Workforce projections for subspecialists in obstetrics and gynecology

Objective: To project the future supply of practicing subspecialists in obs tetrics and gynecology based on the most recent numbers of physicians enter ing fellowships. Methods: A discrete actuarial model was developed, and supply projections w ere examined using 1999 subspecialty fellowship numbers from the American B oard of Obstetrics and Gynecology. Results: The numbers of obstetrician-gynecologists entering subspecialty fe llowships in maternal-fetal medicine (MFM) and reproductive endocrinology-i nfertility (REI) declined sharply between 1994 and 1999. There was a slow i ncrease in gynecologic oncology (GO) fellows. Projections show that the num bers of practicing MFM and GO subspecialists will double by 2020, but they will be serving a 20% larger female population in the United States. Number s of practicing REI subspecialists will increase slowly. Conclusion: The number of fellows in GO continues to enlarge progressively though slightly, whereas those in MFM and REI have fallen sharply in recent years. Among four possible factors affecting growth or decline, the ones t hat seem most important are existing career opportunities for both generali st and subspecialist obstetrician-gynecologists and the length of subspecia lty education. (Obstet Gynecol 2000;95:312-4. (C) 2000 by The American Coll ege of Obstetricians and Gynecologists.).