The responsibilities of a department of Obstetrics and
Gynaecology of a medical school are the following: patient care,
teaching and training, research, administration and, lastly, official
These tasks should be performed in an atmosphere of characterbuilding
and continuous stimulation; THINK should be the motto
of all times. Other essentials include good management and a
team approach, which should be combined with proper planning,
consultation and contact - nationally as well as internationally
- with scientists in this particular field. The cost-benefit factor
should always feature prominently in all departmental activities,
and of particular importance in this connection would be periodical
analyses of the departmental activities aimed at ensuring
that objectives are being fulfilled.
Patient care should have a high priority rating in departmental
objectives. A comparison of the departments of Obstetrics and
Gynaecology of the three Afrikaans-language medical schools in
the country shows that this university attends to approximately
48% of the total number of out-patients and 47% of the total
number of deliveries handled by these three units annually,
while having only 22% of the total personnel complement.
Moreover, as regards apparatus facilities, this department has
only 15% of the total number of colposcopes and 23% of fetal
heart monitors at its disposal.
Specific facilities for which provision should be made include a
reproductive biology unit including a gynaecological endocrinology
and infertility department, preconception clinic, family
planning unit and mature-women clinic; a gynaecological oncology
unit including a clinic for colposcopy and cytology and a
trophoblastic disease unit; a perinatalogy unit including an
intensive-care unit, facilitites for ante-natal fetal monitoring,
fetoscopv and pre-natal diagnosis and genetic advisory clinics;
uro-gynaecological unit; an ultra-sound unit; and a comprehensive service in the form of social workers and psycologists who
must be part of the team. It should also be the responsibility of
the department to convey information to patients by every
possible means, such as symposia and publications in the lay
Training on a pre- and postgraduate level is a specific responsibility
of this department, and once again when comparing the
three Afrikaans universities it appears that this department provides
training to 43% of the total number of students but has
only 33% of the lecturing staff and 16% of the administrative
staff of the three medical schools combined. A specific aim
should be to increase the retention of medical scientists by
stimulating interest in research and academical medicine. Ongoing
training should also be encouraged in order to maintain the
standard of practice of medicine at an optimal level in this country.
The training of nurses and paramedical staff should also be
maintained at a high level, since these people have an important
role in the team approach of this department.
The value of research cannot be overestimated. Such research
should not only be clinically orientated but should include experimental
animal and laboratory research as well.
The newly established in vitro fertilization research programme
of the department is discussed at length, and reference is made
to the ethical consequences of this new technique.