NHS FORTH VALLEY
DEPARTMENT OF OBSTETRICS AND GYNAECOLOGY
EDUCATIONAL SUPERVISORS LIST
Name Position Email on timetable as
Dr Abels O & G Consultant peter.abels@nhs.scot PA
Dr Barr O & G Consultant sarah.barr@nhs.scot SB
Dr Cope O & G Consultant aileen.cope@nhs.scot AC
Dr Wilson O & G Consultant donald.wilson@nhs.scot DW
Dr Kearney O & G Consultant clare.kearney@nhs.scot CK
Dr Hepburne-Scott O & G Consultant kelly.hepburnescott@nhs.scot KHS
Dr Hill O & G Consultant jacqueline.hill@nhs.scot JH
Dr Holmes O & G Consultant paul.holmes@nhs.scot PH
Dr Huda O & G Consultant shahzya.huda@nhs.scot SH
Dr Maheshwari O & G Consultant sapna.maheshwari@nhs.scot Sma
Dr Miller O & G Consultant nicola.miller@nhs.scot NM
Dr Milling-Smith O & G Consultant oliver.millingsmith@nhs.scot OMS
Dr Sonika Misra O & G Consultant sonika.misra2@nhs.scot SMi
Dr Patrick O & G Consultant kate.patrick@nhs.scot KP
Dr Reilly O & G Consultant eileen.reilly@nhs.scot ER
Dr Sewnauth O & G Consultant kara.sewnauth@nhs.scot KS
Dr Heron Iglesias O & G Staff Grade Soraya.heroniglesias2@nhs.scot SHI
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DEPARTMENT OF OBSTETRICS AND GYNAECOLOGY
CLINICAL ATTACHMENTS IN OBSTETRICS AND GYNAECOLOGY
AN INTRODUCTION FOR GLASGOW MEDICAL STUDENTS
Welcome to the Department of Obstetrics and Gynaecology at Forth Valley Royal Hospital.
We hope that you will enjoy your attachment here with us.
Your timetable includes all the core learning activities (Labour Ward, clinics and theatres),
special interest areas and time for private study. You can use your private study time for
self-directed learning or portfolio preparation. Each timetable is individualised to ensure
that all students have the same learning opportunities.
If you have problems with any aspects of your attachment, please bring them to the
attention of your supervisor or to Dr Jacqui Hill, O & G Student Coordinator
(Jacqueline.hill@nhs.scot). If you wish to discuss any general issues related to being a
student in NHS Forth Valley, contact Margot Robinson, the Undergraduate Coordinator
[margot.robinson@nhs.net] direct line 01324 567619 or internal extension 67619.
Your educational supervisor
Your timetable indicates your supervisor although you will be supervised by all the staff at
some time or another. Try to meet up informally with your supervisor every week or so to
discuss your progress. You should also meet if you encounter any difficulties with your
training experience. He/she is responsible for marking your portfolio Case Reports and for
coordinating the feedback for your continuous assessment.
The Case Reports
You will have to prepare two cases in obstetrics and gynaecology using the guidance notes in
the Glasgow University students’ website. These provide your supervisor with insight into
your knowledge, skills and attitudes, so choose a good case (agree the suitability with your
supervisor) and be meticulous in your report. When writing it up, you will find it useful to
refer to any recent RCOG Guidelines on the topic - http://www.rcog.org.uk/guidelines.
During the first two weeks of your attachment you should identify suitable cases. They
should be submitted no later than the end of the fourth week of your attachment, so that
they can be marked before you leave.
Your Assessments
It is your responsibility to ensure that you complete the required assessments before the
end of the block.
The RCOG Undergraduate curriculum (NACOG)
You will be provided with a copy of this. The content is a valuable overview of the
knowledge, skills and attitudes needed to demonstrate that you are a well trained
undergraduate in obstetrics and gynaecology. Try to tick off the areas you have covered, and
read up on those you don’t experience.
