American Board Of Obstetrics And Gynecology Research Articles

Correlation Between Residency Program Characteristics and American Board of Obstetrics and Gynecology Certifying Examination Passage Rates [ID 2683567

INTRODUCTION: The correlation between obstetrics and gynecology residency program size and type with certifying examination passage rates is not previously reported. Our objective was to evaluate the relationship between residency program size and type with American Board of Obstetrics and Gynecology (ABOG) certifying examination (CE) pass rates. METHODS: This is a cross-sectional study of ABOG specialty CE passage rates from 2020 to 2022. The CE passage rates were obtained from the ABOG website and stratified by program size (small 3–4, medium 5–7, large >8 residents per class) and type (community-based; community-based, university-affiliated; and university-based). Military-based programs were excluded, as were programs of unknown size. Passage rates were compared among groups using chi-squared test. RESULTS: During the study period, 3,766 candidates sat for the CE. Small programs accounted for 730 candidates (19.4%), 1,805 (47.9%) candidates from medium programs, and 1,231 candidates (32.7%) from large programs. Passage rates were higher among medium and large programs versus small programs (small [604/730; 82.7%], medium [1,656/1,805, 91.7%], and large [1,149/1,231; 93.3%]; P<.001). Passage rates among community-based candidates (299/347; 86.2% pass rate) and community-based university-affiliated candidates (962/1,100; 87.5% pass rate) were lower versus university-based candidates (2,148/2,319; 92.6% pass rate; P<.0001). CONCLUSION: During the study period, university-based programs and medium or large programs had higher CE passage rates. There are a number of limiting factors to the interpretation of the results such as academic differences upon entry to residency, resources available at each program, and amount of dedicated study time. A causal effect of program size and type cannot be assumed.

Editorial introductions.

Editorial introductions.

NASPAG Pediatric and Adolescent Gynecology Surgery Compensation Survey

IntroductionOver the last decade, the field of pediatric and adolescent gynecology (PAG) has rapidly expanded on the basis of a need for this specialized training to care for children and adolescents with gynecologic concerns. There are 18 PAG fellowship programs within the United States and Canada. Since 2017, which marked the beginning of the American Board of Obstetrics and Gynecology (ABOG) Focused Practice Examination in PAG and PAG Maintenance of Certification program, there has been a growing recognition of this specialty, given the unique population served. However, there is a paucity of information related to compensation in PAG. As the field has grown and more PAG fellow graduates are sought by children's hospitals throughout the United States and Canada, there is an urgent need to ensure that salary is equitable for these specialty PAG providers given the unique skills acquired during fellowship training, beyond that of obstetrics and gynecology (OBGYN) residency. This initial survey aimed to focus on compensation for PAG surgeons in the United States. ObjectivesTo survey NASPAG PAG surgeons in the United States about current benefits, practice metrics, and compensation MethodsA 15-question anonymous survey was sent to PAG surgeons in the United States in February 2022, with 3 reminders sent by email to engage voluntary participation. The survey aimed to understand practice characteristics, current compensation, and relative value unit (RVU) benchmarks. Descriptive statistics were utilized. Compensation means and quartiles were calculated in U.S. dollars for the following categories: assistant professor, associate professor, and full professor. The compensation mean was also calculated for private/hybrid and instructor categories. ResultsAmong 255 eligible members, 88 completed the survey, for a participation rate of 34.5%. Sixty-three point six percent reported having completed a PAG fellowship, whereas one-third reported specializing in this area with no fellowship available at the time. Three-fourths reported having achieved ABOG Focused Practice PAG certification. Most providers were academic (75%) and working full time (82.9%). Among academicians, most were assistant professors (48%) and on the non-tenure track (50.6%). RVU benchmarks varied, with 40.2% reporting OBGYN generalist targets and only 18.3% reporting PAG-specific targets, despite most physicians practicing only PAG (62.5%) and less than 30% practicing PAG plus some adult OBGYN. Salary support varied, with 57% employed by a hospital. Incentives were common, with most receiving a bonus at the end of the year (52.9%). As expected, full professors reported higher mean compensation ($345k) as compared with less senior colleagues ($248k and $302k for assistant and associate professors, respectively). Private practice/hybrid practitioners reported compensation ($251k) similar to that of assistant professors ($248k). Only 2 instructor-level physicians completed the survey. The mean number for this level is skewed and is not a reliable predictor for this academic level. Quartiles could not be calculated for this category. ConclusionThis is the first survey addressing compensation in the field of PAG in the United States. There is an ongoing need to collect this information to prepare PAG fellow graduates for the job market. Additional surveys, including an understanding of the compensation landscape in Canada, are needed in the future to address specific questions related to compensation for those who have less than 50% clinical time.

