Obstetric Medicine training can be acquired through two main training pathways: physician training and obstetrics and gynaecology.
The Royal College of Physicians does not formally recognise Obstetric Medicine training as a speciality of medicine. However, obstetric medicine forms a module within the Acute Medicine Curriculum and some physicians choose to expand their knowledge and experience in obstetric medicine via out-of programme experience/training (OOPE/OOPT). There are two centres in the UK offering such attachments:
Oxford (contact Lucy McKillop for details)
John Radcliffe Hospital: 6 month post, however, funding needs to be obtained independently (often through contribution to the acute medicine on call rota).
London (contact Catherine Nelson-Piercy / Anita Banerjee / Charlotte Frise / Mandish Dhanjal for details)
Queen Charlotte’s Hospital & Chelsea Hospital: 1 year post. Trust funded. ST4 or above (any physician speciality).
St. Thomas’ Hospital: 1 year post. Deanery funded. ST4 or above (any physician speciality)
St. Thomas’ Hospital: 6 month post. Trust funded. ST4 or above (any physician speciality). Contributes to Medical Education (runs PACES exam)
With the formation of Obstetric Medicine Networks and reconfiguration of maternity services in the future, physician training may change and hopefully recognition and money to develop and train physicians will be granted.
Many units around the country do not have obstetric physicians, but rely on trained obstetricians and physicians (often with an interest and experience in looking after pregnant women) in provided joint, multidisciplinary clinics.
Maternal medicine is part of the RCOG Core Curriculum and is a recognised advanced training specialty module (ST 6 and 7). Further training in maternal medicine is possible through subspecialty training in Maternal and Fetal medicine. Theoretically, it should be possible to minimise fetal medicine training and focus on maternal medicine, however the reality is that many units (rightly or wrongly) concentrate on fetal medicine since this requires skills, knowledge and acquisition of invasive techniques that simply take time (several years) to acquire.
Arguably the best way to train as an obstetrician is to take time out to do core medical training and acquire MRCP(UK), either at the beginning (prior to run-through training) or around ST6-7. However, for many this will be difficult due to the expectations of the RCOG run-through training pathway (difficulty negotiating both time out-of-programme and doing the medical rotation itself) and family and/or other commitments.
Depending on your views of obstetrics, the obvious downside to training via the obstetric route is that you will become an obstetrician and therefore be expected to provide acute obstetrics. For many physician-types, this is a deal breaker!
The MacDonald Obstetric Medicine Society actively supports training from both approaches as however and whoever delivers obstetric medicine care benefits through the sharing experience and knowledge.