Lessons Learned in Physician Reentry

Abstract

We describe our early experience with two physicians who successfully completed an obstetrics and gynecology physician reentry program. A 10-step program using an individualized curriculum in a supervised preceptorship is tailored to the candidate's anticipated practice. A reentry curriculum is devised for the candidate based on the advances in the field since they left practice and Accreditation Council for Graduate Medical Education (ACGME) competencies for resident education. The program culminates with an oral boards examination conducted by a panel of obstetrician-gynecologists (ob-gyns). At the completion of the program, the candidate must demonstrate that they are conversant with the field of general obstetrics and gynecology. Both candidates had been part of the medical community, which facilitated their ability to complete the program. One candidate was trained and worked intermittently in obstetrics and gynecology in another country. She used cases from her most recent clinical rotation abroad. The other candidate gathered cases from her future partner and prior colleagues. Both candidates successfully completed the program within 3 months and returned to clinical practice. The first physician practiced as a faculty member for 1 year but had challenges assimilating into a busy resident service while balancing her research duties. We need to enhance opportunities for external reentry candidates to have access to preceptors and their patients. In the future, we will better screen candidates to identify those who are planning to return to active clinical practice. We no longer will accept a case log with cases drawn from other sites. We also will incorporate an assessment of each candidate's surgical skill using surgical simulation.

Returning Inactive Obstetrics and Gynecology Physicians to Clinical Practice: The Drexel Experience

“…Although 6 years of experience in a northeastern university hospital with 9 graduates of differing backgrounds and durations of inactivity does not represent all returning physicians’ needs or all reentry programs across the United States, Drexel's approach and our practical experience, viewed alongside work done by other programs, can provide an initial guide for the growing field of obstetrics‐gynecology physician reentry in the United States.…”

“…Although a few studies have been published on physician reeducation, none provides long‐term follow‐up of physicians who have completed these programs. Nor have any studies reported on physicians’ perspectives about these programs or their assessments of whether the programs prepared them for returning to clinical practice.…”

“…Three papers have described US reentry programs for obstetricians and gynecologists, with samples of 2, 3, and 6 physicians in Los Angeles, Oregon, and Arizona, respectively. To add to this limited experience, we report on a refresher program at Drexel University College of Medicine in Philadelphia that facilitates obstetrician‐gynecologists’ return to clinical practice.…”

Changes in the Practice of Obstetrics and Gynecology

“…Indeed, reports of a small number of OB-GYN re-entry programs already exist. [47][48][49] Delaying Retirement A steady retirement of baby boomer ACOG fellows will compound the projected increased demands on women's health care. While the usual age range of retirement from clinical practice is wide (interquartile range, 59-69 years), OB-GYNs are more inclined to retire slightly earlier than other specialists.…”

Reentering Obstetrics and Gynecology

“…3 The importance of the physician reentry issue will be felt by many hospital systems in the near future, when physicians apply for clinical privileges after an extended period of inactivity. When returning to practice, the Diplomate simply notifies the American Board of Obstetrics and Gynecology, and the "not currently in practice" designation is removed.…”