Editorial introductions.

Editorial introductions.

Creation of Entrustable Professional Activities (EPAs) in obstetrics and gynecology for medical undergraduate students

Abstract: Introduction: This article features “Entrustable Professional Activities (EPAs)” in the Obstetrics and Gynecology field designed for medical undergraduates, aiming to support the teaching/learning process. Objective: The aim is for the graduate to be competent to meet the minimum requirements necessary for the student in this field. Method: In this study, EPAs were created based on an international template already in use and validated using the Delphi technique. The structuring of the EPAs was based on the international literature: “Core Entrustable Professional Activities for Entering Residency: Curriculum Developer’s Guide” from the Association of American Medical Colleges (AAMC). The content for the topics of each EPA was based on the publication “The Obstetrics and Gynecology Milestone Project” from the joint action of the Accreditation Council for Graduate Medical Education (ACGME), the American College of Obstetrics and Gynecology (ACOG) and the American Board of Obstetrics and Gynecology (ABOG). Results: Thirteen EPAs were created with topics for teaching in that field during undergraduate school. A checklist was created for each EPA, aiming to guide the evaluator and the student regarding the performance of the tasks defined in the EPAs. Conclusion: The EPAs with checklists bring an innovative proposal for Obstetrics and Gynecology teaching in medical graduation since they facilitate and operationalize the learning, the development, and the observation of the acquisition of knowledge, skills and attitudes required for the performance of each topic in the area, thus helping the training of a competent professional. At the end of the medical course, the ability to perform all EPAs identifies a competent graduate in Gynecology and Obstetrics regarding the general practitioner.

Can ACGME Milestones predict surgical specialty board passage: an example in Obstetrics and Gynecology.

Background:Multiple tools including Accreditation Council for Graduate Medical Education (ACGME) standardized milestones can be utilized to assess trainee and residency program performance. However, little is known regarding the objective validation of these tools in predicting written board passage.Methods:In this retrospective study, data was gathered on n = 45 Wayne State University Obstetrics and Gynecology program graduates over the five-year period ending July 2018. United States Medical Licensing Examination (USMLE) scores, Council on Resident Education in Obstetrics and Gynecology (CREOG) in-training scores and ACGME milestones were used to predict American Board of Obstetrics and Gynecology (ABOG) board passage success on first attempt. Significance was set at p < 0.05.Results:Written board passage was associated with average CREOGs (p = 0.01) and milestones (p = 0.008) while USMLE1 was not significantly associated (p = 0.055). USMLE1 <217 (Positive predictive value (PPV) = 96%). CREOGs <197 (PPV = 100%) and milestones <3.25 (PPV = 100%), particularly practice-based learning and systems-based practice milestones were most strongly correlated with board failure. Using a combination of these two milestones, it is possible to correctly predict board passage using our model (PPV = 86%).Discussion:This study is the first validating the utility of milestones in a surgical specialty by demonstrating their ability to predict board passage. Residents with CREOGs or milestones below thresholds are at risk for board failure and may warrant early intervention.

