Description

Training level with limited or no previous O & G experience; will involve intensive period of training and skill acquisition under registrar or consultant supervision.

Experience and Diagnosis

Insufficient O & G or other relevant experience to meet the requirement of higher level;
Limited diagnostic skills.

Management

Able to initiate basic management.

Resuscitation.

As outlined in Annexure A.

Procedural Skills

May possess limited skills entry but is rapidly acquiring those necessary for progression to high levels of training.

Description

Competently functions in O & G, though may still be required to consult for the diagnosis an management of some presentations

Experience

Greater than six months full-time (or part time equivalent) of O & G experience at Senior RMO or Registrar level.

Diagnostic

Able to interpret results of history, physical examination, pathology, radiology and monitoring such as CTG in order to arrive at a diagnosis or differential diagnosis for a comprehensive range of O & G presentations though assistance or referral may be required for the diagnosis of some presentations.

Management

Able to take responsibility for ongoing management of a wide range of O & G problems Supervision may be required,

Resuscitation

as defined in Annexure A.

Procedure skills

Competence in the following skills, not just technically proficient but where applicable knowledge of indications, contraindications plus complications and their management.

a) Venous access / large bore peripheral cannula.

Airway management - bag mask - oral nasal airway - uncomplicated endotracheal intubation Nasogastric insertion Urethral catheterisation

b) uncomplicated delivery

Episiotomy /+ 2nd degree tear Lift our forceps - ARM - Induction / Augmentation labour Vacuum extraction Scalp electrode placement PV exam / speculum / PAP Smear EUA IUCD insertion

General

Able to diagnose and initiate management of most uncomplicated presentations in O & G.

Gynaecology

Review and assessment of gynaecological presentations to Emergency Department ie., PID / spontaneous abortion/ectopics. Participate in and manage routine presentations at the Gynae Clinic. Care of post operative gynae patients. Assist in operating theatres with gynae list. Attend family planning and STD clinic

Obstetrics

Participation in antenatal ward and antenatal clinic regularly and understand principles of shared care.

Have wide understanding and management of:

Fetal monitoring
Pain management in labour
Induction and Augmentation of labour
Maternal monitoring - partogram - cervical assessment
Cephalic presentation
Routine 3rd stage labour H.O.P.
A.P.H. Premature labour
Premature rupture of membranes
Rupture of membranes
l.U.G.R. and monitoring (CTG)
Breech presentations
Recognition and initial management of intrapartum and postpartum haemorrhage Recognition and initial management of fetal distress
Assist in operating theatre
Management of shoulder dystocia

Description

Able to function unsupervised in O & G.
Obstetrician on call rarely required except in specific circumstances in critical situations.
Able to supervise junior medical staff.

Experience

Twelve months full time (or part time equivalent) with O & G patients at Senior RMO level or Registrar level

OR

Six months full-time (or part-time equivalent) experience with O & G patients plus other relevant experience at Senior RMO or Registrar level, the combination total of which is greater than twelve months full time or part time equivalent.

Diagnostic

Able to interpret results of history, physical examination, pathology, radiology, and monitoring such as CTG in order to arrive at a diagnosis or differential diagnosis for a comprehensive range of O & G presentations.

Management

Able to be fully responsible for the ongoing management of a comprehensive range of O & G problems.

Supervision required in critical situations.

Resuscitation

as defined in Annexure A.

Procedure Skills

As for LEVEL 2 plus

3rd degree tear
All forceps and vacuum and inductions
Manual removal of placenta
LUSCS with supervision
Abnormal presentations with supervision.

General

As for LEVEL 2 plus

Able to diagnose and initiate management of comprehensive range of O & G presentations Able to supervise

Specifically:

Management of epidurals and complications
Management of pre eclamptic and monitoring
Management eclamptic and monitoring
Management of D.l.C.
Management of A.P.H.
Management of gestational diabetes
Management of inverted uterus
Management of prolapsed cord
Management of prolonged labour
Management of A.P.H..
Have good knowledge of Rhesus Disease
Understand radiology in obstetrics
Neonatal resuscitation

LEVEL I

basic CPR bag/mask ventilation peripheral venous access ECG interpretation/recognition of arrhythmias emergency cardioversion (unconscious patient) use of first line anti-arrhythmic

LEVEL 2

all items specified at level I establish the uncomplicated airway and manually ventilate large bore peripheral venous cannula simple use of fluid and blood products

LEVEL 3

all items specified at levels 1 & 2

maintenance of the established uncomplicated airway
ability to recognise the complicated airway
and to possess an appropriate complicated airway drill
neonatal resuscitation
resuscitation of unconscious patient
resuscitation of hypertensive / eclamptic
resuscitation of hypotensive patient
complicated use of fluid and blood products

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