Obstetrics and gynaecology
Encyclopedia
Obstetrics and gynaecology (or obstetrics and gynecology; often abbreviated to OB/GYN, OBG, O&G or Obs & Gynae) are the two surgical
–medical specialties dealing with the female reproductive organs in their pregnant
and non-pregnant state
, respectively, and as such are often combined to form a single medical specialty and postgraduate training programme. This combined training prepares the practising OB/GYN to be adept at the surgical management of the entire scope of clinical pathology involving female reproductive organs, and to provide care for both pregnant
and non-pregnant patients. In veterinary medicine
, theriogenology
is more commonly used term that also includes andrology
.
, for example, the residency training period is among the longest at six years, matched only by neurosurgery
and maxillofacial surgery
. In the United States
, four years in residency
is required. In India
, post graduate training in obstetrics
and gynaecology
is in the form of a two-year diploma course (DGO) or a three-year (MD
or MS
). Some OB/GYN surgeons elect to do further subspecialty training in programmes known as fellowships after completing their residency training, although the majority choose to enter private or academic practice as general OB/GYNs. Fellowship training can range from one to four years in duration, and usually have a research component involved with the clinical and operative training.
In rural areas of the United States, particularly in areas west of the Mississippi River
, it is not uncommon for general practitioners to offer obstetrical services to their patients. However, these generalists are most often not trained in the surgical aspects of obstetrics
, nor have they been trained in gynaecology
, and as such, they should not be confused with residency-trained and board-certified OB/GYNs. All gynaecologists, therefore, are trained obstetricians, although the reverse is not necessarily true. However, some OB/GYNs may choose to drop the obstetric component of their practice and focus solely on gynaecology, especially as they get older. This decision is often based on the double burden of very late hours and, depending on the country, high rates of litigation
.
This combined training prepares the practising OB/GYN to be adept at the surgical management of the entire scope of clinical pathology involving female reproductive organs, and to provide care for both pregnant and non-pregnant patient.
Of these, only the first four are truly recognized sub-specialties by the Accredited Council of Graduate Medical Education (ACGME) and the American Board of Obstetrics and Gynecology (ABOG). The other subspecialties are recognized as informal concentrations of practice. To be recognized as a board-certified subspecialist, a practitioner must have completed an ACGME-accredited fellowship and obtained a Certificate of Added Qualifications (CAQ) which requires an additional standardized examination.
Additionally, physicians of other specialties may become trained in Advanced Life Support in Obstetrics
(ALSO), a short certification that equips them to better manage emergent OB/GYN situations.
Journals whose scope specifically is within any of the subspecialties of obstetrics and gynaecology are listed in the main articles of these.
In addition, journals with more specific scope, yet not specific to any of the main subspecialties of obstetrics and gynaecology include:
combined with the ACGME's decision to limit resident work hours led to a gradual resurgence in the number of medical students choosing OB/GYN as a specialty. In the medical residency
match for 2007, only six spots in OB/GYN training programmes remained vacant throughout the entire United States
; a record low number, and one that puts OB/GYN on par in terms of competitiveness with some surgical specialties.
Surgery
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...
–medical specialties dealing with the female reproductive organs in their pregnant
Obstetrics
Obstetrics is the medical specialty dealing with the care of all women's reproductive tracts and their children during pregnancy , childbirth and the postnatal period...
and non-pregnant state
Gynaecology
Gynaecology or gynecology is the medical practice dealing with the health of the female reproductive system . Literally, outside medicine, it means "the science of women"...
, respectively, and as such are often combined to form a single medical specialty and postgraduate training programme. This combined training prepares the practising OB/GYN to be adept at the surgical management of the entire scope of clinical pathology involving female reproductive organs, and to provide care for both pregnant
Pregnancy
Pregnancy refers to the fertilization and development of one or more offspring, known as a fetus or embryo, in a woman's uterus. In a pregnancy, there can be multiple gestations, as in the case of twins or triplets...
and non-pregnant patients. In veterinary medicine
Veterinary medicine
Veterinary Medicine is the branch of science that deals with the prevention, diagnosis and treatment of disease, disorder and injury in non-human animals...