Creation of Entrustable Professional Activities (EPAs) in obstetrics and gynecology for medical undergraduate students

Abstract: Introduction: This article features “Entrustable Professional Activities (EPAs)” in the Obstetrics and Gynecology field designed for medical undergraduates, aiming to support the teaching/learning process. Objective: The aim is for the graduate to be competent to meet the minimum requirements necessary for the student in this field. Method: In this study, EPAs were created based on an international template already in use and validated using the Delphi technique. The structuring of the EPAs was based on the international literature: “Core Entrustable Professional Activities for Entering Residency: Curriculum Developer’s Guide” from the Association of American Medical Colleges (AAMC). The content for the topics of each EPA was based on the publication “The Obstetrics and Gynecology Milestone Project” from the joint action of the Accreditation Council for Graduate Medical Education (ACGME), the American College of Obstetrics and Gynecology (ACOG) and the American Board of Obstetrics and Gynecology (ABOG). Results: Thirteen EPAs were created with topics for teaching in that field during undergraduate school. A checklist was created for each EPA, aiming to guide the evaluator and the student regarding the performance of the tasks defined in the EPAs. Conclusion: The EPAs with checklists bring an innovative proposal for Obstetrics and Gynecology teaching in medical graduation since they facilitate and operationalize the learning, the development, and the observation of the acquisition of knowledge, skills and attitudes required for the performance of each topic in the area, thus helping the training of a competent professional. At the end of the medical course, the ability to perform all EPAs identifies a competent graduate in Gynecology and Obstetrics regarding the general practitioner.

Fundamentals of Laparoscopic Surgery Pro Tips Series Part 2: Tasks # 4 & 5

Study Objective This objective of this video is to describe several tips and tricks to help familiarize residents with the Fundamentals of Laparoscopic Surgery (FLS) tasks and to improve their technical skills and efficiency. In part 1 of this 2-part series, we provide specific strategies for the peg board, circle cut, and ligating loop tasks. Design Educational instructional video. Setting N/A Patients or Participants N/A Interventions FLS uses five simulation stations to assess basic laparoscopic surgery skills. It is a reliable and valid curriculum which has been shown to improve intraoperative trainee performance. It was developed in 2004, and since 2009 has been a requirement to qualify for the American Board of Surgery board certification. In 2018, the American Board of Obstetrics and Gynecology (ABOG) announced that FLS will be a prerequisite for specialty board certification for obstetrics and gynecology residents graduating after May 2020. ABOG states that this will “ensure that diplomates possess critical skills for the contemporary practice of obstetrics and gynecology.” Measurements and Main Results N/A Conclusion FLS is now a requirement for all OB/GYN residencies. Mastering the skills requires time and effort on the part of the learners but using these pro tips can help gain confidence and improve efficiency.

Fundamentals of Laparoscopic Surgery Exam: A Cross-Sectional Survey of in-Training Obstetricians and Gynecologists

Study ObjectivePhysicians seeking specialty certification in Obstetrics and Gynecology are now required to successfully complete the Fundamentals of Laparoscopic Surgery (FLS) exam in order to meet the American Board of Obstetrics and Gynecology (ABOG) certification requirement. We conducted a survey of U.S Obstetrics and Gynecology physicians in training in an attempt to assess their laparoscopic surgical training and perceived barriers and limitations to successfully obtain FLS certification.DesignObservational.SettingInternet-based survey of United States Obstetrics and Gynecology residency programs.Patients or ParticipantsU.S Obstetrics and Gynecology residents.InterventionsParticipants were asked to self-evaluate their confidence in conducting laparoscopic procedures.Measurements and Main ResultsOf the 237 U.S Obstetrics and Gynecology programs, 146 residents responded. Seventy-one (48%) respondents completed the FLS exam and reported a 93% pass rate. All those who did not pass reported poor performance on the manual skills portion. Sixty-six (93%) respondents felt the laparoscopic box trainer was most helpful in preparation for the FLS exam. Fifty-five (79%) respondents felt the cognitive portion of the exam was not at all or slightly representative of subjects taught in residency. Thirty-three (47%) respondents felt the skills portion was moderately reflective of laparoscopic skills needed in gynecologic surgery. Thirty-eight (54%) respondents felt preparing for this exam was not at all or slightly helpful in clinical or surgical practice.ConclusionThe laparoscopic box trainer appears to be most useful in preparation for the FLS exam. Most respondents agree the skills portion of the exam represents skills required in Obstetrics and Gynecology. Concern remains whether the cognitive portion of the exam is applicable to Obstetrics and Gynecology residents or if residency programs need to broaden their laparoscopic education. Alterations likely need to be made to the exam to more specifically evaluate fundamental laparoscopic surgical skills in gynecologic surgeons.

