• Program Director
• Associate Program Director
• Chief Resident
• Program Coordinator

The Residency training program in obs/gynae at Shifa International Hospital will comprise of four years of training in Obstetrics and gynaecology. This training is recognized by the College of Physicians and Surgeons of Pakistan for F.C.P.S part II and is formulated as per CPSP guidelines. Both CPSP approved Supervisors and non- CPSP approved Supervisors will conduct and supervise the training program at Shifa International Hospital.

The following general guidelines will be followed:

• The duration of training will be four years
• Most of the training will be in Obstetrics & Gynecology
• Sub-specialties as per guidelines will be followed
• Substantial part of the program will be at Foundation, SIH Clinic & IPD Clinic.
• Dissertation topic as part of requirements will be started within six months and completed during first two years
• Every Postgraduate trainee (PG) will have a faculty member as a mentor other than trainees registered for MRCOG.
• The program will have a Chief Resident. The function of the Chief Resident will include: ensuring that PG’s follow guidelines; prepare discussions, journal clubs, M&M etc.; make changes to schedule with consent of other PG’s; ensure PG’s are available and accessible in areas designated; is available to help other PG’s when needed; keep log books up to date and verified by a faculty on weekly basis etc.
• No more than fifteen days’ leave is allowed every six months (i.e. 2 days per month).
• No leave is allowed calling from home.
• Two half leaves are equal to one full leave and three short leaves are equal to one full day leave.
• In four-year training only one maternity leave is allowed as per CPSP rules.
• Any PG trainee who is unable to prepare an assignment or takes emergency leave will have to arrange on his own with fellow PG’s and will be required to do so in future
• Every PG will be responsible for patients on his/her floor and will make sure history, physical examination on each patient is complete; follow all labs; perform and arrange procedures as ordered by the faculty; write daily notes as per format of SOAP etc. If he or she is absent she will have to make sure another PG follows his/her patients
• Any PG who fails to perform adequately or is found in unethical activities will face disciplinary action.

• Clinical Training Obs & Gynae training will be a graded EXPERIENCE offering more independence, teaching opportunities and supervisory roles to the residents as they progress through training programme.

Year I: Emphasis during the first year will be on direct patient care with acquisition of the basic knowledge and technical skills essential for the care of both sick and routine antenatal patients. First year assignments will include rotations on inpatient obs/Gynae services and emergency room. The first year resident (R-1) will be the primary physician on all of the inpatient units and will gain EXPERIENCE in patient management under the supervision of senior resident and faculty.

Year II: During the second year residents will progress into a supervisory role assisting the work of R-I and helping students in clerking patients. They will be assigned to Inpatient, outpatient, emergency room. Rotation through some subspecialty areas as part of their training will also occur. They will be in the wards and be primarily responsible for the patients in the team. They will be expected to ensure that good quality medical records are being kept, prepare for clinical presentations and help in medical audit, mortality & morbidity meetings.

Year III: This year will be structured to permit the resident to function primarily in a supervisory capacity and to further pursue specific career goals. As the senior resident, rotations may be on all the inpatient areas of the department, ambulatory care and emergency room. Flexibility in these rotations and elective assignment will allow for individual preference and continued exploration of career goals. During this year they will be expected to submit their dissertation for the requirement of FCPS part II.

Year IV: During the fourth year the resident will spend more time in surgeries subspecialty areas and high dependency areas. They will also be expected to work on a research project with the concerned faculty. Their role on the wards will include taking the consults for the team, teaching junior residents, students and coordinating postgraduate sessions. They will be expected to actively take lectures and tutorials of students.

Time framing of the clinical rotation;

Clinical rotations through the different areas would be in line with the broad guidelines given by the College of Physicians and Surgeons and would be structured as below:

• SIH OPD 16 Months
• FALAHI OPD
• Labor Room 16 Months
• IPD Wards 10 Months

• Radiology 3 Months
• Paediatrics 3 Months
• Anesthesia 3 Months

• Didactic Content: This will comprise of daily sessions involving patient care meetings, grand rounds, morning report, journal club, case conferences, clinical seminars and postgraduate lectures. In addition to these there will be perinatal, and maternal morbidity and mortality meeting, radiology conferences and audit evaluation sessions. Guest lectures by eminent gynecologist from Pakistan and overseas are arranged regularly. Interested candidates are encouraged to join the research activities of the department.

