Best practice & research. Clinical obstetrics & gynaecology
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Best Pract Res Clin Obstet Gynaecol · Dec 2010
The development of a new speciality training programme in obstetrics and gynaecology in the UK.
In 2004, the Royal College of Obstetricians and Gynaecologists (RCOG) established a working group of experienced Fellows, Members, trainees and educationalists, who were responsible for writing and coordinating the development of a new curriculum in obstetrics and gynaecology. The curriculum would underpin the new 7-year speciality training programme. In December 2006, the UK Postgraduate Medical Education and Training Board approved the curriculum. ⋯ Successful progress is achieved by meeting the requirements at designated waypoints defined within the programme. The curriculum outlines not only the knowledge and technical clinical skill requirements, but also the professional skills and attitudes that must consistently be adopted by health-care professionals in a modern health service. The curriculum was originally benchmarked against the General Medical Council's Good Medical Practice criteria: (1) Good clinical care; (2) Good medical practice; (3) Successful relationships with patients; (4) Working with colleagues; (5) Teaching and training; (6) Probity; (7) Health.
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Best Pract Res Clin Obstet Gynaecol · Dec 2010
Recertification and continuing professional development: The way ahead.
The arguments in favour of recertification have been made cogently. Doctors in the UK on the whole continue to enjoy the trust and respect of their patients and the general public, but the Shipman enquiry led by Dame Janet Smith questioned the validity of the existing system. Following a lengthy discussion, the Chief Medical Officer of England published his proposal for professional regulation: Trust, assurance and safety - the regulation of health professionals in the 21st century¹ was published in February 2007. ⋯ The Royal Colleges have been delegated to set these standards, and approved by the GMC. Recertification will take place every five years. Recertification will be underpinned by enhanced appraisal, multi source feedback, and a robust continuing professional development programme.
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Best Pract Res Clin Obstet Gynaecol · Jun 2010
ReviewCardiopulmonary resuscitation and the parturient.
Cardiopulmonary arrest occurs in 1: 30 000 pregnancies. Although rare, optimal outcomes are dependent on the cause of the arrest, the rapid response team's understanding of the physiological effects of pregnancy on the resuscitative efforts and application of the latest principles of advanced cardiac life support (ACLS). Anaesthesia-related complications, secondary to difficult or failed intubation, and inability to oxygenate and ventilate can result in adverse outcomes for mother and baby. ⋯ Delivery of the baby helps in the maternal resuscitation efforts and recovery of circulation. Finally, the 2003 International Liaison Committee on Resuscitation (ILCOR) and the 2005 American Heart Association (AHA) advocate the provision of mild therapeutic hypothermia to the survivors of cardiac arrest. This will improve the neurological outcomes by decreasing cerebral oxygen consumption, suppression of the radical reactions and reduction of intracellular acidosis and inhibition of excitatory neurotransmitters.
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Best Pract Res Clin Obstet Gynaecol · Jun 2010
ReviewThe ongoing challenges of regional and general anaesthesia in obstetrics.
The increasing trend of caesarean section in the setting of increasing maternal age, obesity and other concomitant diseases will continue to challenge the obstetric anaesthetist in his/her task of providing regional and general anaesthesia. The challenges of providing anaesthesia for an emergency caesarean section, particularly the risks of general anaesthesia, will be debated. The need for involvement of a multidisciplinary team, good communication and challenges surrounding the provision of anaesthesia to such patients are discussed.