Gender inequality in leadership and academic rank in academic reproductive endocrinology programs.

To identify gender differences in leadership and academic rank within academic reproductive endocrinology (REI) programs with fellowships in the USA. Official institutional websites of the 2017-2018 American Board of Obstetrics and Gynecology (ABOG)-accredited reproductive endocrinology fellowship programs were reviewed, and gender representation at each leadership position and academic rank (Division and Fellowship Director and Full, Associate, and Assistant Professor) was recorded. Univariate comparisons were performed using Chi-square tests, with significance at p<0.05. Among 49 ABOG-accredited reproductive endocrinology programs, 263 faculty were identified, 129 (49.0%) male and 134 (51.0%) female. Division directors were 69.3% male and 30.7% female (p = 0.006). Similarly, fellowship directors were 65.3% male and 34.6% female (p = 0.03). Full professors (n = 101) were more frequently male (70.3% vs. 29.7%, p < 0.001). There was no difference in gender among associate professors (n = 60, 51.7% male vs. 48.3% female, p = 0.79), while significantly more assistant professors were female than male (n = 102, 73.6% vs. 26.4%, p < 0.001). While a majority of residents in obstetrics and gynecology and half of reproductive endocrinology academic faculty are female, women are still underrepresented among leadership positions and full professors in academic reproductive endocrinology programs with fellowship programs.

Effectiveness of ABOG’s Article-Based Questions on Diplomates’ Retention of Knowledge [10G

INTRODUCTION: As part of continuing certification, the American Board of Obstetrics and Gynecology (ABOG) diplomates complete article-based assessments annually. Diplomates read articles, respond to article questions, and must score above a certain threshold to demonstrate competence in their understanding. There is a paucity of evidence that diplomates retain the information after reading articles. The study objective was to evaluate the effectiveness of the two question types (understanding and application) at measuring diplomates’ retention of knowledge over time. METHODS: A sample of 344 diplomates who chose selected articles between January-March 2019 volunteered for the study. Diplomates completed article questions in a business-as-usual setting (with article access) and were assessed again during summer 2019 (without article access). Each participant received 2 questions (one of each type) from 5 of the selected articles, for a total of 10 questions. The timed summer assessment was used as a proxy for retention. Diplomates’ scores, by item type, from each assessment setting were compared using a t-test to determine whether information was retained from the articles. RESULTS: The information assessed by application items was retained at a significantly higher rate (80.58%) than understanding items (60.75%), as demonstrated by mean scores on the assessment (P&lt;.05). CONCLUSION: Application items yielded a higher knowledge retention rate. Understanding items ensure diplomates comprehend the article while application questions ensure diplomates can generalize and apply their understanding from the article. A combination of both item types for article-based assessments is necessary and this study demonstrates that diplomates retain the information they read from articles.

