Health Education East of England O&G Training Hospital Rotations
The East of England is a geographically large deanery but this provides diverse training within a variety of units.
Training Programme Directors (TPDs) recognise that our deanery is far-reaching therefore are supportive in aiming to club hospital rotations to a geographical area within the deanery - typically clustering around the north, south (particularly accessible to commute to or from London), west and east of our deanery. In December each year you are asked for your three preferred units for rotation the next academic year and rotations are organised accordingly. So come join our deanery without worrying about having to commute for hours each day.
Typically each trainee will spend 12 months for each hospital placement before rotating, except in ST2-3 where we recognise that there is a substantial step up to registrar level; therefore TPDs will try to ensure the trainee remains in the same hospital for those two years to support their training and progression to being a registrar (unless the trainee would prefer not to do this).
Please find below information about each training hospital's department from their corresponding RCOG College Tutor.
For a list of the current Trainee Representatives for each unit please click HERE.
Ms Neerja Gupta
I am Neerja Gupta, Consultant O&G and College Tutor at Basildon University Hospital. I was a trainee at Basildon Hospital and came back as a consultant because of the training opportunities given to me as a trainee.
Basildon has a delivery rate of 4500 per year, 11 full time consultants, 5 SAS Registrars, 3 speciality trainee doctors and 3 GP trainees. Despite it being a busy unit, it provides excellent opportunities for hands-on training in theatre and several ATSMs (for example labour ward management, benign gynaecology, gynaecological ultrasound and urogynaecology). We also run RCOG recognised courses in Basildon such as the Urogynaecology workshop. Most of the ST3 to ST5 trainees who have trained at Basildon ask to come back as ST6-7 in our unit.
Our MRCOG pass rate is nearly 100% due to the support and help during preparation. Consultants are very approachable, friendly and supportive. We are also flexible with study leave.
College Tutor and Associate Training Programme Director for ST3-5:
Mrs Sarah Reynolds
Bedford Hospital is a medium size general district hospital with approximately 3000 births per year. The College Tutor is Mrs Sarah Reynolds (also Associate TPD for ST3-5). There are a range of opportunities for trainees at all levels of the training programme, and lots of hands on experience particularly in gynaecological surgery. We also actively encourage ultrasound training. Previous trainees have completed basic training and intermediate ultrasound modules. We have a gynaecology ultrasound simulator which all trainees have access to. Trainees are given opportunity to scan in EPU and have antenatal scanning sessions too.
We performs lots of day case gynae laparoscopic surgery and have one consultant who performs regularly total laparoscopic hysterectomies and laparoscopic myomectomies. There is access to urodynamics and urogynaecological surgery including sacrocolpopexy, colposusupension and urethral bulking. Trainees are able to borrow laparoscopic simulators to practice their skills at home. Previous senior trainees have completed ATSMs in Acute Gynaecology and early pregnancy, benign gynaecology, advanced labour ward practice, Abortion care & Labour ward lead.
Dr Tint Tint Wai
Dr Tint Tint Wai is happy to be contacted and accept foundation year trainees for a taster week in Obstetrics and Gynaecology.
Our unit is known for being a friendly and busy unit. We provide a range of specialist clinics for both obstetrics and gynaecological conditions. We are one of 3 endometriosis centres in the region and see tertiary referrals from all over the UK. Trainees have ample opportunities to achieve skills. I have completed two ATSMs (Early pregnancy and benign abdominal surgery: laparoscopy) in one year when I was ST6 trainee at Colchester.
There is a busy teaching programme held in the department. We run regular skills and drills by using high fidelity simulator ‘SimMom’, ‘desperate Deborah’ (for impacted head at LSCS), ‘Lucy’ (for rotational ventouse) and ‘PROMPT’ birthing trainer for shoulder dystocia and forceps.
The ICENI Centre opened its doors to trainees in O&G to develop their practical skills for free during their time at the trust http://www.icenicentre.org/coursesevents/gynaecology/ .
The ICENI centre has a global proven track record for delivering high quality laparoscopic courses and other non-technical courses, such as patient safety and human factors.
