BackgroundDespite a large body of data suggesting that delivery of fertility care to cancer patients is inconsistent and frequently insufficient, there is a paucity of literature examining training in fertility preservation for those physicians expected to discuss options or execute therapy. The study objective was to compare fertility preservation training between Reproductive Endocrinology & Infertility (REI) and Gynecologic Oncology (GYN ONC) fellows and assess the need for additional education in this field.MethodsA 38-item survey was administered to REI and GYN ONC fellows in the United states in April 2014. Survey items included: 1) Clinical exposure, perceived quality of training, and self-reported knowledge in fertility preservation; 2) an educational needs assessment of desire for additional training in fertility preservation.ResultsSeventy-nine responses were received from 137 REI and 160 GYN ONC fellows (response rate 27%). REI fellows reported seeing significantly more fertility preservation patients and rated their training more favorably than GYN ONC fellows (48% of REI fellows versus 7% of GYN ONC fellows rated training as ‘excellent’, p < 0.001). A majority of all fellows felt discussing fertility preservation was ‘very important’ but fellows differed in self-reported ability to counsel patients, with 43% of REI fellows and only 4% of GYN ONC fellows able to counsel patients ‘all the time’ (p = 0.002). Seventy-six percent of all fellows felt more education in fertility preservation was required, and 91% felt it should be a required component of fellowship training.ConclusionSignificant variability exists in fertility preservation training for REI and GYN ONC fellows, with the greatest gap seen for GYN ONC fellows, both in perceived quality of fertility preservation training and number of fertility preservation patients seen. A majority of fellows in both disciplines support the idea of a standardized multi-disciplinary curriculum in fertility preservation.Electronic supplementary materialThe online version of this article (doi:10.1186/s40738-017-0036-y) contains supplementary material, which is available to authorized users.
Our clinical algorithm for early pregnancy evaluation after ART is effective for identification and prompt intervention of EP and HP without significant over- or misdiagnosis, and avoids the potential catastrophic morbidity associated with delayed diagnosis.
The American College of Obstetricians and Gynecologists selected "Reentry Into Practice" as the subject for the 2012 Issue of the Year. Physician reentry programs in obstetrics and gynecology are driven by the fact that there is a projected physician shortage, and there are physicians who voluntarily leave clinical practice for a period of time. In planning formal reentry programs, evidence-based practice and highest regard for patient safety must be considered. Our department initiated a reentry fellowship program in 2010. This article describes the process of how we developed our program, the challenges encountered, and the solutions used to overcome these challenges. The formal instruction, evaluation, and documentation of competency are presented. Process improvement has been based on feedback and evaluation from the reentry fellows and from staff and residents. Bringing physicians back into the clinical realm will depend on the success of new programs implementing the guidelines recommended by national regulatory bodies. The guidelines recommend that the programs are accessible, collaborative, comprehensive, ethical, flexible, individualized, innovative, accountable, stable, and responsive. Our reentry program has been successful in helping fellows reestablish clinical practice and is a way to incorporate hands-on competency-based experiences for the reentering obstetrician-gynecologist (ob-gyn).
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