EMIG Simulation Systems Construct Validation Trial: Laparoscopic Component

Study Objective Construct validation of the EMIG Laparoscopic Surgery Simulation System. Design A prospective, controlled cohort comparison. Setting Thirteen teaching institutions in the US and Canada and an AAGL Congress Patients or Participants 221 subjects who fit one of 4 categories of exposure to laparoscopic surgery and surgical simulation: 77 novices within 100 days of starting posgraduate year 1 (PGY-1); 71 within the first 100 days of starting PGY-3; 30 American Board of Obstetrics and Gynecology (ABOG) certified and no additional fellowship training (“Proficient”); 43 who had completed the two-year Fellowship in Minimally Invasive Gynecologic Surgery (FMIGS). Interventions Subjects were oriented to the simulation system and then tested under proctor supervision on the 5 EMIG laparoscopic exercises. These included the sleeve to peg transfer (L-1); the circular pattern cut (L-2); extracorporeal knotting (L-3); intracorporeal knotting (L-4); and a running suture (L-5). Time and accuracy scoring were entered electronically on site, but sessions were video recorded and study materials such as cutting and suturing targets were labeled and stored for subsequent review to optimize data quality. Measurements and Main Results Each exercise was timed, and a number of objective metrics recorded that reflected cutting and suturing accuracy and technique. Each exercise had a “time cap”; if a subject had not completed the exercise by the end of the allotted time, they were categorized “Did Not Complete” and the maximum time was entered for data analysis. Preliminary data analysis demonstrates that the novice group consistently demonstrated the poorest performance and the FMIGS cohort consistently the best. The PGY-3 and “Proficient” cohorts were generally similar to each other but each performed better than the PGY-1 group and well below the FMIGS group. Conclusion The EMIG Laparoscopic Simulation System can be used to distinguish amongst PGY-1, PGY-3, Proficient and FMIGS subjects. FMIGS-trained subjects consistently had the best results with almost no “Did not Complete” outcomes. Construct validation of the EMIG Laparoscopic Surgery Simulation System. A prospective, controlled cohort comparison. Thirteen teaching institutions in the US and Canada and an AAGL Congress 221 subjects who fit one of 4 categories of exposure to laparoscopic surgery and surgical simulation: 77 novices within 100 days of starting posgraduate year 1 (PGY-1); 71 within the first 100 days of starting PGY-3; 30 American Board of Obstetrics and Gynecology (ABOG) certified and no additional fellowship training (“Proficient”); 43 who had completed the two-year Fellowship in Minimally Invasive Gynecologic Surgery (FMIGS). Subjects were oriented to the simulation system and then tested under proctor supervision on the 5 EMIG laparoscopic exercises. These included the sleeve to peg transfer (L-1); the circular pattern cut (L-2); extracorporeal knotting (L-3); intracorporeal knotting (L-4); and a running suture (L-5). Time and accuracy scoring were entered electronically on site, but sessions were video recorded and study materials such as cutting and suturing targets were labeled and stored for subsequent review to optimize data quality. Each exercise was timed, and a number of objective metrics recorded that reflected cutting and suturing accuracy and technique. Each exercise had a “time cap”; if a subject had not completed the exercise by the end of the allotted time, they were categorized “Did Not Complete” and the maximum time was entered for data analysis. Preliminary data analysis demonstrates that the novice group consistently demonstrated the poorest performance and the FMIGS cohort consistently the best. The PGY-3 and “Proficient” cohorts were generally similar to each other but each performed better than the PGY-1 group and well below the FMIGS group. The EMIG Laparoscopic Simulation System can be used to distinguish amongst PGY-1, PGY-3, Proficient and FMIGS subjects. FMIGS-trained subjects consistently had the best results with almost no “Did not Complete” outcomes.

EMIG Simulation Systems Construct Validation Trial: Hysteroscopic Component

<h3>Study Objective</h3> Construct validation of the EMIG Hysteroscopic Surgery Simulation System. <h3>Design</h3> A prospective, controlled cohort comparison. <h3>Setting</h3> Thirteen teaching institutions in the US and Canada and an AAGL Congress. <h3>Patients or Participants</h3> 240 subjects who fit one of 4 categories of exposure to hysteroscopic surgery and surgical simulation: 76 novices within 100 days of starting posgraduate year 1 (PGY-1); 69 within the first 100 days of starting PGY-3; 27 American Board of Obstetrics and Gynecology (ABOG) certified and no additional fellowship training ("Proficient"); 43 who had completed the two-year Fellowship in Minimally Invasive Gynecologic Surgery (FMIGS). <h3>Interventions</h3> Subjects were oriented to the simulation system and then tested under proctor supervision on the 2 EMIG hysteroscopic exercises. These included the Targeting Exercise (H-1); and the Polyp Removal Exercise (H-2). Time and accuracy scoring were entered electronically on site, but sessions were video recorded and stored for subsequent review to optimize data quality. <h3>Measurements and Main Results</h3> Each exercise was timed, and a number of objective metrics recorded that were designed to assess accuracy, efficiency and technique. Each exercise had a "time cap"; if a subject had not completed the exercise in by the end of the alloted time, they were categorized as "Did Not Complete" and the maximum time was entered for data analysis. Preliminary data analysis demonstrates that for both H-1 and H-2 the novice group consistently demonstrated the poorest performance and the FMIGS cohort consistently the best. The PGY-3 and "Proficient" cohorts were generally similar to each other but each performed better than the PGY-1 group and well below the FMIGS group. <h3>Conclusion</h3> The EMIG Hystroscopic Simulation System can be used to distinguish amongst PGY-1, PGY-3, Proficient and FMIGS subjects. FMIGS-trained subjects consistently had the best results.