The Trainee on completion of residency programme in Obs/Gynae at SIH will be expected to:

• Have a good knowledge of basic health sciences (e.g. Anatomy, Physiology, Biochemistry, Pharmacology and Pathology) applied to Obs/Gynae.
• Be competent in gathering of pertinent clinical information of patients, including histories, physical examination and be able to order and correctly interpret investigations. She should be skilled in using all the data gathered for efficient and cost effective management of his patients.
• Be competent in data collection and maintenance of efficient records.
• Be able to monitor the health of normal patients.
• Be able to differentiate sick patients from healthy ones.
• Have good communicating skills with the patients, their parents, family, colleagues and peers.
• Have developed supervisory (e.g. supervision of junior residents/interns) and good managerial skills.
• She will be expected to be well versed in all aspects of obs/gynae and have the additional knowledge of the specific needs of the country with regard to maternal health, its health promotion and health education in obs/gynae, including National Health Programs.
• Show interest in self-reading, research, continuous education and keep up with current literature. Be competent in patient advocacy.
• Be able to handle emergencies.
• Be able to practice obs/gynae in the community, keeping in view Pakistan’s maternal and child health problems and the prevalent socioeconomic conditions.
• Be aware of the health delivery system of Pakistan, Ministry of Health, WHO Projects and UNICEF Projects etc.

By the end of the training the gynae resident should be competent in the following procedures:

• Obstetrical Examination
• Gynecological Examination
• Minor Obstetric Procedures e.g./ ARM etc.
• Minor Gynecological Procedures e.g./ P/ S Examination, Bimanual Examination, Pap Smear taking.
• SVD
• Operative Vaginal Delivery
• Cesarean Section
• Diagnostic and therapeutic D&C
• IUCD insertion
• Assisting Major Gynecological Surgeries e.g./ Laparotomy, Hysterectomy (Abdominal + Vaginal)

The prime purpose of residency program in obs/gynae is to enhance and direct the development of young medical doctors so that they can serve with distinction as specialists. Within the residency programme is a recognizable "core" program of knowledge, skills and human qualities essential for all gynecologist + obstetricians. 

The instructional objectives in general Paediatrics are separated into:

I. KNOWLEDGE This will involve the ability to acquire, store, and retrieve facts, information and concepts and to establish relationship among facts and pattern recognition.

II. SKILLS This will include acquisition of clinical skills byz88; history taking, physical examination, communication by written medical record and by case presentation, problem solving, critical appraisal of medical literature and ability to apply rules of evidence pertaining to the value of diagnostic and therapeutic procedures.

The programme will also impart technical skills with an ability to perform the procedures of physical examination and investigation, safely and efficiently.

III. ATTITUDES The various components of doctor-patient relationship including the observable demonstration of sympathy, understanding, objectivity, professional conduct and ongoing support will we hope help in making not only good physicians but compassionate professionals. Additional characteristics including critical attitude towards medical literature, cooperative interpersonal relationship with other members of the health care team, awareness of ethical, moral, social and economic implications will also be part of the programme.

Curriculum of the Core programme of Obs/Gynae

The curriculum of the core program of obs/gynae will include educational objectives with application to the broad fields of obs/gynae.