The unit is well known for offering the advanced laparoscopic, Maternal Medicine and Vulva disorders ATSMs. In addition the following ATSMs are also offered to STRs
- Acute gynae and early pregnancy
- Advanced Labour Ward Practice
- High risk pregnancy
- Benign Abdominal Surgery
- Fetal Medicine
- Labour Ward Lead
The unit is renowned for creating an environment where people can enjoy their work. This often attracts trainees to join the unit, when they complete their training. Currently, there are six consultants in our unit who have been trained at East of England deanery, and five of them were trained at Colchester Hospital.
Mr Alex Field
About Princess Alexandra:
We are a busy district general hospital with around 4,000 deliveries a year serving a diverse population. We are a very friendly group of consultants, permanent non-training grades and midwives with a track record of supporting trainees and a reputation as a very friendly place to work. There are gynaecology operating lists every day including hysteroscopy, termination of pregnancy, vaginal surgery, open surgery and advanced laparoscopic surgery including laparoscopic hysterectomy. We are moving towards a consultant led early-pregnancy service and will shortly be introducing a manual vacuum aspiration service so there should be plenty of training opportunities for early pregnancy ultrasound.
There are plenty of opportunities to attend a wide range of clinics including: general antenatal, general gynaecology, diabetic antenatal, fetal medicine, perinatal mental health, rapid access, colposcopy and outpatient hysteroscopy clinics.
We also support trainees looking to get involved with the non-clinical aspect of medicine including rota design, teaching, publication and committees and forums within the hospital.
We are ideally situated with motorway and train links to London and Cambridge and easy access to Stansted airport.
Dr Sangeeta Pathak
I am Sangeeta Pathak, Consultant and college tutor in Hinchingbrooke Hospital, part of North West Anglia Foundation NHS Trust and on behalf of all consultants, I want to invite you to come and work with us at some point in your training.
We take great pride in providing excellent training across all areas of Obstetrics and Gynaecology. You will be supported by 8 consultants, and work on a 1 in 7 rota.
By working with us you will be able to complete the vast majority of the competencies of the core curriculum and we are able to provide various ATSMs as well as scanning experience.
Approximately 2500 women choose to have their babies at Hinchingbrooke every year and we take some of the excess workload from neighbouring units.
We have a busy Obstetric Medicine clinic, MDAU and we have embraced the GAP project, which has increased our scanning workload, which means more chances for you to learn Obstetric and Fetal Medicine scanning!
The current Eastern Deanery USS preceptor is the Lead for EPAU, TOP and Emergency Gynaecology in our Unit. She facilitates USS training leading to completion of Benign and Intermediate Gynae USS modules and ATSM Early Pregnancy and Emergency Gynae and Termination of Pregnancy. 3 fetal-medicine consultants offer 3 scan lists per week offering plenty of Obstetrics scan training. You can easily achieve basic and intermediate level of Obstetrics scanning competencies.
We perform several advanced laparoscopic gynaecological surgeries with one of the highest total laparoscopic hysterectomy rates and the lowest conversion rate in the region together with other laparoscopic procedures for benign and malignant disease. There is plenty of opportunity to foster your laparoscopic skills and complete the ATSM for Benign Laparoscopic and abdominal surgery.
Ambulatory gynaecology and Rapid Access Clinics are also our pride and joy! You can get your hands on outpatient treatment under local anaesthetic including hysteroscopy (by vaginoscopy), Myosure Polypectomy, Endometrial ablation with Novasure and soon Minitouch endometrial ablation for senior trainees. We have successfully facilitated completion of the hysteroscopy ATSM for various trainees.
We are an BSUG accredited urogynaecology unit and offer training in a range of continence and prolapse procedures including Bulkamid periurethral injections, Botox, Cystoscopy (all offered as outpatients procedures), TVT (currently on hold nationally), Colposuspension, Pelvic floor repair, Vaginal Hysterectomy and Sacrospinous Fixation. We offer urodynamics training including ambulatory urodynamics. We have an excellent record of supporting ATSM trainees through their training.
If reproductive medicine whets your appetite, you can learn gynaecology scanning, ovulation monitoring and we hope soon to be able to do follicular tracking as part of the IVF satellite service. This would provide you with an excellent opportunity to develop skills in assisted reproduction techniques working remotely from an IVF centre.
We are one of the DGH in the region that has managed to create research active culture in the unit. All consultants are GCP trained and Hinchingbrooke has been the highest recruiting DGH in the region. We currently participate in several portfolio research trials and trainees are encouraged to participate actively in these trails at various levels.
