India and the Indian subcontinent is the most populated geographical area of the world (1.2 billion in India). Also medical needs of this subcontinent are the biggest in form of trained manpower and resources.Human resources for health are all individuals engaged in promotion and protection or improvement of health (WHO 2007).Indian subcontinent specially Indian has the largest number of medical colleges (350 in Indian) and we treat a significant number of medical tourism (second after Thailand), this is a reflection of the high level of medical expertize we posses, yet the paradox is that majority of our citizens have limited access to quality health care.Why such a situation has arisen in India, we try to analyze by relooking at the clinical settings where doctors avail training.This review aims to look at the challenges of medical education and role of professional organizations like FOGSI, ICOG, ICMU, IFUMB and IMA in training and educating the practising gynecologists in the field of Obs/Gyn ultrasound.

Transvaginal sonography offers a very accurate, easy and reproducible method to evaluate the female pelvis and the female factors of infertility. The addition of color gives us more information about organ perfusion and addition of 3D has opened a new dimension to diagnosis of pelvic pathologies. Transvaginal sonography has an important role in the management of infertility. Serial pelvic ultrasound examinations are useful in monitoring patients undergoing ovulation induction using ovulation-inducing drugs. In addition, the correct prediction of timing of ovulation is critical for infertility therapies such as intrauterine insemination, artificial or therapeutic insemination using donor sperm and the timing of intercourse during ovulation induction therapies.More than any other new method, ultrasound has made significant improvements in modern management of infertility.

Fetal origins of adult disease, a concept first popularized by Dr David Barker, has subsequently led to many studies which have provided the evidence that certain diseases do have links pointing to fetal origins-adverse influences early in develop ment, and particularly during intrauterine life, can result in permanent changes in physiology and metabolism, which result in increased disease risk in adulthood.Links that are wellestablished are-reduced birth weight and increased risk of coronary heart disease, hypertension and stroke in adulthood.The concept of a fetal origin of adult disease have been extended wellbeyond coronary heart disease and being a risk factor for coronary heart disease, and now includes investigations of the development of the central nervous system, early origins of adult mental health and cognitive function.By understanding fetal origin of adult disease, health care professionals and policy makers will make this issue a high health care priority and implement preventive measures and treatment for those at higher risk for chronic diseases.

Most low resource countries have no definite policies laid down for screening for fetal abnormalities and prenatal diagnostic techniques. The problem with screening scans and prenatal diagnostic techniques is the variable way in which they are conducted. There are no clear guidelines about what should, or what should not be done. What is needed is a standard for a routine anomaly scan.In the past 10 to 15 years, major advances have been made in prenatal screening. It has been suggested that maternal age alone as a screening strategy should be abandoned, but there is still no consensus on the most cost-effective alternative, and thus no national strategy exists.This document will provide parameters for obstetricians, radiologists and sonographers-how much screening could be accomplished within the available resources. With the help of prenatal diagnostic technique guideline we will be able to achieve a methodical, uniform and cost-effective way of fetal evaluation.

Birth defects are major global problems. Even in developed countries, the incidence of birth defects has not reduced.The prevalence of birth defects diagnosable (65%) and preventable (2.5%). Ultrasound screening is a very reliable tool for assessing birth defects.A well done genetic scan at 11 to 14 weeks and at 22 weeks (TIFFA) can accurately detect over 85% of birth defects.With the advent of 3D and 4D ultrasound, the accuracy for functional defects has also increased.Each pregnancy deserves a prenatal diagnostic test and ultrasound is a near ideal diagnostic test to be applied, to large pregnant population, specially in developing countries.