recurrently on night shift at the time of the training day and the local college tutor has not been able to provide a solution to these problems the trainee is encouraged to contact either Mr Ian Aird (Head of School), Mr Sanjay Rao (Advanced Course Director), Dr Sarah Gatiss (Intermediate Course Director), Dr Seema Sen (Basic Course Director) or Dr Leo Gurney (RCOG trainee representative). • Your feedback of teaching is important to the School of O&G and forms an important role in the quality improvement process. Your SPC will communicate how feedback will be collected.

Funding arrangements for the programme

It has been agreed by the Obstetrics & Gynaecology School Board to implement a top slicing arrangement of the study leave budget to cover the costs for the O&G mandatory training. The benefits of this initiative are:

- Ensuring the delivery of mandatory training due to security of funding arrangements - Ensuring study leave funding is appropriately targeted - Reducing administrative bureaucracy for Trusts, trainees and HEE NE

The amount agreed to be top sliced for 2018-2019 training is £180 per trainee.

Trainees must still apply for time off for study leave following the usual process. Your remaining study leave budget can be applied for at your trusts education centre.

The study leave policy and guidance document can be found at the below link: Study Leave Policy

ATSM (Advanced Training Skills Modules) For ST6/ST7 trainees only

Obstetrics and gynaecology is now so diverse that to attempt to train all trainees to the same standard in all parts of the specialty is unachievable and would lead to a cohort of new consultants with no developed expertise to any significant level in any area. A series of ATSMs have been designed based on the skills required by the consultant of the future. Collecting a wide range of unrelated skills is no longer possible and realistic within the time frame of training and some of the skills may not be put to use. It is important to choose ATSMs based on the kind of consultant post that the trainee would like to do, bearing in mind the likely job descriptions of the posts to be appointed to in the next few years. Trainees are required to complete two ATSMs during the 2-year period in order to gain CCT (Certificate of completion of Training). The modules have been designed to equip trainees with the skills they will need for independent practice at consultant level. The signing up of the competences must NOT be a tick-box exercise. Many of the competences will be attained during service commitments and it will be rare for time to be ring fenced for their completion. The trainee will simply need to spend more time in the relevant clinical area e.g. the labour ward, operating theatre, colposcopy clinic etc. and will obtain training while providing a service. These need to be completed in years ST6-ST7. You will need to choose your ATSMs in ST5 so that your ST6 rotation can be planned to meet your needs. You will need to liaise with the Training Programme Director for Advanced Level/ATSMs.

• You will be contacted via email by the relevant TPD. This will explain the application process and provide you with all the information you will need. • All trainees will be fairly and equitably interviewed by the Regional Preceptor and assessed to determine eligibility. All applicants will be ranked.

ARCP

As a specialty trainee you will be required to participate in the annual assessment (ARCP) process as outlined in the Gold Guide.

As a School, our annual assessments take place in May and June with interim reviews in December and March if required.

Your SPC will contact you in January to provide you with the confirmed dates for submission of evidence, when it will be reviewed and for the face to face meetings. However, all of this information is available on the specialty webpages on the HEE NE website. All trainees in O&G will have a face to face meeting with the panel.

Evidence should be collected from the first day you join us on the rotation as it needs to show your progression throughout the year, not just a last minute rush to get enough work based assessments completed! This is mandated by RCOG and failure to comply will be seen as non-engagement in the process.

The evidence required depends on your level of training and is clearly detailed in the RCOG Training Matrix. Progression will be assessed on these criteria. The School of O&G has produced a checklist which explains the evidence required in addition to that outlined in the training matrix with further details of grade specific evidence. This will be updated as and when necessary and can be found on the specialty pages of the HEE NE.

Please see the Specialty Training ARCP Policy and Process Notes for further information. This can be found on the specialty training pages of the HEE NE website under Information for Trainees.

Trainee Revalidation

Revalidation is the General Medical Council’s new way of regulating licensed doctors to give extra confidence to patients that their doctors are up to date and fit to practise. Licensed doctors, including doctors in foundation year two, will have to revalidate, usually every five years. In addition, for doctors in postgraduate training, you will also revalidate when you receive your Certificate of Completion of Training (CCT). As you are on the O&G training programme, you will be revalidated by HEE NE.

Further information can be found on the Professional Standards Unit pages on the HEE NE and on the RCOG website.

Any revalidation queries should be directed to Claire Tiernan [email protected] or 0191 2754709

Out of Programme (OOP)

There are lots of additional opportunities where you can learn and develop your skills that lie out-with the normal training programme and OOP is a way of doing this. There are a variety of forms of OOP and if you are considering one you are encouraged to discuss this with your Programme Director early on.

OOP is not an entitlement but is a flexible possibility. HEE NE and the School of O&G needs to ensure it has enough doctors to provide service commitments and this is why you should discuss your ideas early on so your intentions can be taken into account for workforce planning. It is of course possible to continue to maintain an on-call commitment whilst doing a research post during the day. Not only would this help prevent a frightening pay cut but would also mean HEE NE could possibly be more flexible in letting you undertake the OOP you wish.

Please see the Specialty Training Out of Programme Policy and Process Notes for further information. This can be found on the specialty training pages of the Health Education North East website under Information for Trainees.

Inter Deanery Transfers – IDTs

This is the process by which a trainee can apply to be moved to another training scheme. This is now a nationally run process. The National Inter Deanery Transfer (NIDT) process will be launched to support medical trainees who have had an unforeseen, significant change in personal circumstances since their appointment to their current training programme, enabling consideration to be given to a possible transfer to another deanery. The NIDT process is hosted by London Deanery Provider Support (LDPS) on behalf of Health Education England (HEE) and UK deaneries via arrangements agreed through the Conference of Postgraduate Medical Deans of the United Kingdom (COPMeD). Your point of contact for IDT’s at HEE NE is Angela Johnson [email protected] or 0191 2754621.

Further Information for Trainees The Specialty Training Team has a number of policies and guidelines to assist and support trainees throughout their time in training. These are available on the Specialty Training pages of the HEE NE and they include: • Acting up Application Form • Action Plan Draft Example • Action Plan Template • ARCP Policy • Departure from clinical work form • Doctors and Dentists with differing training needs • Dual Accreditation Dual Accreditation Application Form • LTFT (Less than Full Time) Policy • MTI Guidance MTI Guide 2018 • Out of Programme Policy • Out of Programme Policy Form • Recruitment of Clinical Faculty (Speciality Training excluding GP) • Return to clinical work form • School board and STC Policy • Specialty Guidance Fellowship Post • Specialty Recruitment Planning • Specialty recruitment planning - distribution and amendment of training posts • Trainee Location Procedure • Withdrawal of Specialty Training Number

Glossary

HEE NE Health Education England North East ARCP Annual Review of Competency Progression RITA Record of in training assessment ATSM Advanced Training Skills Module LET Lead Employer Trust RCOG Royal College Obstetrics and Gynaecology RVI Royal Victoria Infirmary GMC General Medical Council SPC Specialty Programme Coordinator ST Specialty Trainee SpR Specialist Registrar LAT Locum Appointment Training FTSTA Fixed Term Specialty Training Appointment CCT Certificate of Completion of Training CESR Certificate of Eligibilty for Specialist Registraion. The equivalent of a CCT OOP Out of Programme CRA Clinical Research Associate