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Why,  what  &  how?  

January  2011  
Background  to  ATSMs  
 ATSMs  -­‐  background  

•  Advanced  training  in  ST6  and  ST7  is  

part  of  the  core  requirement  for  the  
award  of  CCT  
•  21  ATSMs  have  been  developed  
•  Trainees  will  be  required  to  complete  2  
ATSMs  during  the  2  year  period  (from  
CCT  date  1st  January  2010)  
ATSMs  
•  AborLon  care   •  Gynaecological  oncology  
•  Acute  gynaecology  &  early  pregnancy   •  Labour  ward  lead  
•  Advanced  antenatal  pracLce   •  Maternal  medicine  
•  Advanced  labour  ward  pracLce  
•  Menopause  
•  Benign  abdominal  surgery  
•  Medical  educaLon  
•  Advanced  laparoscopic  surgery  for  
the  excision  of  benign  disease   •  Paediatric  &  adolescent  
•  Hysteroscopy   gynaecology  
•  Laparoscopy   •  Sexual  health  
•  Benign  vaginal  surgery   •  SubferLlity  &  reproducLve  
•  Colposcopy   endocrinology  
•  Fetal  medicine   •  Vulval  disease  
•  Urogynaecology  
Advanced  laparoscopic  surgery  for  the  
excision  of  benign  disease  
•  Five  posts  are  available  
–  University  College  London  Hospital  
–  James  Cook  University  Hospital,  Middlesborough  
–  Aberdeen  Royal  Infirmary  
–  Royal  Cornwall  Hospital  
–  Princess  Anne  Hospital,  Southampton  
•  ApplicaLons  open  7th  January  2011  
•  ApplicaLons  close  4th  February  2011  
•  Interview  date  14th  March  2011    
•  Interview  venue  RCOG,  London  
Proposed  changes  to  gynaecology  ATSMs  

•  Significant  revision  of  the  gynaecology  

ATSMs  is  underway  
•  5  gynaecology  ATSMs  are  emerging  as  ‘career  
defining’:  
–  Benign  abdominal  surgery  (open  and  laparoscopic)  
–  Urogynaecology  and  vaginal  surgery  
–  SubferIlity  &  reproducIve  health  
–  Oncology  (to  include  laparoscopic  surgery)  
–  Acute  gynaecology  &  early  pregnancy  
Work  intensity  scores  

•  Each  ATSM  will  be  given  a  “work  intensity  

score”  reflecLng  the  duraLon  of  training  Lme  
that  is  expected  for  compleLon  
•  An  ATSM  with  a  score  of  2,  will  require  12-­‐18  
months  to  complete  
•  It  is  proposed  that  at  any  one  Lme,  a  trainee  
does  not  undertake  ATSMs  with  a  combined  
work  intensity  score  >  3.  
ATSMs  -­‐  background  
•  The  choice  of  ATSMs  undertaken  is  very  
important  in  determining  the  type  of  consultant  
post  to  which  the  trainee  may  be  appointed  
•  The  advanced  labour  ward  pracLce  ATSM  is  
highly  recommended  for  any  consultant  post  
with  an  obstetric  component  
Choosing  your  ATSMs  
Choosing  your  ATSMs  
•  What  are  you  interested  in?  
•  What  are  you  good  at?  
•  What  do  you  want  to  do  in  the  future?  
•  What  ATSMs  are  available?  
hfp://www.wagstraining.scot.nhs.uk/2009/10/atsms-­‐in-­‐west-­‐of-­‐scotland.html  

•  What  is  everyone  else  doing?  

Choosing  your  ATSMs  
•  What  are  you  interested  in?  
•  What  are  you  good  at?  
•  What  do  you  want  to  do  in  the  future?  
•  What  ATSMs  are  available?  
hfp://www.wagstraining.scot.nhs.uk/2009/10/atsms-­‐in-­‐west-­‐of-­‐scotland.html  

•  What  is  everyone  else  doing?  