, theriogenology
Theriogenology
Theriogenology is the branch of veterinary medicine concerned with reproduction, including the physiology and pathology of male and female reproductive systems of animals and the clinical practice of veterinary obstetrics, gynecology, and andrology. Theriogenologists are veterinarians with advanced...
is more commonly used term that also includes andrology
Andrology
Andrology is the medical specialty that deals with male health, particularly relating to the problems of the male reproductive system and urological problems that are unique to men. It is the counterpart to gynaecology, which deals with medical issues which are specific to the female reproductive...
.
Training
The training for physicians in this field is quite long: in AustraliaAustralia
Australia , officially the Commonwealth of Australia, is a country in the Southern Hemisphere comprising the mainland of the Australian continent, the island of Tasmania, and numerous smaller islands in the Indian and Pacific Oceans. It is the world's sixth-largest country by total area...
, for example, the residency training period is among the longest at six years, matched only by neurosurgery
Neurosurgery
Neurosurgery is the medical specialty concerned with the prevention, diagnosis, treatment, and rehabilitation of disorders which affect any portion of the nervous system including the brain, spine, spinal cord, peripheral nerves, and extra-cranial cerebrovascular system.-In the United States:In...
and maxillofacial surgery
Oral and maxillofacial surgery
Oral and maxillofacial surgery is surgery to correct a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. It is an internationally recognized surgical specialty...
. In the United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
, four years in residency
Residency (medicine)
Residency is a stage of graduate medical training. A resident physician or resident is a person who has received a medical degree , Podiatric degree , Dental Degree and who practices...
is required. In India
India
India , officially the Republic of India , is a country in South Asia. It is the seventh-largest country by geographical area, the second-most populous country with over 1.2 billion people, and the most populous democracy in the world...
, post graduate training in obstetrics
Obstetrics
Obstetrics is the medical specialty dealing with the care of all women's reproductive tracts and their children during pregnancy , childbirth and the postnatal period...
and gynaecology
Gynaecology
Gynaecology or gynecology is the medical practice dealing with the health of the female reproductive system . Literally, outside medicine, it means "the science of women"...
is in the form of a two-year diploma course (DGO) or a three-year (MD
Doctor of Medicine
Doctor of Medicine is a doctoral degree for physicians. The degree is granted by medical schools...
or MS
Master of Science
A Master of Science is a postgraduate academic master's degree awarded by universities in many countries. The degree is typically studied for in the sciences including the social sciences.-Brazil, Argentina and Uruguay:...
). Some OB/GYN surgeons elect to do further subspecialty training in programmes known as fellowships after completing their residency training, although the majority choose to enter private or academic practice as general OB/GYNs. Fellowship training can range from one to four years in duration, and usually have a research component involved with the clinical and operative training.
In rural areas of the United States, particularly in areas west of the Mississippi River
Mississippi River
The Mississippi River is the largest river system in North America. Flowing entirely in the United States, this river rises in western Minnesota and meanders slowly southwards for to the Mississippi River Delta at the Gulf of Mexico. With its many tributaries, the Mississippi's watershed drains...
, it is not uncommon for general practitioners to offer obstetrical services to their patients. However, these generalists are most often not trained in the surgical aspects of obstetrics
Obstetrics
Obstetrics is the medical specialty dealing with the care of all women's reproductive tracts and their children during pregnancy , childbirth and the postnatal period...
, nor have they been trained in gynaecology
Gynaecology
Gynaecology or gynecology is the medical practice dealing with the health of the female reproductive system . Literally, outside medicine, it means "the science of women"...
, and as such, they should not be confused with residency-trained and board-certified OB/GYNs. All gynaecologists, therefore, are trained obstetricians, although the reverse is not necessarily true. However, some OB/GYNs may choose to drop the obstetric component of their practice and focus solely on gynaecology, especially as they get older. This decision is often based on the double burden of very late hours and, depending on the country, high rates of litigation
Malpractice
In law, malpractice is a type of negligence in, which the professional under a duty to act, fails to follow generally accepted professional standards, and that breach of duty is the proximate cause of injury to a plaintiff who suffers harm...
.
This combined training prepares the practising OB/GYN to be adept at the surgical management of the entire scope of clinical pathology involving female reproductive organs, and to provide care for both pregnant and non-pregnant patient.
