Training

Welcome to the BSUG Training Subcommittee webpage. Our mission is to improve standards of training and assessment in urogynaecology. We aim to achieve our goals by liaising with the relevant RCOG committees on matters pertaining to urogynaecology. We welcome members contacting us with suggestions and comments on training.   We will provide urogynaecology educational updates on this webpage.

  • Information about Subspecialty training can be found here
  • Information about ATSM training can be found here

Training Subcommittee Update

The main focus of the committee’s activity in 2017-2018 has been liaison with the RCOG on curriculum changes which became necessary following the pause in the use of synthetic mid-urethral slings for stress urinary incontinence by NHS England in July 2018. The committee had already started work on updating the Subspecialty training and ATSM curricula to account for changing surgical practice in urogynaecology and the decline in use of mesh for incontinence and prolapse.

The RCOG have now written to Heads of School, Subspecialty training Program Supervisors, ATSM directors and affected trainees to inform them of the changes and advise them on how training in Urogynaecology can be managed, which will depend on the local situation.

The updated SST and ATSM curricula will be available on the RCOG website as soon as they have been approved by the GMC.   

The Laparoscopic Urogynaecology module is now a compulsory part of the subspecialty training program. It is also available as an optional module for those who have either commenced, or completed the Urogynaecology and Vaginal Surgery ATSM, or who have completed subspecialty training but did not have the option of completing this module. Details of the optional module can be found here

Due to the dominance of synthetic mid urethral sling surgery for stress urinary incontinence over the last 20 years, BSUG recognise that many consultants have either never been taught alternative non-mesh procedures or have become de-skilled. The training committee have developed a Non-Mesh Continence Surgery Mentorship plan to facilitate training post CCT Urogynecologists. This will be in a similar format to pre CCT training and will adhere to the 2018 governance arrangements for continence surgery as set out by NHS England and Scotland. We hope to be able to launch this before the end of the year, after consultation with the RCOG.

Future developments

The Subspecialty and ATSM curricula are due to be revised in line with the Core Curriculum update

What is the difference between subspecialty training and ATSM in urogynaecology?

Subspecialty training programmes are a minimum of 3 years incorporating a 12 month period of research.  Trainees with research exemption are expected to complete a minimum of 2 years clinical training. Details of criteria for research exemption can be found here

In addition to research experience, subspecialty trainees will be expected to complete basic science training and modular attachments in related specialties. By virtue of the duration and nature of subspecialty training, SSTs should progressively develop skills that will enable them to manage recurrent and complex cases of pelvic floor dysfunction. 

ATSM trainees will be expected to spend at least 2 sessions /week in urogynaecology. The remainder of their time will be spent undertaking general training in obstetrics and gynaecology. ATSM trainees will develop a more general skill base in obstetrics and gynaecology in addition to acquiring the competencies required to manage primary cases of urinary incontinence and pelvic organ prolapse.

Subspecialty training in urogynaecology

As of May 2018 there were 14 approved subspecialty training programmes in the UK. To date, there have been 69 accredited subspecialists who have already completed RCOG subspecialty training programmes. However, a recent survey of new consultant appointments indicates that less than 50% of those that complete subspecialty training in urogynaecology are appointed to a subspecialty post in urogynaecology; this is lower proportion than the other subspecialties.

Trainees should seek career advice from their educational supervisor and the urogynaecology subspecialty training programme director or urogynaecology subspecialist within their region. 

  • For advice on eligibility for SST and how to register, please click here.
  • For the curriculum for subspecialty training, please click here.

A list of programmes with Subspecialty Training programme Supervisors (STPS), their Deputies is given below:

Region

Unit

Trainers and Deputies

London (North East Thames)

University College Hospital

Sohier ElNeil
Alfred Cutner

London (South West Thames)

Croydon University Hospital

Ranee Thakar
Abdul Sultan

London (North West Thames)

St Mary's Hospital, London

Mr Vik Khullar
Mr Alex Digesu

London (South East Thames)

King's College Hospital

Linda Cardozo
Dudley Robinson

York and Humber

Sheffield Teaching Hospitals

Stephen Radley
Swati Jha

Mersey

Women's Hospital, Liverpool  

Ruben Trochez
Gillian Fowler

Severn & Penisula

Plymouth

Robert Freeman
Anu Dua

North Western

St Mary's Hospital, Manchester

Karen Ward
Fiona Reid

East of England

Addenbrooke's Hospital

Mark Slack
Ashish Pradhaan

East Midlands

Leicester General Hospital 

Rod Teo
Douglas Tincello

West Midlands

Birmingham Women's Hospital

Phillip Toozs-Hobson
Pallavi Latthe

Oxford

The John Radcliffe Hospital

Simon Jackson
Natalia Price

West Region (Scotland)

Southern General Hospital, Glasgow

Karen Guerrero
Stewart Pringle

ATSM training in urogynaecology

Between 2011 and 2018, 134 trainees have completed the Urogynaecology and benign vaginal surgery ATSM. 101 trainees completed the Urogynaecology ATSM before the 2011 curriculum was launched.

