Exploring the scope of practice and training of Obstetricians and Gynaecologists in England, Italy and Belgium: a qualitative study

Risso-Gill, Isabelle; Kiasuwa, Regine; Baeten, Rita; Caldarelli, Ilenia; Mitro, Silva; Merriel, Abi; Amadio, Giulia; Legido‐Quigley, Helena

doi:10.1016/j.ejogrb.2014.06.017

Cited by 3 publications

(3 citation statements)

References 19 publications

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“…There is no obvious correlation between the type of institution involved and the severity of measures imposed, suggesting that, despite considerable differences, a convergence of disciplinary approaches might be feasible. However, Risso-Gill et al 10 noted how regulatory institutions with broader remits, such as those in Austria, Germany and the UK, reported employing severe sanctions more frequently when presented with a range of examples of professional misconduct. Furthermore, the variability of disciplinary processes found in participating member states implies that a harmonisation of procedures across the board would require detailed analysis of existing structures and the inclusion of alternative options where fundamental differences exist.…”

Section: Discussionmentioning

confidence: 99%

Deciding when physicians are unfit to practise: an analysis of responsibilities, policy and practice in 11 European Union member states

Struckmann¹,

Panteli²,

Legido‐Quigley

et al. 2015

Clinical Medicine

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In 1974, the European Economic Community established mutual recognition of medical qualifications obtained in any of its member states. Subsequently, a series of directives has elaborated on the initial provisions, with the most recent enacted in 2013. However, greater movement of physicians across borders and some high-profile scandals have raised questions about how to prevent a physician sanctioned in one country from simply moving to another, without undermining the principle of free movement. A survey of key informants in 11 European Union (EU) member states was supplemented by a review of peer-reviewed and grey literature, with the results validated by independent reviewers. It examined processes, adjudicative and disciplinary measures that are in place to evaluate physicians about whom concerns arise, and related sanctions, along with other aspects of professional standards and regulation. Overall, responses varied greatly between participating countries, with respect to the institutions responsible for the regulation of medical professions, the investigation processes in place, and the terminology used in each member state. While the types of sanction (removal from the register of medical professionals and/or licence revocation, suspension, dismissal, reprimand, warnings, fines, as well as additional education and training) applied are similar, both the roles of the individuals involved and the level of public disclosure of information vary considerably. However, some key features, such as the involvement of professional peers in disciplinary panels and the involvement of courts in criminal cases, are similar in most member states studied. Given the ABSTRACT variation in the regulatory context, individuals and processes involved that is illustrated by our findings, a common understanding of definitions of what constitutes competence to practise, its impairment and its potential impact on patient safety becomes particularly important. Public disclosure of disciplinary outcomes is already applied by some member states, but additional measures should be considered to protect medical professionals from undue consequences.

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Section: Discussionmentioning

confidence: 99%

Deciding when physicians are unfit to practise: an analysis of responsibilities, policy and practice in 11 European Union member states

Struckmann¹,

Panteli²,

Legido‐Quigley

et al. 2015

Clinical Medicine

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“…Actually, advances in technology have expanded the field of obstetrics and gynecology and made training and developing skills in different subspecialties a great challenge. 8 , 9 It seems that candidates preferred scientific research that enabled them to gain skills, and ultrasonography represented the first choice. Ultrasonography is relatively easy to learn, with great application in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Scientific research in obstetrics and gynecology: changes in the trends over three decades