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DEPARTMENT OF OBSTETRICS AND GYNAECOLOGY
CORE LEARNING OPPORTUNITIES
General Points
All the staff in our department enjoy having students, so engage with them from the start,
show enthusiasm and don’t be afraid to ask about all the areas of their work that you wish
to learn about. When you ‘shadow’ the doctors in Wards 6 & 8, use the time to help them
with their duties and this in turn will help you learn real obstetrics and gynaecology – much
more valuable for passing your exam than memorising from books!
Don’t miss out on any session you are timetabled to – the consultant will be looking out
for you. If you are unexpectedly ill, you must demonstrate your professionalism by
sending an e-mail to Margot and to your supervisor beforehand.
TRAINING IN OBSTETRICS
Labour Ward (LW - Ward 7)
You will have the opportunity to spend several days on LW. The day starts at 8.30am for the
important ‘handover’ which you should attend if you are on LW or SHO shadowing. For
some of these, you will benefit by attending in the evenings and overnight (when there are
fewer student midwives requiring training). Things can happen quite quickly so make your
presence known and stay visible. The midwives are the key people during your time on LW
and you should ask the Midwife-in-Charge (always make your availability known to her – this
reaps benefits) if you can be allocated a patient in labour to ‘sit in’ with. The Consultant,
Midwife or Registrar will confirm with the pregnant woman that she agrees to your
presence.
As well as gaining exposure to ‘normal’ labour, you should aim to understand the methods
for the induction of labour and should witness instrumental and caesarean deliveries. You
should supplement your training in Labour Ward management and fetal monitoring by
attending the lunchtime teaching.
Antenatal Clinics (ANC) – hospital and community
You will have the opportunity to participate in general antenatal clinics and a Twins ANC.
You will have a day in the community with the midwives, which is a great opportunity to
learn obstetrical history-taking and abdominal palpation (ask to be shown this at your first
ANC). You should witness the management of booking, fetal anomaly screening, routine
antenatal care, the management of pregnancy complications and ‘post-dates’ pregnancies.
Take bloods, measure blood pressures, check the urine, get involved!
TOP Clinics
You will have the opportunity to attend clinics. The link below will give you a brief overview
of the topic. https://app.nearpod.com/?pin=DK4U8
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DEPARTMENT OF OBSTETRICS AND GYNAECOLOGY
Antenatal Ward (Ward 8)
Ward 8 has obstetric in-patients who have been admitted with problems in pregnancy such
as bleeding, preterm labour, pre-eclampsia and hyperemesis. There are ward rounds each
morning at 9.00am (following the LW handover). This is an excellent place to see the sort of
patients you need for your portfolio. The ward doctor or the Midwife-in-Charge can suggest
which patients would be suitable for you to see. When you do take a history, present it to
the ward doctor and discuss the important features.
Maternity Assessment Centre (MAC) - Triage and Day Care
This midwife-led service is available for women to present for expert advice (usually without
the need for hospital admission) for symptoms that concern them. After assessment, the
ongoing care is planned by the midwife (in consultation with the woman herself, and, if
required, the obstetric team). It is a great opportunity to gain experience in a variety of
acute pregnancy problems, to take histories and perform examinations. Day Care is attended
by patients requiring frequent monitoring for chronic pregnancy-related problems, e.g. pre-
eclampsia. You can arrange to attend MAC during your Labour Ward sessions (if LW itself is
‘quiet’!).
Community Midwifery
On your timetabled day with the Community Midwives you should meet the midwives, sharp
at 9am, You can find them in the Mayfield Building ( top floor, right side ) in Falkirk
Community Hospital.
TRAINING IN GYNAECOLOGY
Outpatient Gynaecology
You will be allocated to a few general gynaecology clinics and to a variety of specialist clinics
including colposcopy, out-patient hysteroscopy (OPH), infertility, postmenopausal bleeding,
urogynaecology and termination of pregnancy. In general gynaecology, you will be able to
take histories from patients on your own, and to present these to a senior doctor in the
clinic before examination is performed.
