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The Impact of Fellowship Training

Unlike most medical and surgical specialties, board certification in the field of Urogynecology DOES NOT reflect the training of the individual. Board certification was first made available in 2013. Fellowship training in Urogynecology has been available for decades but was not required to become board certified if the physician graduated from Ob/Gyn residency prior to 2010. These individuals were allowed to sit for a multiple choice exam if a certain percentage of their practice was consider Urogynecologic.

Conversely, all individuals graduating from Ob/Gyn residency after 2010 were require to complete a 3-year fellowship in order to sit for the written exam. In 2010, there were 34 fellowships around the country each of which accepted one fellow per year. These are difficult fellowships to obtain. In addition to the written exam, they were required to take a 3-hour oral exam and publish research in the field. The result of this policy is that there are board certified Urogynecologist around the country who have no additional training beyond Ob/Gyn residency. The majority of patients are unaware of this policy. Fellowship training in Urogynecology, like training in most fields, provides specialized skills and knowledge which is passed to the trainee by mentors in the operating room and in clinic. In the case of Urogynecology, trainees often rotate through related fields of colorectal surgery, urology and plastic surgery. Ob/Gyn residency does not provide this level of training. The table below highlights the difference in training between a board certified non-fellowship trained and a board certified fellowship trained urogynecologist.

Non-fellowship trained Urogynecologist

Obstetrics & Gynecology Residency: 4 years
Exams: Written & 3-hour oral exam
Urogynecologic Fellowship: 0 years
Exams: Written

Fellowship trained Urogynecologist

Obstetrics & Gynecology Residency: 4 years
Exams: Written & 3-hour oral exam
Urogynecologic Fellowship: 3 years
Exams: Written & 3-hour oral exam