•  What  ATSMs  will  help  me  get  a  consultant  
post?  
Workforce  Planning  

•  Consultant  expansion  
•  Consultant  vs  specialist  vs  sub-­‐consultant  
•  Changing  role  of  the  consultant  
•  Subspecialty  training  and  the  subspecialist  
•  Academic  training  
•  EWTD  and  consultants  
•  Consultant  obstetrician  and/or  gynaecologist  
THE WHITTINGTON HOSPITAL NHS TRUST
The Whittington Hospital NHS Trust is looking to recruit three full time
Consultant posts in Women’s health two in Obstetrics and one in
Obstetrics and Gynaecology.These posts have arisen as a result of
consultant retirements, EWTD pressures on junior doctors and the need
to increase the amount of consultant provided care in the service.
Obstetrics and Gynaecology with a special interest in Gynaecological
Emergencies and Early PregnancyRef no: 220-O&GEP-BK Experience in a
Gynaecology Assessment service and early pregnancy unit would be an
advantage as well as an interest in medical education.
Obstetrics with a special interest in Maternal Medicine and the
Management of Diabetes in PregnancyRef no: 220-OBS-MATMED-BK
Obstetrics with a special interest and training in Fetal Medicine and High
Risk ObstetricsRef no: 220-OBSFM-BK
Wrightington, Wigan and Leigh NHS Foundation Trust
THREE CONSULTANTSOBSTETRICS AND GYNAECOLOGY
Post 1 This is a substantive Consultant post, attracting 10 PAs. The
post will include General Obstetrics and General
Gynaecology. Applicants should have experience in Urogynaecology
and BSCCP accreditation. On-call duties will be non resident.
Posts 2 and 3 These are substantive Consultant posts, attracting 10
PAs. Weekday night time (9pm – 9am) and weekend on-call duties are
delivered by being resident on-call (1 week in 9) supported by one
Junior Doctor and a non resident Consultant. The resident
Consultants will prospectively cover each other. Apart from resident
on-call sessions at night and at weekends, these Consultants will
work in the same way as the existing Consultants in the department.
Post 2 will include General Obstetrics and General Gynaecology and
requires BSCCP accreditation. A special interest in Fertility would be
particularly welcomed. Post 3 will include predominantly Obstetrics
with emphasis on high risk Obstetrics and Antenatal Care. The
Gynaecological component will be Outpatient Gynaecology including
Early Pregnancy Care and Emergency Gynaecology.
KING’S COLLEGE HOSPITAL NHS FOUNDATION TRUST
CONSULTANT

GYNAECOLOGY

(4 Programmed Activity)

Applications are invited for a part time Consultant post in Gynaecology

with an interest in Colposcopy.
The postholder would be expected to be fully BSCCP accredited and
have experience in the management of General and Emergency
Gynaecological problems. The successful candidate will join an
impressive team of Consultants dedicated to providing a first class
women-centred service
ATSMs  and  ultrasound  modules  

•  Advanced  labour  ward  pracLce  =  Modules  1  &  2  (basic  modules)  