Inpatient Gynaecology
Gynaecology Ward (Wards 6)
You will be able to ‘shadow’ the doctors and nurses in the Gynaecology Ward. This is for
gynaecology inpatients, admitted either for the management of acute symptoms or after
major surgery. It is also a good place to practise taking gynaecological histories. Always
introduce yourself to the nursing staff so they know why you’re there.
The day starts in LW at 8.30am for the handover from the night on-call team, and moves to
Ward 6 at around 9am to review all the gynaecology patients, arrange emergency theatre,
etc. Gynaecology Triage is open each week-day afternoon (except Monday). Join the ward
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DEPARTMENT OF OBSTETRICS AND GYNAECOLOGY
doctors involved in their gynaecological assessment of emergency and routine admissions.
Take histories and present cases to them when you have the opportunity.
Gynaecological Surgery
During your attachment you are allocated sessions to experience gynaecological surgery.
The theatre used for these is Theatre 6, adjacent to the Ambulatory Care area. You will be
able to observe both major and minor gynaecological surgery, to familiarise yourself with
the common procedures.
It is essential that you meet the patients beforehand (they are all admitted to Ambulatory
Care an hour prior to the start of theatre) and you should aim to accompany the surgeon on
the pre-operative round (theatres start at 9.00am or 1.30pm so you have to be present to
see patients 30 minutes earlier). This is particularly important as you will have the
opportunity to examine the patients in theatre (most patients agree to this, although you
require written consent from them - there is a section in the Consent Form).
If you have written consent, you may also be able to assist in theatre, which is very useful
experience, especially for major cases. It is also important that you read the appropriate
Clinic letters (usually in the front of the case-notes) so that you are completely familiar with
the patient’s history and planned management. Watching an operation is not educational if
you don’t know the patient and her history!
Major cases include hysterectomies (for cancer or benign pathology) and other operations
that might require a few days’ stay in hospital. Theatre is a good place to learn how to ‘scrub
up’ and to assist the surgeons (with the patient’s written consent).
Minor cases include laparoscopies, sterilisations, hysteroscopies, terminations, evacuations
and other simple gynaecological surgery. These provide opportunities to learn speculum and
pelvic examination (with the patient’s written consent).
CLINICAL ACTIVITIES GUIDE
FORTH VALLEY ROYAL HOSPITAL (FVRH)
Labour ward handover is at 8.30am and at 8.30pm; all Clinics are in Women & Children’s Unit
(Outpatients’ Department on the Ground Floor) and start at 9am or 1.30pm
Obstetrics Gynaecology
Area Location and schedule Area Location and schedule
Labour Ward (LW) Ward 7, handover at 8.30am Gynaecology Clinic OPD, days vary, 9.00am &
(GOPD) 1.30pm
Maternity Theatre Theatre Suite Wards 6 Gynaecology Ground Floor
Antenatal Clinics OPD, 9.00am & 1.30pm Theatres Ambulatory Care area, 1st floor
(ANC), including then Theatre 6, 9.00am or
Twins 1.30pm start, **see patients at
least 30 minutes earlier**
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DEPARTMENT OF OBSTETRICS AND GYNAECOLOGY
Cancer MDT Rooms 111 and 12, OPD, 8.45am Colposcopy and Out- Suite next to OPD, Ground Floor,
with Dr Milling Smith/ Dr Barr patient Hysteroscopy 9.00am & 1.30pm
Ward 8 Obstetrics 1st Floor Postmenopausal OPD, days vary, 9.00am or
Bleeding (PMB) 1.30pm
Obstetric Triage Ward 8, Tuesday – Friday pm Subfertility Suite next to OPD, Ground Floor;
1.00pm Mondays; 9.00am
Tuesday or 1.30pm Tuesdays &
Wednesdays
Prenatal Diagnosis Ultrasound Department, Ground Urogynaecology OPD, days vary, 9.00am &
(PND) Floor, Monday or Friday, 9.00am 1.30pm
Teaching Meetings Mondays, Tuesdays & Thursdays Termination of OPD, 1.30pm Tuesdays
(12.45pm – 1.30pm); LW or Pregnancy (TOP)
Training Room
Teaching areas
Departmental ‘lunchtime’ teaching (multi-disciplinary, with medical and nursing/midwifery
staff) takes place on Tuesdays (gynaecology M & M), Thursdays (Obstetric) and
Mondays(CTGs), usually in the Training Room, 1st Floor W & C.