Subspecialties
Examples of subspecialty training available to physicians in the US are:- Maternal-fetal medicineMaternal-fetal medicineMaternal-Fetal medicine is the branch of obstetrics that focuses on the medical and surgical management of high-risk pregnancies. Management includes monitoring and treatment including comprehensive ultrasound, chorionic villus sampling, genetic amniocentesis, and fetal surgery or treatment....
– an obstetricalObstetricsObstetrics is the medical specialty dealing with the care of all women's reproductive tracts and their children during pregnancy , childbirth and the postnatal period...
subspecialty, sometimes referred to as perinatology, that focuses on the medical and surgical management of high-risk pregnancies and surgery on the fetus with the goal of reducing morbidity and mortality. - Reproductive endocrinology and infertilityReproductive endocrinology and infertilityReproductive endocrinology and infertility is a surgical subspecialty of obstetrics and gynecology that trains physicians in reproductive medicine addressing hormonal functioning as it pertains to reproduction as well as the issue of infertility...
– a subspecialty that focuses on the biological causes and interventional treatment of infertility - Gynaecological oncology – a gynaecologic subspecialty focusing on the medical and surgical treatment of women with cancers of the reproductive organs
- Urogynaecology and pelvic reconstructive surgeryUrogynecologyUrogynecology or urogynaecology is a surgical sub-specialty of urology and gynecology.-History:In 1893, Howard Kelly, a gynecologist and pioneering urogynecologist, invented an air cystoscope which was simply a handheld, hollow tube with a glass partition...
– a gynaecologic subspecialty focusing on the diagnosis and surgical treatment of women with urinary incontinenceUrinary incontinenceUrinary incontinence is any involuntary leakage of urine. It is a common and distressing problem, which may have a profound impact on quality of life. Urinary incontinence almost always results from an underlying treatable medical condition but is under-reported to medical practitioners...
and prolapseProlapseProlapse literally means "to fall out of place", from the Latin prolabi meaning "to fall out". In medicine, prolapse is a condition where organs, such as the uterus, fall down or slip out of place. It is used for organs protruding through the vagina or the rectum or for the misalignment of the...
of the pelvic organs. Sometimes referred to by laypersons as "Female urology" - Advanced laparoscopic surgeryLaparoscopyLaparoscopy is an operation performed in the abdomen or pelvis through small incisions with the aid of a camera...
- Family planningFamily planningFamily planning is the planning of when to have children, and the use of birth control and other techniques to implement such plans. Other techniques commonly used include sexuality education, prevention and management of sexually transmitted infections, pre-conception counseling and...
– a gynaecologic subspecialty offering training in contraceptionContraceptionContraception is the prevention of the fusion of gametes during or after sexual activity. The term contraception is a contraction of contra, which means against, and the word conception, meaning fertilization...
and pregnancy termination (abortionAbortionAbortion is defined as the termination of pregnancy by the removal or expulsion from the uterus of a fetus or embryo prior to viability. An abortion can occur spontaneously, in which case it is usually called a miscarriage, or it can be purposely induced...
) - Paediatric and adolescent gynaecology
- MenopausalMenopauseMenopause is a term used to describe the permanent cessation of the primary functions of the human ovaries: the ripening and release of ova and the release of hormones that cause both the creation of the uterine lining and the subsequent shedding of the uterine lining...
and geriatricGeriatricsGeriatrics is a sub-specialty of internal medicine and family medicine that focuses on health care of elderly people. It aims to promote health by preventing and treating diseases and disabilities in older adults. There is no set age at which patients may be under the care of a geriatrician, or...
gynaecology
Of these, only the first four are truly recognized sub-specialties by the Accredited Council of Graduate Medical Education (ACGME) and the American Board of Obstetrics and Gynecology (ABOG). The other subspecialties are recognized as informal concentrations of practice. To be recognized as a board-certified subspecialist, a practitioner must have completed an ACGME-accredited fellowship and obtained a Certificate of Added Qualifications (CAQ) which requires an additional standardized examination.
Additionally, physicians of other specialties may become trained in Advanced Life Support in Obstetrics
Advanced Life Support in Obstetrics
Advanced Life Support in Obstetrics is a program developed by The American Academy of Family Physicians . This course helps physicians, certified nurse midwifes , OBGYN Registered Nurses, and other health care providers involved in potential emergencies in perinatal care of mothers...
