"The specialisation Obstetrics and Gynaecology residents work with has multiplied"

Eduard Gratacós is an expert and pioneer in Fetal Medicine and, for more than six years, has been director of the BCNatal consortium, which brings together the activities of SJD Barcelona Children's Hospital and Hospital Clínic. In this interview, Gratacós reviews the key elements of the Obstetrics and Gynaecology MIR at both centres. Gratacós, who teaches at both hospitals, discusses how training has evolved at Hospital Clínic, where he completed his residency during the 1990s, and the growth and specialisation of joint activities with SJD Barcelona Children's Hospital.

What kind of activities do Gynaecology and Obstetrics residents currently perform?

They perform diverse and highly specialised activities. This is one of the advantages of BCNatal, which enables rotations both inside and outside of SJD Barcelona Children's Hospital. Residents will be able to observe and follow Gynaecological Oncology cases thanks to our agreement with the Institut Català d'Oncologia - Hospital de Bellvitge and will also do rotations at the Hospital Clínic, specifically in the field of assisted reproduction. This is one of the most in-demand reproduction units and one of the most prestigious centres in Europe, with more than 1,500 cycles every year and a longstanding academic tradition. They will also work extensively in Gynaecology and Obstetrics at SJD Barcelona Children's Hospital, where they will take part in surgeries, low, medium and high risk consultations, the Obstetric Intermediate Care Unit, childbirth and hospitalisation, among other things.

What type of cases do resident medical interns highlight throughout their residencies?

Particular focus should be placed on high specialisation and multidisciplinary care for the complexity. Our residents may come across over a thousand highly complex cases, more or less, while training at SJD Barcelona Children's Hospital, thanks to weekly joint sessions with Hospital Clínic. They will be able to analyse and witness the course of different types of maternal and fetal pathology at a centre that treats the most fetal anomaly cases in Spain and throughout Europe.

During the residency they also gain extensive knowledge of our lines of research, including fetal neurodevelopment, cardiovascular disease, therapy and fetal surgery and prematurity, among others. Moreover, in addition to contact with pioneering research teams in Europe, they will also have the opportunity to carry out teaching activities themselves and to answer questions from other residents at a later stage in their training.

The residency paves the way for each individual's career, and with all the specialities available, resident medical interns are able to make the right choices about their future.

How has the residents' situation changed over the last few years, based on your own experience?

The journey towards a high level of specialisation has been and continues to be unstoppable and during the last 20 years we could even say that it has quadrupled. Our goal is that the residents work with very specific knowledge from which they learn a lot. Our greatest achievement to date has been maintaining a global vision and not fragmenting patient care, which is always conducted in a coordinated and multidisciplinary manner. The residency paves the way for each individual's career, and with all the specialities available, resident medical interns are able to make the right choices about their future.

What did a resident's future look like 20 years ago and what does it look like today?

When I did my residency, Fetal Medicine was still in its early stages. Nowadays, prenatal care is not complete without this discipline, which has evolved alongside techniques, knowledge and research.  Sant Joan de Déu and Hospital Clínic boast excellent technological resources (diagnostic imaging tests, surgical material, 3D planning and reconstruction), and these tools are included in the teams' routine practice.

Finally, both centres are highly advanced, not only in terms of clinical healthcare but also in the support and comprehensive care they provide to the individual. We place special emphasis on the patient experience and quality care, avoiding traumatic processes and providing them with information. Our compassion towards our patients, together with the use of pioneering techniques, make our centre the perfect choice to learn about the medicine of the future which, in fact, is already in use on a daily basis.