FVRH has a library with computer desks and is accessible at all times. There is Wi-Fi in the
accommodation and Eduroam in FVRH
LABOUR WARD EXPERIENCE FOR MEDICAL STUDENTS
Experience of what happens in the Labour Ward is an essential component of your teaching
in obstetrics and gynaecology. The following is a list of the sort of clinical situations you
should become involved with:
Normal Labour
You should sit with a patient in labour for a few hours, hopefully till delivery, noting the role
of the midwife, the monitoring and analgesic regimes, and any medical input to the labour.
Normal Vaginal Deliveries (NVD)
You should witness at least two NVDs conducted by the midwife, then assist at the delivery
yourself, under the midwife's guidance, in a further three patients. Remember that it is not
acceptable to appear at the last minute and expect to 'get the delivery'.
Assisted Deliveries
You should try to witness assisted delivery (forceps, ventouse) on three occasions, and be
present at two caesarean sections.
Various other activities take place in the Labour Ward, and you should be able to learn
about some or all of the following:
the diagnosis of labour pre-labour rupture of the intra-partum fetal
membranes monitoring
fetal blood sampling artificial rupture of the manual removal of placenta
membranes
analgesia and the role of the prioritising tasks the central role of the
anaesthetist midwife
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DEPARTMENT OF OBSTETRICS AND GYNAECOLOGY
TIPS FOR MAXIMIZING YOUR LABOUR WARD EXPERIENCE
• Keep a brief log of your experience on the reverse of this sheet and show it to the
Midwife-in-Charge and the LW Registrar so that they can help you progress in your LW
experience (e.g. from ‘sitting in’ with a patient in Labour to being able to assist the
Midwife at delivery)
• let the midwifery staff & the ‘On-Call’ medical staff know you are around and keen to be
called
• write your room/page numbers on the board
• show interest, professionalism & enthusiasm
• be patient
• don’t be upset if she ends up with a section (or at least don’t show it!)
Try to visit the proud mother and her baby the next day (and thank them for having you!)
CASE PRESENTATIONS IN OBSTETRICS AND GYNAECOLOGY
Look right Maintain eye contact, don't over-use your notes
Sound right Clear, fluent, not too fast, no boring rambling, no abbreviations, always
deferential to patient
Be relevant Try to grasp the main problem(s), whether social or clinical, and make
everything else take second place. Avoid 'strings of negatives'
Be thorough Omit nothing except irrelevancies
THE OBSTETRIC CASE
The History
1. Opening sentence, with full name, age, parity (x + y), gestational age and presenting
complaint (in as few words as possible).
2. Now elaborate on the presenting complaint (if there is one), being as fluent,
chronological and economical (yet omitting nothing) as possible.
3. Make clear the dates (LMP & EDD) and how they were derived, explaining any
discrepancies.
4. Work through the pregnancy from beginning to end, mentioning any 'highlights', e.g.
msAFP, any bleeding or infections, the use of iron or anti-D prophylaxis, etc.
5. Past obstetric history, being concise in the case of Mrs 'para 10+6 disasters'.
Mention year of delivery, mode of delivery, outcome ('healthy male weighing 7lbs')
and, very concisely, any significant obstetric problems.
6. Gynaecological history if any, including past and future contraception and most
recent smear (plan for next smear).
7. Medical, surgical, drug, family and allergy history - very briefly unless relevant to
pregnancy.
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DEPARTMENT OF OBSTETRICS AND GYNAECOLOGY
8. Social history, including marital status, employment and plans for returning to work,
partner details, smoking, drinking, plans for feeding the baby, accommodation.
9. Closing summary, just to repeat the opening sentence with the addition of any plan for
management.