Trainees should seek career advice from their educational supervisor, deanery ATSM director and urogynaecology ATSM preceptor in their region. They should discuss their ATSM preferences and rotations within their region. STs should plan their ATSM options during year 4 which should be documented on their ARCP on conclusion of year 4. During year 5 they should make arrangements for ATSM training and confirm their rotation commencing at the end of year 5.
 
• For advice on RCOG regulations for ATSM Training, please click here.
• For the current curriculum for Urogynaecology and benign vaginal surgery training, please click here.

Details of ATSM Directors and Urogynaecology Preceptors in the different regions are as follows.
The preceptor is responsible for overall training but there will be Educational supervisors for the ATSM in individual units.

Deanery

ATSM director

Urogynae ATSM Preceptor

East Midlands LETB (South) (Northampton; Leicester; Kettering)

Clive Aldrich

Misa Salmon/Doug Tincello/Sunil Doshi

East Midlands LETB (North) (Derby; Nottingham; Linclon)

Summi Abdul

Paul Hooper

East of England LETB

Helen Johnson

Helen Johnson

KSS LETB

Melanie Tipple

Jonathan Duckett

London South LETB

Sonji Clarke

Demetri Panayi

London - North West London LETB

Sadaf Ghaem-Maghami

Vik Khullar

London - North East London LETB

Charlotte Kingman

Arvind Vashisht

North West LETB (Northwest)

Rebekah Samangaya

Sanjeev Prashar

North West LETB (Mersey)

Victoria Sephton

Lorraine Dinardo

North East LETB (Northern)

Karen Brown

Karen Brown

Oxford LETB

Jill Ablett

Jill Ablett

South West LETB (Severn)

Tim Overton

Mark James

South West LETB (Peninsula)

Morven Leggott

Morven Leggott

Wessex LETB

Abigail Kingston

Christian Phillips

West Midlands LETB

Andrew Tapp

Jason Cooper

Yorkshire and the Humber LETB

Marina Flynn

Carmel Ramage

Northern Ireland

Lorraine Johnston

Lucia Dolan

Scotland East

Kalpana Ragupathy

Zbig Tkacz

Scotland South East

Alastair Campbell

Carolyn McKinley

Scotland West

Andrew Thomson

Karen Guerrero

Wales

Ros Goddard

Jeremy Gasson

Urodynamics Training

Urogynaecology subspecialty and ATSM trainees are expected to receive training in dual channel subtracted cystometry. A curriculum for training in all types of urodynamics is outlined in the ‘Joint statement on minimum standards for urodynamics practice in the UK’, 2009.

To download the minimum standards curriculum for training in urodynamics, please click here.

There are 6 modules outlining minimum skills required for six types of urodynamics investigation:
A1 (female) and A2 (male) basic cystometry
Module B (Videourodynamics)
Module C (Urodynamics in neuropathic patients)
Module D (Ambulatory urodynamics)
Module E (Urodynamics in children)

A trainee undertaking an ATSM would be expected to complete A1(female) and SST would be expected to have completed A1 and have had experience of B, C and D.
 
Trainees are expected to attend a theoretical course, in addition to practical experience acquired through regular attendance at urodynamics clinics.
For further information about the RCOG theoretical course please click here.

Resources for Trainers and ATSM Preceptors

Subspecialty training – for information about subspecialty training centre criteria click here.

ATSM training - there are no criteria for ATSM training centres or for Educational supervisors delivering the ATSM. It is strongly advised that trainers should be members of BSUG and use the BSUG database to facilitate audit of outcomes and review of complications.

Heads of School and ATSM preceptors may find the following information helpful when assessing the ability of a centre to deliver the ATSM in vaginal surgery and urogynaecology with or without the laparoscopic urogynaecology ATSM. Centres offering the laparoscopic surgery ATSM should meet the requirements for the vaginal surgery ATSM, in addition to the laparoscopic ATSM criteria:

• For a checklist to assess ability to deliver vaginal surgery and urogynaecology ATSM, please click here

• The suggested centre criteria for the laparoscopic urogynaecology ATSM are the same as for those of the laparoscopic module of urogynaecology subspecialty training. i.e. the centre should perform more than 20 laparoscopic apical procedures (sacrocolpopexy and / or sacrohysteropexy) per year and have arrangements in place for trainees to access laparoscopic hysterectomy.

Current BSUG Training Subcommittee

Karen Ward (Chair)

Anu Dua (Vice Chair)

Sunil Dhoshi

Demetri Panayi

Helen Johnson

Karen Guerrero

Dr Carmel Ramage

Trainees

Victoria Kershaw
Trainee


Rufus Cartwright
Trainee