We organise various courses for foundations years and senior trainees; laparoscopic course, ATSM LW and ATSM early pregnancy. These courses will be a great opportunity for trainees to be faculty and gain management skills.
School visit have praised us for gynae, early pregnancy, obstetrics scanning and our hands on approach to teaching and our supportive environment.
One of our recent trainees who is now a consultant says “Hinchingbrooke Hospital is a great unit for training in all areas of the curriculum. There is plenty of obstetrics and gynae surgery and ample opportunity for both obstetric and gynae scanning. Valuable training for both junior and senior registrars. Furthermore, the consultants in this unit are all committed to training and provide plenty of support where necessary”.
If you share our ethos of dedication, sincerity and openness, we can work together and we look forward to welcoming you soon.
If your area of interest is not covered and you would like to discuss anything with us before making a decision, please find below contacts of relevant team members:
Erika Manzo - Reproductive/Minimal Access surgery
Hema Nosib - EPAU/Laparoscopic/Minimal access surgery
Sangeeta Pathak - Fetal Medicine/Obstetrics/Research
Suzanne Hamilton - Fetal Maternal Medicine/Obstetrics
Tarang Majmudar - Colposcopy/Gynae Oncology
Yves van Roon - Urogynaecology
Dr Haroona Khalil
Ipswich hospital provides excellent opportunities for all O&G training levels, especially for ST1 and ST4-7. We have adequately busy labour wards with a figure of around 4000 deliveries annually. We are a team of 12 consultants.
We are one of few hospitals of EOE that have a Gynaeoncology centre and receives referral from about 1.25 million population. Trainees feel that they get excellent opportunities for all Gynaeoncology surgeries including trachelectomies. We in addition to Urogynaecology outpatient services and also run full day weekly operative list for urogynaecology and pelvic surgery. There are ample opportunities to learn benign gynaecology surgery as we run about 15 operative sessions in a week. Ipswich hospital offers Specialist Fertility services including clinics like Hysterosalpingo Contrast Sonography (HyCoSy). Other specialist gynaecology clinics are Colposcopy; HMB; PMB; TOP; Urodynamic; Pessary and Paediatric & adolescent gynaecology clinics. Ambulatory gynaecology has been started.
In Ipswich basic and intermediate scanning competencies are easily achieved.
In addition to general antenatal clinics we run high risk pregnancy clinics including combined Diabetic antenatal clinic, medical disorders antenatal clinic, birth choices clinic, fetal medicine US sessions and psychiatric disorder antenatal clinic.
We conduct three consultant led elective CS lists which are hence ideal for ST1-2 who are encouraged to perform these procedures and most of trainees can do around 50-70 CS in a year.
Medical education is our vision, in this regard we have been hosting maximum number of regional teaching days, and perineal repair course, and strongly encourage trainees to participate as organisers and speakers. We are also participating in few national research projects and trainees can get involve for this unique opportunity.
We offer a range of ATSM support, (I myself completed three ATSMs in Ipswich hospital as ST6-7 trainee before becoming a consultant at Ipswich):
- Abortion care—we are in a position to supervise this ATSM
- Acute gynaecology and early pregnancy
- Advanced labour ward practice
- Benign abdominal surgery: open and laparoscopic
- Benign gynaecological surgery: hysteroscopy
- Labour ward lead
- Maternal medicine
- Medical education
- Subfertility and reproductive health
- Urogynaecology and vaginal surgery
If you are thinking to get best skill mix with support and encouragement, we will help you to accomplish your endeavors.
College Tutor and Associate Training Programme Director for Teaching and ST1-2:
Mr Siya Sharma
Mr Sharma is happy to be contacted and accept foundation year trainees for a taster week in Obstetrics and Gynaecology.
I am Mr Siya Sharma – I am the current RCOG Tutor and Consultant Gynaecologist & Obstetrician here at QEH Kings Lynn. I am also Associate Training Programme Director for Teaching and ST1-2.
I take great privilege in being consultant in the region as I was a Specialist Trainee in EoE and I am aware about the high quality Training and Education offered by EoE Hospitals.
My special interests include Medical Education, Laparoscopic and Hysteroscopic Surgery, Assisted Conception and Infertility Management, Early Pregnancy and Acute Gynaecology.
