O & G
Welcome and introduction
We would like to welcome you to the department of Obstetrics and Gynaecology at the Countess of Chester Hospital. We hope that you find your time with us both enjoyable and rewarding. There is a lot of senior support available to our junior doctors and we encourage you to ask for help if you are unsure.
Contributions and acknowledgements
Dr Tim Chan
Dr Janneke Van Rij
The department
Consultants
All of the Consultant’s offices are based in the Longhouse on the first floor; they also have a Consultants office on Labour ward for when they are OGW (Obstetrician and Gynaecologist of the Week). A contact list for the team is updated regularly and can be found around the department, you will find contact details for the consultants here or you can reach them via their secretaries.
Secretaries
All of the secretaries can be found in the Obs & Gynaecology office in the Longhouse building on the first floor.
The secretaries will be able to help you to;
· Organise appointments for patients
· Gather patient’s records
· Arrange meetings with their consultant
· Typing letters
Currently within the team we have 2 Associate specialists;
Dr Riad Bules
Dr Jaya Kovvali
Bleep: 2550
Bleep: 2594
7x O&G ST3-7
2x O&G ST1-2
5x GP trainees
1x F2.
Consultant timetable
The consultants with in the Obstetrics & Gynaecology department work on an 8 week rotation.
Current team structure (to be amended with each new team)
You will be emailed which team you are a part of and who your educational supervisor is prior to starting.
Blue Team
Dr Brighan, Mr Wood, Dr Dinardo
Red Team
Dr Davies, Mr Hawe, Dr Van Rij
Green Team
Mr Mc Cormack, Mr Semple,
Yellow Team
Mr Ibraheim, Dr Rao, Dr V Finney
Specialist nurses
Women and Children’s pharmacist
Gemma Webster Ext: 5620, Bleep 3451
Maternity/ gynaecology physiotherapist
Hazel Dutton Bleep 2584
Services
Please check the rota for up to date information regarding clinics.
The wards
Labour Ward
Labour ward is located on the ground floor of the women’s and children’s building. The ward contains and assessment area, low-risk delivery rooms, high risk delivery rooms and the Obstetric Theatre.
When you are on call, you will spend most of your time on this ward.
Women’s Surgical Unit (Ward 40)
Ward 40 is located on the first floor in the main building of the hospital. The ward takes both elective and emergency admissions for Gynaecology.
There is an assessment-room for Gynae Emergencies on the ward. Patients may only be accepted for review in the assessment room if there is a bed available for them.
Every week-day morning, all gynae patients on ward 40 are reviewed by the on-call Gynae SHO and a registrar. After the ward-round, the registrar will go to their allocated clinic. The ward SHO should remain on the ward following the ward round and complete any outstanding jobs.
Cestrian Ward (Ward 32)
Ward 32 is the antenatal/postnatal ward. It is located on the first floor of the women’s and children’s building. Daily ward rounds are conducted 8:30-9:00. Each team sees their own patients (see team structure), a list of patients by team is provided by the ward staff.
If no members of a team are present, the patients are reviewed by members of another team. Please check the flow-chart can be found in the midwives office on ward 32.
Early Pregnancy Assessment Unit (EPAU)
This is a Rapid Access Clinic for complications in early pregnancy, providing appointments between 09:00-12:30 daily. Two emergency slots are reserved between 09:00-09:30 for ward admission or for patients in their 2nd trimester who require an urgent scan (these patients must be discussed with SpR).
The Early Pregnancy Unit is located in Gynae Outpatients. Patients can be referred via GPs, A+E, Midwives and O&G Staff.
The diary is held in EPAU/GAU 9:00 - 17:00. Out of hours the EPAU diary is held on W40.
Gynae Assessment Unit
The GAU is an assessment unit for urgent gynae referrals. Patients are seen via referral only. The opening times are 9:00 - 17:00 (the last patient must be in the department by 16:30).
Annual and study leave guidance
You must give 6 weeks’ notice for all leave requests. Up to 3 juniors can be on leave at any time (2x SpR, 1x F2-ST2 or 1 SpR, 2 F2-ST2). Requests are made using the pink annual leave forms. The can be found at medical staffing or in the junior doctor’s office in the Longhouse.
Study leave is applied for using the HENW electronic forms, junior doctors employed by the Trust should request study-leave using a paper study-leave form. Study leave must be requested for all courses including regional teaching. If you wish to attend specialist clinics outside the Trust, please request study-leave as well. If you are on call, you will not be able to attend regional teaching.
If you have lieu days from previous jobs you will not be able to carry these over to your obstetrics and gynaecology rotation. Equally, if you have not taken all of your leave by the end of your placement you may not be able to take these days in your next placement.
All AL and SL requests should be submitted to the rota-master (Dr van Rij). You will receive a signed copy of your form to confirm (alternatively, you will receive confirmation via email).
Swaps
A swap-form must be signed by both doctors for all swaps. Swap-forms must be submitted prior to publication of the weekly rota.
Nights must be swapped as a full set.
If you are swapping weekend or night on calls, the rest periods are swapped too. You may have to swap long days in order to keep rest-days, long days must be swapped as a whole day not 17:00-20:45.
Please submit all swap-forms to the rota master.
Sick Leave
It is important you ring the OGW on the Labour Ward between 08:30-08:45.
You must also ring Medical Staffing to inform them of your absence, you will be required to have a return to work interview with a medical staffing officer or your Education Supervisor.
Teaching
Next to weekly departmental teaching, there are 13 Rolling Half Days per calendar year. Clinical activities are cancelled for these half-day sessions. Attendance is mandatory unless you are on call.
Handover
Handover occurs on Labour ward at 08:30, 17:00 and 20:30 and occasionally at 13:00 if a member of staff is working a half day.
The following members of staff are expected to attend the handover: OGW, Labour Ward Registrar (Day & Night), Labour Ward SHO (Day & Night), Gynae SHO, Gynae Ward Round Registrar (9:00 only).
Any outliers or acutely unwell patients are noted on the white-board on labour ward.
Useful Guidelines
We have a large number of guidelines on O&G, which are updated regularly. Please see the document library on the intranet.
Medical student induction guide
You may examine a patient if they are awake and give consent. You can perform an intimate examination on a patient who is under a general anaesthetic and a written consent has been obtained prior to the operation. The consent should be obtained during pre-op ward-round by both a member of the surgical team and the student.
You will receive a copy of this form during your induction.
Gynaecology
Your gynaecology experience will centre around both outpatient and inpatient care. It is important that you clerk in-patients who are going to theatre prior to the theatre session, attend theatre and follow their care pre and post-operatively.
Obstetrics
Obstetric care will involve antenatal clinics and labour ward sessions. There is also the need for you to attend the postnatal ward round. You should try and attend a postnatal ward round each week with the midwives, noting the assessment they make of the patients.
On-call
You are encouraged to spend time out of hours during your placement.
Bedside Teaching
You are encouraged to arrange bedside teaching with the firm you are attached.
Examples of useful cases
Obstetrics
· Normal vaginal delivery
· Caesarean section
· Pre-eclampsia
· Gestational Diabetes
· Antepartum Haemorrhage
· Placenta Praevia
· Hyperemesis
· Gestational Hypertension
Gynaecology
· Abnormal bleeding
· Bleeding in early pregnancy
· Cervical cancer/ CIN
· Ectopic pregnancy
· Endometrial carcinoma
· Contraception
· Endometriosis
· Fibroids
· PID
· PCOS