Dr Joels has the following qualifications:

• MB ChB – Bachelor of Medicine and Surgery
• MD – Doctorate of Medicine
• FRCOG – Fellow of the Royal College of Obstetricians and Gynaecologists
• FHEA – Fellow of the Higher Education Academy

In addition to her explicit qualifications, Dr Joels has extensive additional training in the following areas:

• Advanced laparoscopic surgery
• Hysteroscopic surgery
• MOET (Management of Obstetric Emergencies and Trauma)
• Paediatric and adolescent gynaecology
• Reproductive medicine and surgery including assisted conception
• Contraception including insertion of contraceptive coils and implants
• Clinical governance and risk management

Throughout my career, I have trained in and delivered gynaecology services, including as a tertiary consultant in University Hospital settings for the last 19 years.

I am confident in both abdominal and vaginal hysterectomy, open myomectomy, vaginal repairs and hysteroscopic resection of polyps and fibroids. I am trained in advanced laparoscopic surgery, including a focus on treating infertility and chronic pelvic pain. I currently undertake surgery for grade 4 endometriosis including, excision of endometriosis, ovarian cystectomy, bowel and ureteric dissection and other operative laparoscopic procedures including adhesiolysis, salpingo-oophorectomy and ectopic pregnancy. I have carried out LAVH and laparoscopic subtotal hysterectomies and total laparoscopic hysterectomies.

Additionally, I am trained in gynaecological ultrasound scanning and conduct this routinely in clinic. I can also carry out HyCoSy (tubal patency) scanning for appropriately selected patients.

Furthermore, I was the clinical lead for paediatric and adolescent gynaecology, a member of BritSPAG and I saw babies, girls and adolescents in the joint PAG clinic with a paediatric consultant colleague.

Diagnosis and management of benign gynaecological problems:

• Menstrual disorders including bleeding after intercourse, postcoital bleeding or post-menopausal bleeding
• Pelvic pain and painful intercourse
• Urogynaecological problems including prolapse and incontinence
• Fertility assessment
• Hormone problems including menopause and polycystic ovary syndrome
• Ovarian cysts and fibroids
• Vulval disorders
• Contraception
• Screening services including cervical smear tests
• Gynaecological ultrasound

Treatment of gynaecological problems

• Minimal access surgery including advanced laparoscopic procedures to excise or treat endometriosis and adhesions and benign ovarian cysts
• Hysteroscopic surgery including removal and resection of polyps and fibroids and investigation of postmenopausal bleeding
• Open surgery including hysterectomy, removal of fibroids and large benign ovarian masses
• Prescribing medications as appropriate where a surgical approach isn’t required

Paediatric and Adolescent gynaecology

• Pre-pubertal girls – vulvo-vaginitis, discharge and soreness of the vulva, skin tags and fusion of the labia
• Problems of puberty – delayed puberty, early puberty, heavy periods, painful periods and pelvic pain
• Laparoscopic surgery for benign ovarian cysts and endometriosis
• Contraceptive advice

I have obstetric experience spanning 34 years, with 19+ years at consultant level, including the majority at tertiary level, with a heavy emphasis on obstetric safety, including being the Prize Winner on the Internationally-recognised obstetric safety course (called MOET).

As a tertiary-trained and experienced consultant, I have a considerable experience in the management of complications of pregnancy including managing obstetric haemorrhage with Rusch balloons and B Lynch sutures, caesarean hysterectomy, severe pre-eclampsia and eclampsia. I have managed antenatal and postnatal care throughout my career and I believe in supporting women in shared decision-making about mode of delivery and encourage aiming for normal vaginal delivery and vaginal birth after caesarean section. I am experienced in caesarean section, instrumental vaginal delivery including ventouse, Neville Barnes forceps and rotational delivery with manual rotation and Kiellands forceps. I have experience of vaginal breech deliveries and vaginal twin deliveries.

Pre-conception care

• Advice about pre-existing medical conditions prior to pregnancy working with specialist colleagues as necessary

Antenatal care

• Holistic management of antenatal care throughout pregnancy including screening for complications of pregnancy, monitoring fetal growth and advice about vaccinations and medication as appropriate
• Management of pregnancy related conditions and complications
• Joint decision making regarding birth plans
• Referral on to specialist services as necessary

Care in labour and delivery

• Intrapartum care including active management of labour and working with midwifery colleagues
• Normal vaginal delivery
• Instrumental delivery including Ventouse (vacuum) and forceps delivery)including repair of perineal tears or episiotomy
• Caesarean sections both as a planned procedure and as an emergency if complications arise in labour
• Management of delivery of placenta and bleeding after delivery

Care after birth

• Postnatal care until discharged home
• Six week postnatal check and contraceptive advice
• Support for problems arising after delivery

Fertility Services

• Diagnostic assessment of both female and male partners experiencing a delay in conceiving
• Investigations including ultrasound and laparoscopic assessment of the woman’s pelvis and tubal patency
• Assessment and treatment of hormone disorders
• Onward referral to assisted conception services where appropriate
• Understanding of the psychosocial consequences of a delay in conceiving

For the last 6 years in the UK, I have been Clinical Lead for Exeter Fertility, a tertiary standalone service under the umbrella of Royal Devon & Exeter NHS Foundation Trust, a service renowned throughout the region. I was awarded a Doctorate of Medicine for my research into fertility issues, from University of Bristol.

In reproductive medicine I am experienced in diagnosis and management of infertility and manage patients undergoing ovulation induction, IVF and IUI. I have been trained to perform open tubal microsurgery including reversal of sterilisation, tubal surgery and cuff salpingostomy. I now carry out most of the tubal surgery laparoscopically.

• Diagnostic assessment of both female and male partners experiencing a delay in conceiving
• Investigations including ultrasound and laparoscopic assessment of the woman’s pelvis and tubal patency
• Assessment and treatment of hormone disorders
• Onward referral to assisted conception services where appropriate
• Understanding of the psychosocial consequences of a delay in conceiving