QEH King's Lynn is a well-knit unit of all stake holders. Junior and senior trainees take pride in an environment where each one of them is guided and supported in their progress by trainers. In past decade, all senior ST trainees who have been here at QEH King's Lynn, have been able to a secure a consultant post in and outside the region.
We offer following ATSMs:
- Medical Education
- Acute Gyanecology and Early pregnancy.
- Benign Abdominal Surgery – Open and Laparoscopy.
- Benign Gynaecological Surgery – Hysteroscopy.
- Urogynaecology and Vaginal Surgery.
- High Risk Pregnancy.
- Advanced Labour Ward Practice.
- Labour Ward Lead.
- Obstetric Medicine.
At QEH King's Lynn, there are plenty of opportunities in Gynaecological training. So as a trainer and consultant I enjoy the opportunities I have to offer to my trainees.
Our current FY2, GPVST and ST1-2 trainees have shared their experience with complimentary feedback on induction days:
“I am truly impressed that College Tutor spent two whole days with new staff, introducing department, giving survival tips and showing around wards and theatres. Nice and approachable”.
“Nicely organised (induction) programme”.
“Very useful information for new SHOs + hands-on experience”.
“Good structure, covering all aspects
“SHO tips – practical and useful on the job”.
“I did find this induction useful, especially the clinical sessions”.
“Thank you to everyone who contributed. It was very useful and helpful to feel more prepared”.
I give importance to work-life balance. My family has my full attention on day-to-day basis. Out of my busy work schedule, I spend plenty of time with my family. I enjoy photography, visits to natural habitats like wildlife sanctuaries, jungle and mountain expeditions.
Dr Myat Pann
The Luton and Dunstable University Hospitals serves a local population of approximately 310,000 and has excellent access to Central London by road or rail and to the Midlands and the North via the M1/A1. The town also has an international and domestic airport. It has always been renowned for its friendly atmosphere and good working relationships and an enthusiasm for teaching and training. There are well-developed links with Tertiary Units in both London and Cambridge and there are a number of specialist Outreach clinics. The Trust has Associate Teaching Hospital Status with UCL and The Royal Free. There are strong links with Cambridge Medical School and across the region we have an excellent reputation for Junior staff training.
The hospital has a modern Medical Centre with an active Postgraduate Teaching Programme and a well-stocked library with up to date computer facilities. Good facilities for study and training are also available. The modern Postgraduate Centre provides excellent facilities for continuing education of hospital medical and dental staff and general practitioners. Within the Centre there is an excellent medical library with internet facilities. There is a weekly Grand Round to which the Obstetrics and Gynaecology Department is a regular contributor and a weekly postgraduate meeting attended by both hospital staff and local general practitioners.
With over 5,000 deliveries per year, the maternity unit has one of the highest delivery rates in the East of England region and has the responsibility for treating the most premature babies across the whole of Bedfordshire and Hertfordshire.
The Unit provides various specialist services, also supporting various ATSMs:
1. Fertility services: Satellite unit for IVF and patients referred to Bourne Hall.
2. Urogynaecology: Specialises in advances laparoscopic surgeries including laparoscopic hysteropexy, colposuspensions, tape procedures and various vaginal procedures. Also there is ambulatory Urogynaecology providing outpatient cystoscopy, urodynamics, pessary clinics etc..
3. Endometriosis clinics: We are an accredited centre for endometriosis and we provide advanced laparoscopic surgeries including laparoscopic excision of DIE, excision of endometriotic lesions, cyst removal, stenting, excision of endometriosis in other organs.
4. Colposcopy: We have accredited colposcopists who could help in colposcopy training and exposure to Dysis.
5. Outpatient hysteroscopy: We have dedicated PMB clinics, HMB clinic, Out patient Myosures, Novasure clinics.
6. TOP clinics: we have dedicated TOP clinic and we could provide scanning opportunities and experience in TOP service.
7. Early pregnancy clinic: We have dedicated clinics run by consultant and gives exposure to gynaecology scanning; manage patients with early pregnancy problems, recurrent miscarriage clinics, MVA clinics.
8. Oncology: Luton and Dunstable Hospital is part of the Mount Vernon Cancer Network. The current arrangements are that major gynaecological cancer surgery is centralised at the Herts and South Beds Cancer Centre based at Watford General Hospital. This gives exposure to PMB clinics, oncology clinics, and MDTs.
