Obstetrics and gynaecology

Obstetrics and gynaecology (O&G) is a broad specialty with many areas of interest ranging from largely surgical, such as gynae oncology, to largely medical, such as maternal medicine, with plenty of variety in between. O&G also involves research; for example, research into infertility, stem cell research and genetics, with the many ethical and moral dilemmas associated with conception and the ante-natal period. All the different areas of O&G have in common a stimulating and fulfilling contact with patients.

Training pathway

From August 2007, those wishing to enter O&G will compete for entry to training during F2 and receive an NTN. Following F2 there are two years’ basic training (ST1 and ST2). It is expected that you would take Part 1 MRCOG exam before the start of intermediate training (ST3 to ST5). You will have taken Part 2 MRCOG before starting advanced training (ST6 and ST7). During advanced training you will spend time developing your special interests in the various parts of O&G. If you wanted to be very specialised, you could apply for subspecialty training schemes, which last two to three years, with some element of research. This could also result in a career in academic O&G.

Key skills and aptitudes

Since O&G has many parts, there is a niche for virtually everyone. The common requirement, however, is the necessity to relate well to patients who are often anxious and need careful explanations and reassurance. People who choose this specialty, therefore, tend to be sociable and keen to enjoy life both inside and outside of work.

Training posts and competition

There has been a recent increase in national training numbers in O&G to keep up with the European working time directive (EWTD) and so there are good opportunities now for progression in a career in O&G. Once you are given an NTN, there is usually flexibility in the training – with opportunities to gain further experience abroad and to take out-of- programme experience to learn special skills. Most of the on-call in hospital is done by training registrars with good consultant cover; most labour wards now have direct consultant presence during the day to help training. Consultant expansion has occurred to cover this on-call commitment.

Best and worst

Obstetrics has always been popular as it is generally a very happy specialty involving young couples in a creative process. Gynaecology, likewise, tends to be a happy specialty where most of the patients can be helped and are usually very grateful. The disadvantages of O&G are perceived to be the on-call commitment and fear of litigation. In fact, unlike some specialties, virtually all units have registrar cover at night so consultants are not required to be resident on call. Litigation is due to a small number of high profile, very expensive birth-related claims but these problems nearly always involve hospitals and teams rather than individuals. Obstetrics certainly can have its key dramatic moments, which require a cool head and the ability to make quick decisions.

Key information resources

• Royal College of Obstetricians and Gynaecologists

Further information can be obtained from the Royal College’s careers guidance officer. 

John Beynon FRCS FRCOG is the careers adviser at the Royal College of Obstetricians and Gynaecologists and consultant obstetrician and gynaecologist at St Richard's Hospital, Chichester.