O&G offers a combination of medicine and surgery, with opportunities to
subspecialise in diverse areas. Obstetrics is a practical specialty that
deals with women who (for the most part) are young and fit, during what is
usually a happy life event. For these reasons it can be very satisfying.
Gynaecology also deals mainly with young or middle aged women who tend to be
otherwise healthy. Gynaecologists see a wide range of problems, most of
which can be treated successfully.
Effective communication skills with an ability to listen to and
empathise with women are vital since there is a high degree of patient
contact. It is also important to be able to remain calm and act decisively
in emergency situations. Good hand/eye co-ordination skills are necessary.
While you are training and undertaking call work you need to be
well-organised and able to prioritise your workload.
A daily schedule can vary enormously, depending on the type of
specialist practice and the number of hours worked. Full time hospital
specialists usually spend 7/10 of their time in contact with patients
(including clinics, operating lists and fixed on-call sessions) and 3/10
devoted to administration, CME and audits.
There are many ethical issues to be faced in a wide range of areas such
as management of unwanted pregnancies, genetic screening, assisted
reproductive technology, and management of very pre-term labour and delivery
and care of the neonate. For obstetrics in New Zealand there are concerns
about the rising caesarean section rate and medico-legal pressures, and the
interface between independent midwifery services and specialists presents an
ongoing challenge. Staffing of hospitals in the public sector is an issue
that needs addressing, since there is a shortage of middle grade staff. It
will also be important to maintain the correct balance between training and
service for registrars.
It is recommended that you should undertake a six month run as a house
officer if you are interested in pursuing this specialty. It is possible to
complete a diploma in O&G at National Women’s Hospital. While this is not a
prerequisite for entry into the training programme, it may be worthwhile
considering if you are undecided about the direction of your career.
Opportunities in this specialty depend on the type of practice and the
location. Employment prospects are particularly good in provincial centres,
and it is likely that the number of full time hospital posts in Auckland
will increase over the next few years. Gynaecology referrals in private
practice tend to be directed to female specialists.
Overseas work is strongly encouraged during training or the
post-Membership years to provide greater breadth and depth of experience.
Having children during the first four years of training would be difficult:
contributors suggest that you would require a live-in nanny or a high level
of support from a spouse. Ideally you should complete the exams before
having children, as it is relatively easy to carry out the two
post-Membership years later on if necessary (you have a total span of five
years in which to complete this work).
During training you need to be prepared to travel, which could affect
family life. One contributor said that the impact of the specialty on family
is significant and that you need to be well-organised in order to maximise
quality time at home. Private practice usually entails a considerable amount
of paperwork and hours that are very long.
Complaints and medico-legal issues can arise in all fields of medicine,
and because of the nature of the work, obstetrics and gynaecology is prone
to receive its share of these. Most complaints result from communication
problems rather than specific negligence.
The course is said to be well-structured, with excellent teaching in the
training programme. Trainees recommend that you should consider attempting
the Membership exam at the beginning of the fourth year of training so that
you can re-sit at the end of the year if necessary.