9. Obstetrics: We have dedicated specialised clinics including joint haematology clinic, diabetic clinics, Cardiology clinics, endocrine clinics, VBAC clinics, specialist midwives clinic, birth options clinics, Perinatal mental health clinics, fetal medicine clinics, preterm clinics, etc…
10. Risk management: We have robust Obstetrics and Gynaecology risk management structure Our Medical team have a key role to play in leading work to improve the safety of patients both in terms of demonstrating exemplary practice and in participating in improvement initiatives. Job plans will reflect this emphasis and a key objective will be to demonstrate your contribution to driving up patient safety at the hospital and the L&D’s aim to “Lead the NHS in Patient Safety”. There are opportunities to attend Risk meeting, clinical governance meeting, etc.
Email: ILIAS.GIARENIS@nnuh.nhs.uk Mr Ilias Giarenis
Mr Gautam Raje
The Norfolk and Norwich University Hospital NHS Foundation Trust is the sixth largest foundation trust in the UK and a centre of excellence for teaching and training.
We are able to offer a three tier-rota to support development of trainees passing from ST2 to 3 as well as resident consultants on labour ward during daylight hours. We deliver around 6000 babies per year and have a full complement of tertiary services. We offer the advanced labour ward ATSM, urogynaecology, benign gynaecology, advanced laparoscopic excision of benign disease, gynae-oncology, paed and adolescent gynaecology as well as advanced antenatal care and labour ward lead. Other ATSMs may well be possible, please contact us to ask.
We are very proud of the quality of care and teaching we can provide, but what makes Norwich unique is our friendly and supportive environment which spans across specialities and professions.
We really hope you will choose Norwich for your training and would be happy to chat about any requirements you might have.
Dr Rebecca McKay
I am Bec McKay, College Tutor for Peterborough City Hospital. I have been a Consultant in Peterborough since 2013 but am a local trainee, so have been part of the region for over 15 years. I worked in Peterborough as a registrar for 3 years during my training and was thrilled to be able to come back.
I am the Lead for Early Pregnancy, Emergency Gynaecology and Termination in PCH and also Gynaecology Governance lead. I have been an Educational Supervisor for over 5 years and was previously Deputy College Tutor.
I am very proud of our unit and its staff, particularly with respect to training. In the last two TEF we have been rated as one of the best in the country for gynaecological training. Our last seven consultant appointees (including me!) were our own trainees, which testifies that our trainees like to stay in our department for ever! The GMC survey for the last 2 years showed our department was the best in the region and second best in the country. Almost all of our trainees request to stay a second year.
Peterborough is a large and busy District General Hospital. We offer almost all ATSMs and most of our hysterectomies are done laparoscopically. We run a very efficient EPAU department with facilities for early pregnancy and gynaecology scanning so completion of the Intermediate Transvaginal Ultrasound modules is easily accommodated. We also run a comprehensive termination of pregnancy service. Our Urogynaecologists perform laparoscopic sacrocolpopexy, Burch colposuspension and other complex urogynaecological surgeries. We have five BSCCP accredited colposcopy trainers. Our delivery rate is more than 5000 and we deal with very complex antenatal patients. We have a large diabetic service and are expanding our Fetal medicine services. Our patients are ethnically and socio-economically diverse making a fascinating and unique area of the region to work in. Our previous College Tutor, Mr Sriemevan embedded an ethos of teaching and training within the department which our whole consultant body has taken on board. Every opportunity is seen as an educational opportunity. I have every ambition to continue Mr Sriemevans’ work and encourage everyone to come and see what Peterborough has to offer.
Ms Radhika Padmagirison
About East and North Herts:
We are a very warm and friendly unit, consisting of seventeen consultants. Whilst we are spread across three hospitals the majority of the work is carrying out at the Lister hospital in Stevenage. The two other hospitals host outpatient clinics.
There is a two tier registrar (Senior and Junior) on call rota and with resident consultants cover between Mondays – Thursday nights, both of which provide great support to both tiers of registrars. The unit is very supportive to ST2’s who are looking at acquiring skills to progress to ST3.