•  Advanced  antenatal  pracLce  =  Modules  1  &  2  
•  Fetal  medicine  =  Module  3  (intermediate  ultrasound  of  normal  fetal  
anatomy)  
•  Acute  gynaecology  &  early  pregnancy  =  Modules  4  &  5  (intermediate  
ultrasound  in  gynaecology  &  intermediate  ultrasound  of  early  pregnancy  
complicaLons)  
•  SubferLlity  &  reproducLve  endocrinology  =  Module  4    
ATSM  courses  
Cost  of  mandatory  courses  
   Advanced  LW  PracLce  
 £450  -­‐  500  (3  days)  
Scolsh  LW  Course  (24-­‐26  May)  
 £350  
ATSM  in  Fetal  Medicine  
 £360  -­‐  410  (2  days)  
Early  Pregnancy  &  Emergency  Gynaecology  
 £360  -­‐  410  (2  days)  
SubferLlity  &  ReproducLve  Endocrinology    and  
Assisted  ConcepLon  
 £625  -­‐  675  (5  days)  
How  do  I  embark  on  an  ATSM?  
•  Plan  ahead  
–  What  do  I  want  to  do  when  I  am  a  Consultant?  
–  What  ATSM(s)  do  I  want  to  do?  
–  What  units  in  the  WoS  can  offer  this  module?  
•  Speak  with  the  EducaLonal  Supervisor  in  that  
unit  
–  Can  you  really  offer  all  of  the  components  of  the  
ATSM?  
–  If  not,  will  I  get  protected  Ime  to  aQend  another  unit  
to  complete  the  module?  
–  When  I’ll  be  working  in  your  unit,  can  you  guarantee  
that  I’ll  get  the  module  done?    
How  do  I  embark  on  an  ATSM?  
•  Speak  with  the  module  Preceptor  
–  I’d  like  to  do  ‘your  module’  –  is  that  okay?  
–  Are  you  happy  for  me  to  do  ‘your’  module  in  unit  X?  
–  If  I  am  unable  to  get  all  the  components  of  the  module  
in  unit  X  can  you  suggest  where  I  can  go  to  get  it  
finished?  
•  Speak  with  the  ATSM  Director  
–  I’m  keen  to  do  ATSM  A  –  I’ve  spoken  to  Dr  B  at  my  next  
placement  and  he’s  happy  to  supervise  me.    I’ve  also  
spoken  to  Dr  C,  the  module  preceptor  and  she’s  also  
supporIve.    Is  this  okay?  
ATSMs  in  the  WoS  
•  We  have  a  ‘bulge’  of  trainees  at  ST6  level  (30+)  
•  Most  of  these  trainees  will  want  to  do  the  Advanced  
Labour  Ward  PracLce  ATSM  
•  Half  of  the  trainees  are  currently  doing  this  module  
(2010-­‐2011);  the  other  half  will  do  it  in  2011-­‐2012  
•  Some  trainees  may  wish  to  do  Advanced  LW  PracLce  
and  LW  Lead  together.    Only  those  showing  parLcular  
leadership  skills  will  be  invited  to  do  this  
Advice  for  ST5s  

•  Let  me  know  what  TWO  ATSMs  you  want  to  do  and  
where  you’d  like  to  do  them  
•  I’m  assuming  that  most  of  you  will  want  to  do  
Advanced  LW  PracLce  
•  I  will  meet  with  Phil  Owen  before  the  ARCP  meeLngs  
to  prioriLse  your  allocaLons  
•  If  a  parLcular  module  is  over-­‐subscribed,  (eg  
urogynaecology)  an  interview  process  (or  similar)  will  
take  place  
Advice  for  ST6s  

•  Remind  me  what  ATSM(s)  you  have  done  or  are  

currently  doing  
•  Let  me  know  what  other  ATSM(s)  you  want  to  do  in  
ST7  and  where  you  want  to  do  it.  I  will  meet  with  Phil  
Owen  before  the  ARCP  meeLngs  to  prioriLse  your  
allocaLons  
•  If  a  parLcular  module  is  over-­‐subscribed,  (eg  
urogynaecology)  an  interview  process  (or  similar)  will  
take  place  
 AnLcipated  problems  

•  Urogynaecology  (with  vaginal  

surgery)  
•  SubferLlity  and  reproducLve  
health  (to  include  a  laparoscopic  
component)  
•  The  ongoing  bulge  of  trainees  
Advice  for  all  STs  
•  Keep  a  log  of  your  experience  
•  You  CANNOT  register  for  an  ATSM  
unLl  you  have  successfully  
completed  ST5  (this  may  change)  
•  You  CAN  begin  to  keep  your  log  
of  experience  before  ST6  and  
then  meet  with  your  supervisor  
once  you  have  registered  to  
assess  your  competencies  
 How  to  get  the  job?  
•  If  you  are  uncertain  about  the  
future,  keep  your  ATSM  choices  
‘general’  
•  If  you  have  strong  views,  follow  
them  (eg  oncology)  
•  Work  hard,  be  pleasant,  be  a  good  
colleague  and  go  out  of  your  way  to  
be  kind  and  helpful  and  considerate