The impact of subspecialties on obstetrics and gynecology.

The role of subspecialties in obstetrics and gynecology was evaluated by a mail questionnaire to department chairpersons, members of the American Gynecological and Obstetrical Society, nonuniversity directors of obstetrics and gynecology residency programs, and others. Results from the questionnaire were evaluated by conventional statistical methods. The issues identified included subspecialties and the further development of our specialty in role modeling, enhanced education for both residents and students, and the recruitment of a higher-quality resident for our specialty. Additional issues included: Were subspecialties a mistake, and have they fragmented our specialty? Some of the results include the following: (1) More than 90% of respondents agree that subspecialties have helped in the development of obstetrics and gynecology. (2) The subspecialties have enhanced our image in medical schools (88%) and in the community hospitals (77%). (3) The education of medical students (73%) and of residents (86%) has been enhanced by the development of subspecialties. (4) As predicted, the subspecialties have fragmented our specialty (69%), but patient care has not suffered. (5) Disagreement is noted between chairpersons and other respondents that a higher-quality resident is going into subspecialties, but all agreed that the improved quality of residents was due to the development of subspecialties. (6) Only 10% of respondents wished subspecialties had never been developed as contrasted to 82% of all respondents who felt they were commendable. (7) If another subspecialty area is to be identified, more respondents prefer reproductive urology than the next two areas combined.