Gynaecology

Introduction

Guy’s and St Thomas’ Gynaecology Visiting Professional Programme (VPP) is designed to provide international visiting professionals with the opportunity to experience first-hand our leading gynaecology service. The programme offers a unique chance to be fully integrated within a service which is at the forefront of clinical activity, training and research. 

The programmes are designed by our clinical leads to provide unique development experiences which enable visiting professionals to broaden their clinical expertise and learn new skills that can be transferred back to their work place. We are excited to deliver exclusive access to observe and work alongside our gynaecology faculty and to provide an opportunity for international professionals to gain insight into our Trust and the role that our staff play within the NHS.

Programme aims

The programme is aimed at those who wish to extend their clinical expertise in gynaecology within Guy’s and St Thomas’ NHS Foundation Trust.

The aims of the programme include:

• The opportunity to have direct experience and exposure to clinics and ward rounds at a leading gynaecology department
• Participation in multidisciplinary team meetings
• Access to departmental and national seminars and teaching sessions
• The opportunity to develop networks and close links for future close working relations through peer mentorship throughout the programme from a named mentor
• The opportunity to complete specialty projects and research with a view to submission for peer review
• Individual weekly timetables will be created depending on each visiting professional’s requirements.

A Certificate of Attendance will be awarded to visitors upon the end of their programme.

Format

The Gynaecology programme is delivered within the hospital work place and it includes exposure to clinics, inpatient ward rounds, multidisciplinary team meetings, depending on the length of programme that visitors request.

Visiting professionals will be aligned with supervisors from within the clinical teams who will facilitate agreed learning and development needs. We would expect visiting professionals to be totally integrated in the day to day service within our gynaecology team.

We will also provide visitors with the opportunity to get involved in research and improvement projects.

Who can apply

This programme is intended for non-U.K. junior trainee gynaecologists and nurses.

Visitors have the choice of applying for a hands-on attachment or observership programme. Those wishing to apply for a hands-on attachment must have GMC registration and NMC registration. You can apply for GMC registration directly through the main GMC website, alternatively The Royal College of Physicians run a medical training initiative which facilitates GMC registration and provides sponsorship for a Tier 5 visa. You can find out more about their Medical Training Initiative by visiting their website. NMC registration can be applied for via NMC website.

Programme duration

It is recommended that in order to get the most out of the Gynaecology programme, that visiting professionals undertake observership of four to 12 weeks. However, the programme’s duration can be tailored to the specific learning requirements of those visiting the Trust.

Gynaecology service

The gynaecology service at Guy’s and St Thomas’ hospital provides comprehensive care for women with a wide range of gynaecology issues. The service provides inpatient, outpatient and emergency services.

Inpatient services

Our gynaecology ward at St Thomas’ Hospital cares for women who need to stay in hospital after surgery and emergency admissions. The ward has been fully modernised and many of the rooms provide superb views over the river Thames.

Emergency services

The emergency gynaecology unit is based at St Thomas’ and is open seven days a week.

Our clinics

Our clinics are multi professional so doctors, nurses, clerical and secretarial staff work together to try and make sure that patients’ journey through the outpatient department is a smooth one. We want patients to be able to make informed choices about their health, current illness or continuing condition. We aim to respect all cultural and religious beliefs and provide interpreters as needed.

Referrals to our clinics

All patients are referred to the department by a GP or other medical doctor (except for the emergency unit).

Urgent referrals

Patients with suspected gynaecological cancers are seen in our Rapid Access Clinics and can be referred under the two week wait pathway. Two week wait referrals are handled by a designated team.

We predominantly receive referrals from the London Cancer Alliance, which includes:

• Guy’s and St Thomas’
• King’s College Hospital, London
• Princess Royal University Hospital, Farnborough
• Queen Mary’s Hospital, Sidcup
• Queen Elizabeth Hospital, Woolwich
• University Hospital, Lewisham

Outpatients clinics

We run a wide range of general and specialist clinics including:

• suspicion of cancer rapid access clinic (strict referral criteria)
• cancer follow-up clinic
• multi-disciplinary oncology clinic
• colposcopy clinics
• continence and urodynamic service
• reproductive medicine clinic
• recurrent miscarriage service
• outpatient procedure clinics
• menopause clinic for women experiencing a problematic menopause or those requiring HRT (hormonereplacement therapy) advice
• laparoscopic sterilisation clinic offerings counselling to women requesting sterilisation as a contraceptionoption
• hormone dysfunction clinic
• minimally invasive surgery
• endometriosis clinics

General outpatients clinic

This clinic provides consultation and management for women experiencing general gynaecological problems such as heavy or painful periods, fibroids and pelvic pain. We also have an advanced endometriosis clinic. Patients may need to have investigations such as blood tests or a pelvic scan before coming to this clinic.

Pre-assessment clinic

These clinics are nurse-led. They run alongside the general gynaecology clinic.

The clinic nurses assess women booked for surgery shortly before their surgery date. They check that there have not been any significant changes since patients’ last appointment. They also make sure that patients are physically fit for surgery and understand what it involves.