Design of a Laparoscopic Curriculum for Obstetrics and Gynecology Residents

PROBLEM: The American Board of Obstetrics and Gynecology (ABOG) announced in January, 2018 it is requiring completion of the Fundamentals of Laparoscopic Surgery (FLS) program as prerequisite for board certification for residents graduating after May, 2020. Currently, our residency program has no formalized laparoscopic curriculum and has never required residents to participate in the FLS program. INTERVENTION: Needs assessment was performed to survey faculty in the residency program regarding residents’ current skill levels and faculty perspectives of level-appropriate laparoscopic skills by training year. A comprehensive laparoscopic curriculum was designed to support resident progression through different competency milestones required to ultimately be able to perform laparoscopic hysterectomies as the surgeon. The laparoscopic curriculum addresses a parallel group of requirements designed to assist residents in successful completion of the FLS curriculum. CONTEXT: The laparoscopic curriculum was designed in the context of an academically-based obstetrics and gynecology residency program. The residency program has 9 residents a year who rotate at 5 different clinical sites and work with over 50 faculty who perform laparoscopic procedures. OUTCOMES/LESSONS LEARNED: The curriculum will be implemented in July 2019 with the new academic year. The curriculum will be assessed in several ways: formal testing of residents with FLS skills by the program administration, time takes resident to progress through the competency milestones for laparoscopy, the FLS pass rate, and scores of our residents. Main lesson learned through the design process was how to manage the varying resident and faculty expectations for surgical skills training.

CREOG In-Training Examination Results: Contemporary Use to Predict ABOG Written Examination Outcomes.

The in-training examination (ITE) offers formative assessments of residents' developing medical knowledge. Identification of an ITE performance level associated with success on the specialty board examination allows identification of "at risk" residents. This study sought to identify a threshold score for obstetrics and gynecology residents' performance on the Council on Resident Education in Obstetrics and Gynecology (CREOG) ITE that predicts successful performance on the American Board of Obstetrics and Gynecology (ABOG) written examination. We analyzed ITE and ABOG results of 80 residents who completed 4 years of CREOG ITEs at 2 institutions between 2002 and 2012. We assessed the level of performance associated with successful performance on the ABOG written examination. Data analyzed included scores for 71 of 80 residents (89%), with an overall pass rate of 82%. A postgraduate year (PGY) 4 score of 200 on the CREOG ITE or twice in any of the PGY training years was associated with a 100% ABOG pass rate. Scoring ≥ 205 in any PGY also was associated with a 100% pass rate. Residents who did not attain a score of 200 had a 35% to 45% chance of failing the ABOG written examination, depending on the PGY of the ITE performance. Our findings suggest that a CREOG ITE score of at least 200 twice, or as a PGY-4, offers assurance of successful performance on the ABOG examination. Scores lower than this threshold may be used to identify "at risk" residents for added learning and provide program elements in need of improvement.

