GYNECOLOGIC REPRODUCTIVE ENDOCRINOLOGY & INFERTILITY

A university program in gynecologic reproductive endocrinology and infertility must provide opportunities for residents to achieve the educational objectives that are outlined in the document, Specialty Training Requirements in Gynecologic Reproductive Endocrinology and Infertility.

A university wishing to have a program in gynecologic reproductive endocrinology and infertility accredited must also sponsor an accredited program in obstetrics and gynecology. The resident must be provided with responsibilities appropriate to his/her level of competence in both the clinical and laboratory aspects of the specialty.

Clinical training must be based on adequate resources to ensure full training for each resident in all aspects of gynecologic reproductive endocrinology and infertility.

There must be a sufficient number of qualified teaching staff to supervise residents and provide teaching in the basic and clinical sciences related to gynecologic reproductive endocrinology and infertility.

Through the facilities of the university and the participating institutions, the overall training program must satisfy the following requirements:

1. CLINICAL PROGRAM

Clinical training must be based on adequate resources to ensure full training for each resident in all areas of gynecologic reproductive endocrinology and infertility.

  1. Clinical Gynecologic Reproductive Endocrinology and Infertility

Residents must be familiar with diagnostic procedures, their indications, contra-indications, techniques, limitations, sources of error, and interpretation. Clinical facilities must be organized for teaching the investigation and treatment of the disorders defined under reproductive endocrinology and infertility.

These disorders include reproductive endocrinopathy in the female and male, the infertile couple, habitual abortion, abnormalities of childhood and adolescence, menopause, dysfunctional uterine bleeding, premenstrual syndrome and psychosexual dysfunction.

Residents must be familiar with and monitor the impact of the new reproductive technologies on bioethics and health economics.

Special skills include:

    • Competence in the general diagnostic techniques and procedures used for the assessment of reproductive disorders and the ability to formulate an appropriate treatment plan.
    • Competence in microsurgical techniques as they apply to oviductal and other reproductive surgery.
    • Competence in the use of laparoscopy and hysteroscopy for pelvic assessment and the treatment of pelvic pathology affecting reproduction.
    • Management of anovulation.
    • Competence required to permit active participation with the urologist, medical endocrinologist and other health care professionals in the management of some complex reproductive disorders.
    • Competence in the use of pelvic ultrasound for both diagnostic and therapeutic procedures.
    • Competence in the principles and practice of assisted reproductive technology, including in-vitro fertilization.

Where certain clinical conditions occur so infrequently that clinical material is not always available, then the teaching program must ensure that by formal didactic means, journal clubs, or other suitable forums, adequate exposure to these areas is achieved.

  1. Supporting Facilities and Services

The following special facilities and services must be available for the training of residents and closely coordinated with the overall program:

                                 i.            Core diagnostic radioimmunoassay facilities for steroid and peptide hormones.

                               ii.            Clinical and diagnostic investigation units for both in-patient and/or out-patient assessment of patients with gynecologic reproductive endocrinology and infertility disorders.

                              iii.            A department of internal medicine with a program in endocrinology and metabolism.

                             iv.            A department of pathology with provision for the study of endometrial biopsies and other material obtained surgically.

                               v.            A department of nuclear medicine and/or radiology, including specialized staff and facilities in the following areas— CT, scanning and ultrasonography.

  1. Ambulatory Care Facilities

Organized clinics or other ambulatory care facilities must be available to provide opportunities for pre-admission investigation and post-discharge follow-up of patients. Such assignments to these clinics must constitute a learning experience supervised by the teaching staff.

2. EDUCATIONAL PROGRAM

A coordinated educational program must be provided in gynecologic reproductive endocrinology and infertility. This should include teaching in the basic science related to the specialty, including the physiology, pathophysiology and pathology of the hypothalamus, pituitary-gonadal axis.

The program may include didactic lectures and/or seminars which may be interdisciplinary in nature, teaching rounds, special conferences, assignment of laboratory work, technical demonstrations and continual appraisal of the literature.

The milieu of scholarship should be enhanced, whenever possible, by close association between residents and active investigators on the staff.

3. EVALUATION OF THE RESIDENT

The program, through the Director, must demonstrate the effective presence of formal mechanisms for ongoing and final evaluation of the resident's competence relative to the knowledge base, clinical and technical skills and attitudes as outlined in The Specialty Training Requirements document. Evidence of the evaluation and the standard of performance of the resident must be incorporated into the final in-training evaluation report. This evaluation will also include the investigative paper summarizing the research project carried out by the resident as a prerequisite for successful completion of the residency program.

PROGRAMS (WITH TRAINING REQUIREMENTS):

Diplomas(Dip):

Six months of approved residency training.

Doctor of Medicine(M.D):

Eighteen months of approved residency training.

Doctor of Philosophy(Ph.D):

Forty eight months(four years)of approved residency training.