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South west O&G trainees perspectives on the transition between ST2 and ST3
  1. A L Richardson
  1. Derriford Hospital, Plymouth, UK


The transition between ST2 and ST3 in O&G is a challenging and daunting time. Following the introduction of MMC and the EWTD, clinical experience prior to commencing second on call responsibilities has reduced. Furthermore, statements such as ‘mothers face more risk at night because trainee obstetricians tend to be less experienced’ and ‘junior obstetric doctors could lack the technical skills and experience needed to help make the birth process easier’1 are concerning to all.

In August 2010, when the first complete cohort of specialty trainees was approaching the end of ST3, a survey was distributed to senior SHOs and junior Registrars in Severn, Wessex and Peninsula deaneries to assess trainees' self-perceived readiness to proceed to ST3. Data collected included training experience; confidence and competence levels; number of essential procedures performed with and without supervision and experience of obstetric emergencies. Trainees were also asked whether anything was/could be done in order to prepare them more for their new role.

Although all trainees had at least 2 years experience, 44% were ‘not very confident’ or ‘terrified’ about commencing ST3. Trainees generally felt ‘reasonably competent’ despite having performed minimal numbers of essential procedures without supervision and having nominal experience of obstetric emergencies. Most trainees felt that despite this they did not require more time as an SHO but would appreciate a more formal period of ‘acting up’.

This information can now be fed back to training programme directors to action in attempts to ease and improve the transition period and ultimately patient safety.

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