The Labour Ward: The Diamond Jubilee Maternity unit opened in 2011 with a delivery rate of approximately 5,500 a year. It consists of 9 large labouring rooms with a pool room and two theatres well supported by midwifery staff with whom the doctors work very closely. We provide remote CTG monitoring for woman in labour and also try and accommodate woman to deliver in the pool room. There is a separate Triage area and also a Day Assessment unit which are supported by registrars and junior doctors and helps in out-patient management of various obstetric conditions. Our SCBU is a level two unit and able to cater to babies from 27 weeks of gestation. There is the midwifery lead birthing unit which is very popular amongst women who wish to have pool delivery. The elective caesarean section list runs daily and is consultant led providing excellent opportunity for ST1 and ST2 trainees in obtaining competencies in Caesarean sections and also for senior trainees undertaking advanced labour ward ATSM. There is a weekly CTG meeting; joint perinatal meeting and Labour ward forums which all provide with ample teaching and training opportunities. We have monthly Audit meetings where trainees are encouraged to actively participate in audit projects, case presentations well supported by consultants.
Fetal medicine: there are currently three consultants who have fetal medicine clinics and have successfully supported the trainees with the fetal medicine ATSM. There is also a weekly fetal medicine MDT where consultants discuss fetal medicine cases and management.
Woodlands clinic (EPU/Gynaecology emergency): The woodlands clinic was newly built in 2015. It is opened seven days a week, has 5 of supporting nurse practitioners and scanning lists six days a week. In additional to the counselling and assessment rooms it has its own dedicated hyperemesis bay. There is a weekly MDT meeting on Thursday AM to discuss complex cases (PUL) and provide teaching for the juniors. We offer out-patient management of Bartholin’s abscess with Word Catheter and Medical management of Ectopic pregnancy with Methotrexate.
Antenatal Clinics : We have Antenatal clinics running across all sites with specialised Joint Diabetic clinics, Twin Clinics, Perinatal mental health clinics, specialised Maternal medicine clinics to manage woman with Cardiac, Renal and Haematological problems in pregnancy.
Gynaecological clinics and surgery: We have recently become an endometriosis centre and have a consultant who performs advanced laparoscopic procedures. Most of the gynaecology consultants are performing total Laparoscopic hysterectomy and there are about twelve operating lists each week which includes both day cases and inpatient procedures, and the consultant team are keen to give provide training to the trainees to enhance their surgical skills and support various Gynaecology ATSM’s. We provide specialised gynaecology clinics like Endometriosis, urogynaecology including urodynamics and pessary clinic, fertility, recurrent miscarriage clinic. There is a weekly Gynaecology oncology MDT and Uro-gynaecology MDT.
Bancroft suite - we have a dedicated suite for outpatient hysteroscopy and colposcopy lists, run by both consultants and nurse practitioners. These are great opportunities for trainees to increase their skill mix.
Ultrasound Scanning: for both Obstetric and Early pregnancy and Gynaecology scanning, trainees are allocated scanning sessions with the sonographers to ensure completion of their basic log book and to develop their scanning further if desired. In addition there are opportunities to scan in the fetal medicine and early pregnancy clinics with Consultants. We have supported our ST1-3 trainees in completing the Basic Ultrasound log book.
ATSMs: we are currently offering: Advanced labour ward practice, Fetal medicine, Early pregnancy and acute gynaecology, Hysteroscopy, Benign gynaecology: open and laparoscopic, Termination of pregnancy, colposcopy, Obstetric medicine, Urogynaecology.
In addition to the ATSMs we encourage trainees to get involved in audits and service improvement projects. On-going projects include the human factors projects and a sepsis campaign.
For Trainees: The unit provides extensive support to the trainees; we have a College Tutor and Deputy College tutor (overseeing the registrar rota) and a separate consultant who oversees the SHO rota. We have eleven Educational Supervisors who provide support to the trainees all through. We have a Robust Induction program led by the college tutor and Weekly teaching bleep free teaching is well supported by the consultant team. The college tutor meets the trainees once a month to discuss any training issues and feedback from these meetings are vital to improve the quality of training. There is a good education centre with computer facilities. There is a Trust Based “Grand Rounds” which provides with excellent teaching opportunities and to interact with trainees from other departments. There is also a Trust Trainee forum.
And finally we would like to say that most of junior trainees have come back to the Trust as senior trainees and you will certainly enjoy your stay at the hospital and will meet your training targets by working in this very supportive and friendly environment. And last but not the least we would like to mention that the consultants interact with trainees socially and we have had some good social meetings outside work.