•  Clinical anatomy of the pelvis and reproductive tract
• Maternal physiology
• The placenta and fetal membranes
• Normal fetal growth
• Pre-conception counselling
• Antenatal care
• Normal labor
• Fetal monitoring during labor
• Analgesia and anesthesia
• Puerperium and lactation
• Neonatal care for obstetricians
• Spontaneous miscarriage
• Recurrent miscarriage
• Ectopic pregnancy
• Trophoblast disease
• Prenatal diagnosis and genetics
• Fetal medicine in clinical practice
• Obstetric emergencies
• Disorders of fetal growth and assessment of fetal well-being
• Multiple pregnancy Preterm labor
• Preterm Labor
• Prolonged pregnancy
• Induction and augmentation of labor
• Mal presentation, malposition, cephalopelvic disproportion and obstetric procedures
• Hypertensive disorders
• Heart disease in pregnancy
• Diabetes and endocrine disease in pregnancy
• Renal disease
• Hematological problems in pregnancy
• Miscellaneous medical disorders Obstetric statistics
• Contraception
• Termination of pregnancy
• Normal and abnormal development of the genital tract
• The menstrual cycle
• The role of ultrasound in gynecology
• Gynecological disorders of childhood and adolescence
• Primary amenorrhea
• Polycystic ovary syndrome and secondary amenorrhea
• Menstrual problems: menorrhagia and primary dysmenorrhea
• Premenstrual syndrome
• Pelvic infection
• Chronic pelvic pain
• Endometriosis
• Infertility
• Assisted reproduction
• Menopause and the postmenopausal woman
• Pelvic floor dysfunction I: utero vaginal prolapse
• Urinary incontinence
• Hysteroscopy and laparoscopy Benign disease of the vulva
• Malignant disease of the vulva and the vagina
• Benign diseases of the vagina, cervix and ovary
• Premalignant and malignant disease of the cervix
• Epithelial ovarian cancer
• Benign disease of the uterus
• Cancer of the uterine corpus
• Sexual dysfunction
• Ethical dilemmas in obstetrics and gynecology
• The law and the obstetrician and gynecologist
• Domestic violence and sexual assault

Daily Schedule:

• Morning Reporting Time 08:00 am
• Morning Teaching Session 09:00 – 10:00 am (Includes morning report and topic discussion)
• Duties at the assigned station 10:00 am - 04:00pm

Rotation Stations:

• Labor Room
• OR
• Floors
• OPD SIH
• OPD FALAHI

All Pg’s are assigned at different stations for period of 2 months after which they rotate to next station.

Monthly Events:

• Multi – Departmental CPC (Every 3 months)
• CPC (Every 2 months)
• Grand Round (Once Every Six months)
• Audit (Once in a month)

There will be a one-in- four (or three) nights and weekends on-call Rota. A total of at least 4 residents will be covering all the pediatric IPD areas.

PG-II/III or IV resident will be on night call in L&D to cover Labor Room, Ward and Operating Room. One PG each will cover the following areas: Wards (G3, B3), Wards (Foundation IPD) and ER.

Residents are evaluated by faculty every month, based on their rotation. Feedback is provided by the Programme Director and Coordinator, every 3 months.
Annual TOACS and Year end PGME exams are conducted. In addition, formative assessments based on assorted topics may be arranged every 2-3 months.

Candidates are required to fill on-line application form. Please follow the steps mentioned below:
1. Register yourself by defining user name and password.
2. After your account is created, you will need to login to fill the Application Form. Programs offered will be displayed after registration.
3. A candidate can apply for only one program at a time.
4. Candidate may partially fill the form and save it on-line for resuming filling out the form later using login credentials.
5. Once the on-line application form is filled and submitted, candidate would be able to take a printout.
6. The hard copy of the on-line application form along with the required documents mentioned in the Application Form must be submitted to the PGME Office, Medical Staff Affairs either personally, through friends/relatives or through reliable courier service.

7. Check your junk emails (in case of email not received).

If there is still confusion, then follow these Steps

Step 1. Register yourself
Step 2. Check your email address and click on the received link
Step 3. Login
Step 4. Fill the Profile necessary information
Step 5. Submit
Step 6. Ok
Step 7. Online Application Form
Step 8. Select Program or Medical Officer
Step 9. Select specialty
Step 10. Submit
Step 11. Print application form.

All residents are encouraged to get involved in audits and research projects, however research project as per CPSP requirements is mandatory for all.

• MBBS or equivalent
• One-year House Job
• FCPS Part 1
• MRCOG Part 1
• MCPS

Candidates applying for the program must have completed their M.B.B.S. from a recognized institution, one year of internship (House job) and should have cleared their F.C.P.S. part I examination.