(ALSO), a short certification that equips them to better manage emergent OB/GYN situations.
Academic journals
Academic journals in obstetrics and gynaecology include:- BJOG: An International Journal of Obstetrics and Gynaecology. Owned by the Royal College of Obstetricians and GynaecologistsRoyal College of Obstetricians and GynaecologistsThe Royal College of Obstetricians and Gynaecologists is a professional association based in the UK. Its members, including people with and without medical degrees, work in the field of obstetrics and gynaecology, that is, pregnancy, childbirth, and female sexual and reproductive health...
(RCOG), but editorially independent. It is formerly known as British Journal of Obstetrics and Gynaecology. - AJOGAmerican Journal of Obstetrics and GynecologyAmerican Journal of Obstetrics and Gynecology is a peer reviewed journal of obstetrics and gynecology. It is popularly called the "Gray Journal".It is the official publication of the following societies and associations:...
: American Journal of Obstetrics & Gynecology. It has approximately 45,000 readers - EJOG: European Journal of Obstetrics & Gynecology and Reproductive Biology
- Obstetrics & GynecologyObstetrics & Gynecology (journal)Obstetrics & Gynecology is a peer-reviewed medical journal in the field of obstetrics and gynecology. It is the official publication of the American College of Obstetricians and Gynecologists. It is popularly known as the "Green Journal"....
is the official publication of the American College of Obstetricians and Gynecologists (ACOG). It is popularly known as "The Green Journal". - Human ReproductionHuman Reproduction (journal)Human Reproduction is a peer-reviewed scientific journal covering all aspects of human reproduction, including reproductive physiology and pathology, endocrinology, andrology, gonad function, gametogenesis, fertilization, embryo development, implantation, pregnancy, genetics, preimplantation...
, published on behalf of the ESHREEuropean Society of Human Reproduction and EmbryologyThe European Society of Human Reproduction and Embryology was founded in 1985 by Robert Edwards and J. Cohen , who felt that the study and research in the field of reproduction needed to be encouraged and recognized.- Aims :...
Journals whose scope specifically is within any of the subspecialties of obstetrics and gynaecology are listed in the main articles of these.
In addition, journals with more specific scope, yet not specific to any of the main subspecialties of obstetrics and gynaecology include:
- PlacentaPlacenta (journal)Placenta is a peer-reviewed medical journal in the field of obstetrics and gynecology. It provides information on scientific and clinical investigations pertaining to placental research and their applications...
, the official journal of The International Federation of Placenta Associations
Recent shortage in US
From 2000 through 2004, American medical students were increasingly choosing not to specialize in obstetrics. This led to a critical shortage of obstetricians in some states and often fewer health care options for women — although it did not lead to higher average salaries. However, beginning in 2004, increasing state legislation mandating tort reformTort reform
Tort reform refers to proposed changes in common law civil justice systems that would reduce tort litigation or damages. Tort actions are civil common law claims first created in the English commonwealth system as a non-legislative means for compensating wrongs and harm done by one party to...
combined with the ACGME's decision to limit resident work hours led to a gradual resurgence in the number of medical students choosing OB/GYN as a specialty. In the medical residency
Residency (medicine)
Residency is a stage of graduate medical training. A resident physician or resident is a person who has received a medical degree , Podiatric degree , Dental Degree and who practices...
match for 2007, only six spots in OB/GYN training programmes remained vacant throughout the entire United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
; a record low number, and one that puts OB/GYN on par in terms of competitiveness with some surgical specialties.
Other readings
- Llewellyn-Jones, Derek, Fundamentals of Obstetrics and Gynecology, 7th ed., Mosby, 1999.
External links
- http://www.rcog.org.uk Royal College of Obstetricians and GynaecologistsRoyal College of Obstetricians and GynaecologistsThe Royal College of Obstetricians and Gynaecologists is a professional association based in the UK. Its members, including people with and without medical degrees, work in the field of obstetrics and gynaecology, that is, pregnancy, childbirth, and female sexual and reproductive health...
- http://www.acog.org American College of Obstetricians and Gynecologists
- World Congress on Controversies in Obstetrics, Gynecology & Infertility (COGI)
- http://www.bjog.org BJOG: An International Journal of Obstetricians and Gynaecologists