Residency Program

Goals and Objectives

The NUHS mission is Advancing Health by Integrating Excellent Clinical Care, Research and Education.

The overall goal of the Department of Obstetrics and Gynaecology at the National University Health System is to provide an academic environment that promotes a structured educational experience. It is dedicated towards effective and efficient patient care, stressing a graduated experience of resident responsibility. We aim to provide holistic medical training to develop evidence-based and compassionate clinicians, in a vibrant academic environment with a culture of continual improvement.

By meeting these objectives, residents that graduate from this programme will be capable of entering into the practice of obstetrics and gynaecology whist actively participating in research, quality improvement and innovation, education. In the Singapore context, graduating residents will be eligible to undertake 2 years of further training in fellowship or advanced specialty training programmes to become an accredited specialist in Obstetrics & Gynaecology.

At the beginning of the residency programme, each resident is provided a hard copy of the goals and objectives for the programme. These goals and objectives are reviewed as a group together with the Programme Director for uniform understanding. This document is also available on the department website.

Residents are expected to participate in the yearly CREOG examination. The results of this examination are used to identify areas of weakness in the resident’s knowledge. These areas will be addressed with targeted readings or direct tutoring.

Each resident will be evaluated by the faculty supervisor during his / her rotation. A comprehensive set of evaluation tools has been designed and all residents and faculty are instructed on how to use these work based assessments. All evaluations are reviewed twice per year by the clinical competency committee. Before the resident graduates from residency training at the end of 4 years, a final review is performed.

Residents will be required to take and pass Part 1 of the MRCOG (Membership of the Royal College of Obstetricians and Gynecologists UK) examination. After satisfactory completion of four years of training, residents will be expected to pass Part 2 and 3 of the MRCOG examination. Successful obtainment of the MRCOG is required for progression to the senior residency years R5 & R6.

Resident's Role and Responsibilities

The resident's roles and responsibilities are centered around helping them develop the 6 core ACGME-I competencies – patient care, medical knowledge, practice-based learning, interpersonal and communication skills, medical professionalism, and systems– based practice.

Core Competencies

1. Patient Care

   Residents must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health. Residents must demonstrate competence in:

   1. Evaluating a patient's complaint, providing an accurate examination, employing appropriate diagnostic tests, arriving at a correct diagnosis, and recommending the appropriate treatment;
   2. The essential areas of obstetrics and gynaecology including:
      1. normal physiology of reproductive tract;
      2. high risk behaviours;
      3. diagnosis and nonsurgical management of breast disease;
      4. medical and surgical complications of pregnancy,
      5. delivery including the use of obstetric forceps and/or the vacuum extractor;
      6. gynaecologic surgery;
      7. critically ill patients; and,
      8. obstetric and gynaecologic pathology.
   3. Manual Dexterity
   4. The full range of commonly employed obstetrical diagnostic procedures, including ultrasonography and other relevant imaging techniques; and,
   5. Counselling of women regarding nutrition, exercise, health maintenance, high-risk behaviours, and preparation for pregnancy and childbirth and of those who have undergone genetic amniocentesis.

2. Medical Knowledge

   Residents must demonstrate knowledge of established and evolving biomedical, clinical, epidemiological, and social-behavioural sciences, as well as the application of this knowledge to patient care. Residents must demonstrate knowledge in:

   1. Reproductive health care and ambulatory primary health care for women, including health maintenance, disease prevention, diagnosis, treatment, consultation, and referral;
   2. Menopausal healthcare and geriatric medicine;
   3. The fundamentals of basic science as applied to clinical obstetrics and gynaecology;
   4. Applied surgical anatomy and pathology;
   5. Normal and abnormal reproductive function;
   6. The principles of genetic amniocentesis; and,
   7. Basics of risk-benefit analysis, epidemiology, statistics, data collection and management, and use of medical literature and assessment of its value.

3. Practice-based Learning and Improvement

   Residents must demonstrate the ability to investigate and evaluate their care of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self-evaluation and life-long learning. Residents are expected to develop skills and habits to be able to meet the following goals:

   1. Identify strengths, deficiencies, and limits in one's knowledge and expertise;
   2. Set learning and improvement goals;
   3. Identify and perform appropriate learning activities;
   4. Systematically analyse practice using quality improvement methods, and implement changes with the goal of practice improvement;
   5. Incorporate formative evaluation feedback into daily practice;
   6. Locate, appraise, and assimilate evidence from scientific studies related to their patient's health problems;
   7. Use information technology to optimize learning; and,
   8. Participate in the education of patients, families, students, residents and other health professionals.

4. Interpersonal and communications skills

   Residents must demonstrate interpersonal and communication skills that result in the effective exchange of information and collaboration with patients, their families, and health professionals. Residents are expected to:

   1. Communicate effectively with patients, families, and the public, as appropriate, across a broad range of socioeconomic and cultural backgrounds;
   2. Communicate effectively with physicians, other health professionals, and health related agencies;
   3. Work effectively as a member or leader of a health care team or other professional group;
   4. Act in a consultative role to other physicians and health professionals;
   5. Maintain comprehensive, timely, and legible medical records, if applicable; and
   6. Have the fundamentals of good medical history taking and thoughtful, meticulous physical examination.

5. Professionalism

   Residents must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles. Residents are expected to demonstrate:

   1. Compassion, integrity, and respect for others;
   2. Responsiveness to patient needs that supersedes self-interest;
   3. Respect for patient privacy and autonomy;
   4. Accountability to patients, society and the profession;
   5. Sensitivity and responsiveness to a diverse patient population, including but not limited to diversity in gender, age, culture, race, religion, disabilities, and sexual orientation; and
   6. Ethics and medical jurisprudence.

6. Systems-based Practice

   Residents must demonstrate an awareness of and responsiveness to the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care. Residents are expected to:

   1. Work effectively in various health care delivery settings and systems relevant to their clinical specialty;
   2. Coordinate patient care within the health care system relevant to their clinical specialty
   3. Incorporate considerations of cost awareness and risk-benefit analysis in patient and/or population-based care as appropriate;
   4. Advocate for quality patient care and optimal patient care systems;
   5. Work in inter-professional teams to enhance patient safety and improve patient care quality; and,
   6. Participate in identifying system errors and implementing potential systems solutions.