Advanced Training Study Modules

Details

The RCOG has now updated the Advanced Training Skills Modules (ATSMs). The curricula for each is now available on the RCOG website, the 20 available ATSMs listed below with hyperlinks to the location on the RCOG website. It should be noted that many of these ATSMs require OSATS and some have CBDs and mini CEX's embedded in them.

1. Fetal Medicine
2. Advanced Labour Ward Practice
3. Labour Ward Lead
4. Maternal Medicine
5. Advanced Antenatal Practice
6. Vulval Disease
7. Benign Gynaecological Surgery: Hysteroscopy
8. Colposcopy
9. Acute Gynaecology and Early Pregnancy
10. Benign Vaginal Surgery
11. Benign Gynaecological Surgery: Laparoscopy
12. Abortion Care
13. Gynaecological Oncology
14. Sexual Health
15. Sub-Fertility and Reproductive Endocrinology
16. Menopause
17. Urogynaecology
18. Paediatric and Adolescent Gynaecology
19. Benign Abdominal Surgery
20. Medical Education

The ATSMs are designed to be both deliverable at District General Hospital level and achievable within the normal working week over a 12 month period. The ATSMs have been designed to equip trainees with the skills they will need for independent practice. Most of the competencies required for the ATSMs will be acquired during service commitments and it will be rare for time to be ring fenced for their completion. The trainee will merely spend more time in that particular area eg labour ward or colposcopy clinic. A further ATSM in advanced laparoscopic surgery will be published in the New Year.

It is now mandatory that StRs complete 2 ATSMs prior to CCT. Whilst not mandatory, SPR's are expected to achieve the same. Depending on availability, it may be possible to some trainees to undertake more than two ATSMs during the two years of advanced training. It would however be exceptional for a trainee to be allowed to register for more than two ATSMs at any one time.

The Choice of ATSMs
The choice of ATM is very important as the skills acquired are likely to determine the subsequent specialty interest of the inpidual as a consultant. The Advanced Labour Ward Practice or the Labour Ward Lead ATSM will be a mandatory requirement for any Consultant Obstetric or Obstetrics and Gynaecology post. It is envisaged that the majority of trainees will undertake at least one of these.

The prospective combination of ATSMs should be made by the trainee after discussion with his or her Educational Supervisor and with the Training Programme Director for ST3-7 at the end of year 4 and 5. Table 1 illustrates the ATSMs which will be necessary to apply for a particular post in Obstetrics & Gynaecology based on the RCOG Future Role of the Consultant Document however other combinations are possible. The availability of ATSMs will inform placement of trainees in years ST6-7.

Registering for an ATSM

Director of ATSMs is This email address is being protected from spambots. You need JavaScript enabled to view it.  and lead preceptor for obstetric ATSMs is This email address is being protected from spambots. You need JavaScript enabled to view it. and This email address is being protected from spambots. You need JavaScript enabled to view it. for Gynaecology ATSMs

Interviews are held for all Yr 5 and 6 trainees in March / April to discuss the trainee's ATSM intentions. At interview the trainee should provide;

1. letters of support for each ATSM from their educational supervisor which states the trainee's skills and aptitude for the relevant intended ATSM
2. their log book
3. a 5 minute presentation (title set out in appointment letter)

Placement for Yr 6 and 7 will be based on ATSM training needs. The availability of ATSMs within the region are limited and therefore it is possible that competitive entry to some which are oversubscribed will be necessary. The selection process will depend upon the module and may take the form of:

1. A written testimonial from an educational supervisor indicating whether, after direct observation, they feel the trainee has the aptitude and skills required.
2. A hand-eye coordination test in a skills laboratory.
3. The March / April interview.

Log book evidence can be accumulated up to a maximum of 3 months before registration of the ATSM.

The ATSM can only be registered once the trainee has received an outcome 1 or 2 for ST5

The registration form should be signed by the educational supervisor(s) for that ATSM in your training unit and then forwarded to the relevant ATDM preceptor and director for completion. It is then ready to be submitted with fee to the RCOG.

Selection for ATSMs
The availability of ATSMs within the region are limited and therefore it is possible that competitive entry to some which are oversubscribed will be necessary. The selection process will depend upon the module in question but for example with laparoscopic surgery it may take the form of:

1. A written testimonial from an educational supervisor indicating whether, after direct observation, they feel the trainee has the aptitude and skills required.
2. A hand-eye coordination test in a skills laboratory.
3. Formal interview.

Timetable for Trainees undertaking ATSMs
Timetables for trainees undertaking ATSMs will have to reflect that ATSM in order to allow completion within 12 months. This will be particularly true for the surgical based ATSMs but is of relevance to all. Both trainers and trainees are only to well aware of the reduced opportunities for surgical training. This is the result of several factors the most influential being reduced numbers of gynaecology surgery cases and the reduced hours of trainees. It is now well recognised that many consultant posts in the future will have only limited amounts of major gynaecological surgery within them. It is anticipated that this should be an amount sufficient to maintain the skills required to participate in gynaecology on-call rotas ie the ability to open an abdomen and to deal with ectopic pregnancy and ovarian cyst accidents. It is therefore appropriate that the volume and type of surgical training should reflect the different amounts of surgery anticipated in a consultant job plan. A trainee who is undertaking a surgical ATM will therefore be given several theatre lists a week (still allowing them to complete the curriculum) whereas a trainee doing a non-surgical ATM will go to gynaecology theatre much less frequently in order to maintain their skills at performing a laparotomy, diagnostic hysteroscopy and laparoscopy. It is self evident that this will mean the inpidualisation of timetables for ST6-7 reflecting the ATSMs being undertaken.

Table 1: Suggested Combinations of ATSMs