Since 2013 National Women’s Health (NWH), Auckland City Hospital has been accredited for 12 months training for the Society of Obstetric Medicine of Australia and New Zealand (SOMANZ) Obstetric Medicine Certificate and has recently expanded to two trainees: an advanced trainee registrar and a fellow. This training experience is supported by the SOMANZ curriculum “Recommended training experiences for Advanced Trainees with an interest in obstetric medicine”1. We sought to determine if the rotation offers learners the broad range of clinical experiences required to address the curriculum objectives.
A retrospective review of all inpatient and outpatient clinical encounters experienced by the trainees was conducted over a 6 month period. These encounters were matched with the Obstetric Medicine Curriculum to identify any gaps in the training experience.
Five hundred and seven unique patient encounters were experienced in a range of Obstetric Medicine settings including inpatient (46%) and outpatient clinics (54%). Clinic exposures included general obstetric medicine (22%) , high risk (46%) and maternity diabetes (32%). Preconception consultations, and post partum followup occurred, alongside consultations in pregnant women. Trainees experienced 93% of clinical encounters recommended by the curriculum. The most frequent inpatient consultations were: diabetes, cardiac disease, and hypertensive disorders and for outpatients: diabetes, thyroid disease, cardiac disease and thrombotic disorders. Identified gaps in experience included medical complications of tocolytic therapy and exposure to gynaecologic, menopause and male preconception referrals.
The obstetric medicine rotation at NWH offers a broad range of clinical experiences and settings enabling a robust and comprehensive training experience. Notable strengths include the volume of exposure to women with congenital and acquired cardiac disease as well as diabetes. Identified gaps will be addressed by targeting clinical experiences and developing case-based teaching scenarios. Next steps will include formal curriculum mapping and the development of a competency based Obstetric Medicine curriculum.