Subspecialization manpower in obstetrics and gynecology.

Growing interest in the emergence of subspecialties within obstetrics and gynecology prompted a survey of all Junior Fellows of the ACOG. That survey, representing the attitudes and expectations of 1702 housestaff and practitioners, disclosed that nearly 31% of obstetric-gynecologic residents planned to subspecialize as contrasted to 19.5% of postresidency obstetrician-gynecologists who either engaged in or plan to engage in subspecialty training/practice. The highest demand areas seemed to be in endocrinology and perinatology, and most subspecialists either limit or plan to limit their practice to the area specified. There was, in addition, a general feeling that subspecialists should confine their activities to major medical centers, and an unfavorable attitude was expressed toward subspecialty-board-imposed practice restrictions. Details regarding the factors influencing Junior Fellows' response to subspecialization are discussed.

Subspecialization in obstetrics and gynecology.

The formal development of subspecialities with obstetrics and gynecology has focused attention on problems of physician supply and demand. The need for subspecalized practitioners appears to be 750 in maternal-fetal medicine and 350 each in reproductive endocrinology and gynecologic oncology. Taken together, this number represents about 10 per cent of presently certified specialists. As supply is now developing, the demand in gynecologic oncology should soon be saturated, but there will be a longer term demand in maternal-fetal medicine and in reproductive endocrinology. However, the expectation of 30 per cent of present residents that they will enter subspecialities is far in excess of available fellowships or ultimate need. Fellowships leading to subspecialty certification should be approved by the Residency Review Committee, and numbers should be limited to best estimate of need.