Any investigations and blood tests needed before surgery will be done in this clinic. The clinic is also an opportunity to identify patients who are more likely to develop complications due to the anaesthetic. A specific plan is then drawn up to lower their complication risk.

Research shows that patients who are pre-assessed before being admitted for surgery are less anxious and have a better relationship with the medical staff. Because of this, they generally recover quicker.

We offer a ‘one stop’ pre-assessment clinic for the day surgery unit, so we can assess patients and perform ant tests on the same day as patients’ clinic visit.

Sterilisation clinic

This clinic is led by experienced nursing staff and offers counselling to women considering sterilisation as a contraception method. It aims to make sure that patients fully understand the advantages and disadvantages of the procedure. If patients decide against sterilisation, patients are given advice so patients can make an informed decision about the best long-term contraception method for patients.

Menopause and early menopause clinics

These clinics are run by a medical consultant and a nurse consultant. They see women who have a wide range of menopausal problems, such as severe symptoms, early menopause, problems finding the correct hormone replacement therapy (HRT), bleeding while taking HRT and women who need specialist care as they have other medical conditions. There are also facilities available to investigate abnormal bleeding within this clinic.

Minor procedures clinic

These are nurse-led one-stop clinics for consultation, diagnosis and treatment. Patients will see either a nurse or a doctor who will carry out any investigations needed to diagnose patients’ problem, explain what could be wrong and offer advice and/or treatment. The clinics see women with:

• abnormal or heavy vaginal bleeding, such as bleeding in between periods
• cervical polyps (small growths of tissue on the neck of patients’ womb)
• heavy or offensive (bad) smelling vaginal discharge
• problems with their vagina/vulva
• problems with coils (a method of contraception)

While patients are at this clinic and depending on patients’ specific symptoms, patients may be offered:

• an ultrasound scan – this involves placing a small ultrasound probe into patients’ vagina, so patients’ doctor ornurse can see an ultrasound ‘picture’ of patients’ ovaries and womb

Endometriosis clinic

This clinic is specifically devoted to endometriosis patients provided by a ‘multidisciplinary’ team of gynaecologists, two dedicated lead gynaecology consultants for endometriosis, Professor Janice Rymer and Mr Kumar Kunde, a nurse specialist, laparoscopic bowel surgeons and urologists. We also work closely with the pain management team.

Our consultants are expert in the management of all stages of endometriosis, including the most complex surgical techniques. Patients are involved in all decisions about their care, and their treatment plans will always be based on what is right for their needs.

Our nurse specialist runs a weekly clinic as well as telephone consultations, which provide patients with ongoing support as well as monitoring the impact of their symptoms on their quality of life for up to two years following surgery.

We also run a monthly support group run with volunteers from Endometriosis UK.

Reproductive medicine clinic

This clinic gives advice to women and their partners who are experiencing difficulties conceiving or who have repeatedly experienced problems in early pregnancy. It is linked with the assisted conception clinic on the 11th floor of Tower Wing at Guy’s Hospital.

The clinic team consists of four consultant gynaecologists and other senior doctors who specialise in subfertility, a consultant andrologist (who specialises in male infertility).

Rapid access clinic

This clinic provides a one-stop assessment clinic for patients meeting the NICE (2004) referral criteria for urgent suspected cancer referrals.

This clinic also provides assessment service for suspected gynaecological malignancies from other sources of referral within Guy’s and St Thomas’ i.e. GUM clinic, A&E, other consultants within the Trust.

Bladder, bowel and pelvic floor muscle disorders

The women’s and men’s health physiotherapy service provides specialist physiotherapy care for men and women with bladder, bowel and pelvic floor muscle related disorders.

Treated conditions include incontinence, birth-related pelvic floor conditions, chronic pelvic pain and antenatal and postnatal lower back and pelvic pain.

Early Pregnancy and Gynaecology Unit

This is a nurse-led, specialist unit for women who need emergency care for GP referral of an acute gynaecological problem (problems related to the female reproductive system) or self referral of women having a problem in early pregnancy (up to 18 weeks into), such as pain, bleeding or severe vomiting.

Gynaecological oncology

Our gynaecological oncology clinic offers:

• a one-stop diagnostic and assessment clinic, providing ultrasound, colposcopy, hysteroscopy and biopsies
• fertility preserving surgery for women of reproductive age with early cervical and ovarian cancers. Access to the assisted conception unit (ACU) for in vitro fertilisation (IVF), embryo freezing and advice on surrogacy
• advanced laparoscopic and robot assisted surgery (key hole surgery)
• complex radical surgery for recurrent gynaecological cancers, with reconstructive surgery, provided by a specialist team of pelvic surgeons.
• If patients’ GP suspects that patients’ symptoms may be due to cancer patients will be given an appointment to see one of our specialists within two weeks.

Fees

A course fee per week will be applied; this fee excludes accommodation and travelling expenses. To find out the fee amount please email vpp@gstt.nhs.uk.

Please note

Clinicians are able to offer bursaries or discounted placements on an individual basis. This is at the discretion of the Directorates of GSTT and does not affect the terms and conditions of the Visiting Professional Programme agreements.