The Obstetric Examination
general appearance
pulse
blood pressure
heart sounds & chest examination
urine (test yourself if encouraged)
ankle oedema
reflexes (if hypertensive)
optic fundi (if hypertensive or diabetic)
Examination of the pregnant abdomen
inspection (pregnancy, scars, movements, striae, linea nigra)
symphysio-fundal measurement
lie
presentation
head palpable (in 5ths)
liquor assessment
fetal heart rate
THE GYNAECOLOGICAL CASE
The History
Remember that the objectives here are to fully describe the patient's problem, its effect on
her life, and her fitness (or otherwise) for surgical treatment.
1. Opening sentence, with full name, age, parity and presenting complaint (in as few
words as possible).
2. Now elaborate on the presenting complaint, discussing the patient's problems and
their effect on her well-being. Don't forget to mention any investigations and/or
treatments initiated earlier, and the patient's response to these.
3. Gynaecological history, if any.
4. Past obstetric history, more concise than in obstetrics.
5. Medical, surgical, drug, family and allergy history. Expand on this where it is relevant
to her fitness for surgery, or to her recovery thereafter.
6. Social history, including marital status, employment, support at home, plans for
returning to work, smoking and drinking.
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DEPARTMENT OF OBSTETRICS AND GYNAECOLOGY
7. Closing summary, just to repeat the opening sentence with the addition of any plan
for management.
The Gynaecological Examination
Here again, the emphasis is not only on any gynaecological signs, but also the patient's
general fitness for surgery, so general examination is more important, and you should
mention
general appearance
pulse
blood pressure
heart sounds
chest
anything else relevant to the past history
abdominal examination
inspection (swellings, scars)
palpation (lower abdominal, LKKS)
percussion (if ascites)
vaginal examination
inspection of vulva
speculum – inspection of cervix
bimanual examination (uterus size, anteverted/retroverted/axial/not sure, mobility; adnexal
palpation for masses/tenderness)
MEDICAL STUDENTS – GENERAL INFORMATION
Undergraduate Co-ordinator
Margot Robinson is the undergraduate co-ordinator for Forth Valley she can be contacted on
Extn 67619 (direct line 01324 567619) or by e-mail at margot.robinson@nhs.scot . Please
feel free to contact her at any time during your stay.
Swipe Card Access for FVRH
Many areas in FVRH are only accessible by swipe card access, learning centre, theatres etc.
Student swipe cards are available from the undergraduate co-ordinator. These cards also
entitle you to staff discount in Starbucks.
Accommodation
Limited accommodation is provided on the FCH site in the Junior Doctors Residence. Do not
give your room keys to anyone else and do not exchange rooms without the prior
permission of the Accommodation Manager, Karen Nimmo, or ring “0” for the switchboard
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DEPARTMENT OF OBSTETRICS AND GYNAECOLOGY
and ask them to page you a domestic supervisor if you have any problems with your
accommodation. Cooking facilities are available in the residences.
Please take care of your room keys and at the end of your attachment leave the keys in your
room and ensure the room is locked before leaving. If you do not return the key this may
mean another student will not have accommodation at the start of their attachment.
Travel expenses, to the equivalent rate of the bus fare, will be paid to students preferring
not to stay in the accommodation.
Parking
If you have a car with you it can be easily parked at the Falkirk site. There is access to the
overflow purple car park at Larbert where the barriers are always raised. We would ask you
not to park in the front visitor’s /patient car park at FVRH
Public Transport
For students who do not have their own transport Forth Valley will provide weekly vouchers
for First Buses. There is a Number 38 bus which travels between Stirling and Falkirk and
which calls at FVRH en-route. This service runs approximately every 15 minutes. When
handing your voucher to the bus driver ask for a weekly one zone ticket.
Student Concerns:
If you have any concerns whatever, patient safety, personal, learning, staff issues etc please
tell your supervisor in the first instance or feel free to discuss with any of the Medical
Education Undergraduate Team.
