The Urgent Need to Reform Graduate Medical Education Funding

This year there were over 20,000 graduates of US medical schools who applied to the National Resident Matching Program. Many of them, including over 100 who applied to ob-gyn, were without a residency position on Match Day.

It’s no surprise. While the number of US medical school graduates is growing through increased class sizes and new medical schools, the number of graduate medical education (GME) residency slots has not increased proportionately. Indeed, there has been no significant increase in the number of obstetrics and gynecology resident positions since the mid-1990’s. Continue reading

Advocating for Women’s Health: Finding Common Ground

I have had many opportunities, particularly in the past year, to discuss how important women’s health issues are to investing in our country. Recently our Committee on Government Affairs and staff carried that message to the highest level at ACOG’s 32nd Annual Congressional Leadership Conference (CLC) in Washington, DC. With themes like ‘meeting you halfway,’ we were instilled with faith in our congressional leaders who are looking for collaboration, consensus, and progress. Women’s health should be a nonpartisan, centrist issue. After all, blue and red together create purple, the theme color for this year’s “Every Woman, Every Time” CLC.

A large conference like the CLC can be a scheduling nightmare in the best of circumstances. But add six inches of snow on the day of the main conference and all could have failed. What do you do if you are hosting a roundtable discussion with a congressman who was out of state and snowed in? No problem—we had Skype. Another snowbound yet determined congresswoman was delivered to the CLC via a four-wheel drive. A keynote speaker’s flight was cancelled, so he rented a car and drove four hours to deliver his lecture for us. Where there’s a will, there’s always a way.

At this year’s CLC, we prepared for four important “asks” before we met with our congressional leaders. We discussed SGR repeal, graduate medical education funding to improve access and create residency slots, legislation around gestational diabetes screening and research, and medical liability reform with Safe Harbor legislation. AMA President Elect Dr. Robert Wah, an ob-gyn, summarized many of these issues and then wrapped them all together in a great package. Our final launch was a greeting by Congresswoman Jackie Speier (D-CA 14th District), followed by a rousing presentation by Dr. Ernie Bodai as he described the role of advocacy in getting the postage stamp for breast cancer awareness passed. Finally, we were ready to go to Capitol Hill with our ‘asks.’

Now, what is my ‘ask’ for you? To get involved. You are our leaders and we need you to advocate for women and physicians. Plan now on attending the 33rd CLC in 2015 with Dr. John Jennings.

Building a Better Ob-Gyn—Retooling Resident Education

I recently had the honor to speak with some of our specialty’s greatest leaders—the educators and directors of our obstetrics and gynecology programs across the United States.

It was my first time attending the Association of Professors of Gynecology and Obstetrics (APGO)/Council on Resident Education in Obstetrics and Gynecology (CREOG) Annual Meeting. I was rewarded with inspirational and creative presentations on the challenges facing us about how we educate and how we learn. Do we learn best from the standard lecture and exam model? I don’t think so. Even I realized in medical school over 30 years ago—when I was balancing life with a newborn, a medical school heavy on lectures, and tests every few months—that students retain information better with interactive learning and retain more with case examples.

The APGO/CREOG meeting included engaging roundtable discussions on leadership and advocacy. Ob-gyn professors are looking at how best to train students for the next steps in their education. For instance, do we need to prepare students by instituting “boot camps” before they begin their first year in residency? How do we set milestone expectations for residents in their training? Our educators face the ongoing challenges of developing and maintaining ob-gyn resident surgical skills, teaching empathic patient care, and promoting and sustaining strong leadership in ob-gyn.

Residents and medical student attendees presented poster sessions on how they learn, what training was most effective, and the challenges they face. Some of the best parts of the program were the one-on-one discussions I had with these leaders in women’s health who are at the very early stage of their careers. Of course, I took the opportunity to discuss our national maternal health initiative, describe ACOG’s Well-Woman Task Force, and put in a plug for advocacy and our annual Congressional Leadership Conference (CLC).

Educating the future generations of ob-gyns in today’s challenging and quickly-changing health care environment will require the type of creative and provocative ideas that came out of the APGO/CREOG meeting. Here’s to all the ob-gyn professors and residency program directors who have been devoted to education for all the hard work that they do.