Kassem¹

2014

IJWH

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AimThe aim of this work was to assess scientific research of master’s and doctoral theses and essays in the Department of Obstetrics and Gynecology, Zagazig University, Egypt.Materials and methodsAll master’s and doctoral theses and essays since the foundation of Department of Obstetrics and Gynecology, Zagazig University, Egypt, in 1975 till end of 2012 were reviewed.ResultsA total of 703 theses and essays were reviewed. The important topics in the specialty of obstetrics and gynecology were covered and updated. Infertility, in vitro fertilization–embryo transfer (IVF-ET) and related techniques, and polycystic ovarian disease were the most common gynecologic topics (27.2%), followed by gynecologic oncology (18.5%). Preeclampsia was the most common obstetrics topic (18.8%), followed by issues of high-risk pregnancy, fetal growth restriction, and fetal well-being (11.6%). The number of researches that allow the candidates to learn skills was 183 and it was increased from 4.4% of all research in the period 1979–1988 to 33.2% in period 1989–2000 then slightly decreased to 31.2% in period 2001–2012. Ultrasonography was on the top and was present in 99 out of 183 (54.1%) followed by laparoscopy (30, 16.4%), hysteroscopy (25, 13.7%), IVF-ET and related techniques (16, 8.7%) and colposcopy (13, 7.1%) researches. Multi-disciplinary research was decreased by 61.7% in the period 2001–2012. Researches in academic fields were abandoned and in some clinically important areas like preeclampsia were decreased.ConclusionScientific research of master’s and doctoral theses and essays was comprehensive, updated, and had some autonomy independent of plans. Research which enable the candidate to learn skills were increased on the expense of academic, clinical and multidisciplinary research. It could be recommended that plans for scientific research should be flexible and should leave a space for local departmental views. Proper training of residents during their rotation in these subspecialties may help to revive the lost interest in clinically important areas.

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“…In the United Kingdom and Australia, the introduction of combined early pregnancy and acute gynecological units led to a drop in hospital admissions, improved patients' satisfaction, accounted for significant cost savings and decreased ED occupancy [6] [7] [8]. In France and Italy, similar results were obtained by hospital-based emergency services run by obstetriciangynecologists [9] [10]. Striking similarities exist between emergency medicine physicians and obstetrician-gynecologists: caring for unscheduled patients with urgent health problems, dealing with unanticipated crises, facing circadian disruption, coping with medical legal liability and work related stress are only few of the features these providers share [11] [12] [13].…”

Section: Introductionmentioning

confidence: 94%

Retrospective Cohort Study on Acute Care in Obstetrics and Gynecology: Analogies and Differences When Compared to Emergency Medicine

Chiossi¹,

Palomba²,

Balduzzi³

et al. 2017

OJOG

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Introduction: the demand for urgent obstetric and gynecology care has progressively increased: in the United States approximately 1.4 million gynecologic visits are made to the emergency department (ED) annually, while almost 75% of women make at least 1 unscheduled visit during pregnancy. Moreover, research has recently focused on setting standards in unscheduled care, and developing quality indicators to improve patients' health. Therefore, we investigated the characteristics of women with acute gynecological or pregnancy complaints using quality indicators developed for emergency medicine, to better define the needs of this population and improve care. Methods: Retrospective cohort study on ED, and Obstetrics and Gynecology (ObGyn) triage visits, at a tertiary care hospital in Italy, during 2012. Data were analyzed with population-averaged logistic regression and Poisson regression. Results: When compared to the 33,557 ED visits, the 9245 ObGyntriage referrals were more frequently associated with pregnancy (≤12 weeks ' gestation, OR: 30.7, 95%CI; >12 weeks' gestation, OR 81.2, 95%CI; vaginal bleeding (OR 156.6, 95%CI;, diurnal (night access OR 0.87, 95% CI; 0.78 -0.96) and weekday access (holiday access OR 0.87, 95%CI; frequent users (recurrent ED visits IRR 0.87, 95%CI;) and lower hospital admissions (ED admission OR 1.6, 95%CI; 1.4 -1.8). Conclusion: ObGyn triage patients differed from ED users, and were at higher risk of "crowding". Such diversities should be considered to improve female healthcare services and allocate resources more efficiently.

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Exploring the scope of practice and training of Obstetricians and Gynaecologists in England, Italy and Belgium: a qualitative study

Cited by 3 publications

References 19 publications

Deciding when physicians are unfit to practise: an analysis of responsibilities, policy and practice in 11 European Union member states

Deciding when physicians are unfit to practise: an analysis of responsibilities, policy and practice in 11 European Union member states

Scientific research in obstetrics and gynecology: changes in the trends over three decades

Retrospective Cohort Study on Acute Care in Obstetrics and Gynecology: Analogies and Differences When Compared to Emergency Medicine

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