Undergraduate Team
Name Title Extn. Email
Dr Kate Patrick Director of Medical 67399 kate.patrick@nhs.scot
Education (DME)
Dr Chris Kelly Deputy DME and UoG 66846 chris.kelly@nhs.scot
Sub Dean
Dr Alasdair Cooper Clinical Teaching Fellow 67836 alasdair.cooper@nhs.scot
(CTF)
Dr Lucy McNally Clinical Teaching Fellow 67478 Lucy.McNally@nhs.scot
(CTF)
Margot Robinson Undergraduate Co- 67619 margot.robinson@nhs.scot
ordinator
Name Badges
You should wear your University Medical student badge at all times while on NHS Forth
Valley premises.
Dress Code
University Scrubs should be worn on the wards at all times
Dining Facilities
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DEPARTMENT OF OBSTETRICS AND GYNAECOLOGY
The restaurant is open 7.30am to 7.30pm
Paging/Bleeping
To bleep a doctor on the same site dial 68100 and follow instructions. If you wish to contact
a Doctor on the Stirling site dial the SCH/FCH hospital switchboard on 01786 434000 and
follow the recorded instructions which require you to know the name or department you
want to contact.
Library/Computer Access:
The Library is situated on the 2nd Floor, above the restaurant at FVRH, within Clinical and
Medical Education Services. Contact the Librarian, Elizabeth Carney, on 01324 567406 or
email:
fv.forthvalleylibraryservices@nhs.scot
The library is manned Monday – Friday from 8.30am to 4.30pm. Access is available at all
times using a valid swipe card.
Library Facilities
NHS Forth Valley Library Services provide free membership to medical students. The library
stocks a range of books on the Knowledge Network, together with journals and educational
resources which are available through the internet. There are many computers within the
Library to facilitate access to the resources and study space where you can use your own
device.
http://nhsforthvalley.com/health-services/library-services/
The Knowledge Network is NHS
Scotland’s National eLibrary available from any computer at:
http://www.knowledge.scot.nhs.uk
Among the wealth of resources, the Knowledge Network provides:
• Full text journal articles, abstracts and citations
• Electronic books
• Point of care resources including evidence summaries
• Assistance to enable users to keep up to date in their field of interest
• A wide range of apps
• Access to Library Search, the national catalogueScottish Hospitals Library Catalogue
An Athens password is required to access NHS Scotland’s Knowledge Network on-line
resources. You can apply for an Athens password online by visiting
www.knowledge.scot.nhs.uk and clicking ‘register’ at the top right hand corner
Support is available to enable staff to develop their information and knowledge skills. Please
call or email us if you would like to come along for a tutorial. Or if you have any questions.
A multi function device is available to facilitate printing, copying, scanning... Please note that
a print code is required to use this device; codes will be provided together with your
computer log-in.
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The library has a portable DVD player as some volumes contain DVDs. When using the library
please have respect for other users.
In FCH there is open wi-fi access available in the Junior Doctors Residence where you will be
staying and Eduroam is available in FVRH
Access to Clinical Systems
You will be given access to the following clinical systems whilst you are on
placement:
Clinical Portal
Using your generic computer log-in
SCI Store
A username and password will be provided
HePMA
A username and password will be provided but you must complete a Turas Learn
module in order to activate this, the module is called NHS FV HePMA View Only
TrakCare
A username and password will be provided but you must complete two Turas Learn
modules in order to activate this as follows:
• NHS FV Introduction to TrakCare module
• NHS FV TrakCare Acute Inpatient Doctor module
We require you to undertake an additional Turas Learn module this is not a clinical
system but an invaluable teaching tool
NHS FV ReSPECT
FVRH Useful Contact Numbers
Main Hospital Number 01324 Fire 5555
566000
Cardiac Arrest 2222 Outpatients Department Main Reception 66400
Endoscopy 67518 X-Ray Main Reception 67000
Pharmacy Main Reception 66700 Theatre Recovery Main Reception 66088
Theatre Main Reception 66090 Ambulatory Care Main Reception 67500
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Day Medicine 67505 Day Surgery 67537
Occupational Health 66663 Oncology 66300
Reception
Renal Unit 66387 IT Service Desk 903333232310
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