Council on Resident Education in Obstetrics and Gynecology In-Training Examination Results

BACKGROUND: The Council on Resident Education in Obstetrics and Gynecology (CREOG) In-Training Examination (ITE) was designed to serve as a tool to provide feedback on resident progress along with training program strengths and weaknesses. OBJECTIVE: The objective of this study was to identify predictive factors for success on American Board of Obstetrics and Gynecology (ABOG) Written Examination using CREOG ITE scores. METHODS: CREOG ITE and ABOG written examination results collected from 2002 to 2012, inclusive, from Reading Hospital and Greenville Health System residents who took the CREOG ITE exam for 4 years. Data were analyzed using logistic regression to identify key factors in predicting ABOG written examination outcomes. Categorical data were analyzed using χ2. RESULTS: Seventy-one residents were included for analysis, of whom 68.9% were female. Gender differences existed. For women, a low score starting in postgraduate year (PGY)-1 was correlated with ABOG failure (P<.001), but it was not associated in men (P=NS) until PGY-3. Results showed that while each year's score contributed to the chance of pass–fail, the contribution increased each year. For every point increase in year 4 examination score, chances of passing increased by 21.5% (P=.001). Calculations using all 4 years resulted in an area-under-the-curve (AUC) of 0.920, significantly better (P<.001) than the null hypothesis of 50%. CONCLUSION: Results indicate that the score of each subsequent PGY is more important than the previous PGY's score. CREOG ITE scores could be a useful tool for identifying residents requiring structured interventions.

If a Man Needs a Gynecologist, Will He Be Able to Find One?

If a Man Needs a Gynecologist, Will He Be Able to Find One?

Editorial introductions

Editorial introductions

Pursuit of Accredited Subspecialties by Graduating Residents in Obstetrics and Gynecology, 2000–2012

To estimate whether there has been an increase in resident graduates pursuing fellowship training in the currently accredited subspecialties and to compare whether any trend toward subspecialization is similar to those seen in other specialties. This descriptive study examined data from the National Residency Match Program for academic years 2000-2012. Annual comparisons were made between the numbers of residents who either pursued careers in their specialty or were accepted into fellowship training in an accredited subspecialty. We compared the numbers in each group who took the American Board of Obstetrics and Gynecology (ABOG) written board examination and who became board-certified. Although the annual number of residency graduates in obstetrics and gynecology remained essentially the same (1,185 ± 56), the proportion of graduates accepted into fellowships increased steadily in all subspecialties (from 7.0% in 2000 to 19.5% in 2012). All other core specialties saw higher proportions of their graduates pursuing subspecialties except for family medicine. Coincident with rises in fellowship programs and positions was eventual increase in trainees who took the ABOG written examination for the first time in the three established subspecialties (maternal-fetal medicine, gynecologic oncology, reproductive endocrinology and infertility) and who became board-certified. Like with residents in other specialties, more graduates in obstetrics and gynecology are pursuing accredited subspecialty fellowship training, adding to the complexities of workforce planning. The percent of obstetrics and gynecology residents who pursued accredited subspecialty fellowship training was lower than all but one other specialty.

Surgical education and training program development for gynecologic oncology: American perspective

The purpose of this paper is to provide information about gynecologic oncology fellowship training and guidance in program development. The characteristics necessary for a physician to develop into a successful gynecologic oncologist include an extensive fund of knowledge related to the subspecialty, strong interpersonal skills, the ability to practice within the complex systems required for management of gynecologic cancer patients, surgical expertise, and the clinical ability to provide comprehensive oncologic care for these women. In order for a trainee to acquire these skills, a gynecologic oncology training program must accept only highly qualified individuals as fellows, have a dedicated core faculty, practice in a supportive environment that has appropriate facilities, and provide adequate clinical material. The gynecologic oncology training program must be organized with an emphasis on education of the fellows. Part of the educational program is formal (lectures, assigned reading, basic skill sets, etc.). Training in clinical and surgical skills is a day-to-day process that occurs during the course of patient care. One requirement of The American Board of Obstetrics and Gynecology (ABOG) is that the fellow spends 12 months of protected time doing research. Fellows are also required to take 2 courses, one in biostatistics and one in cancer biology. A thesis of publishable quality is also required. All programs must perform ongoing quality assurance and reassessment of potential areas for improvement. ABOG is responsible for the accreditation and ongoing monitoring of the fellowship programs.