Subspecialization in obstetrics and gynecology.

The formal development of subspecialities with obstetrics and gynecology has focused attention on problems of physician supply and demand. The need for subspecalized practitioners appears to be 750 in maternal-fetal medicine and 350 each in reproductive endocrinology and gynecologic oncology. Taken together, this number represents about 10 per cent of presently certified specialists. As supply is now developing, the demand in gynecologic oncology should soon be saturated, but there will be a longer term demand in maternal-fetal medicine and in reproductive endocrinology. However, the expectation of 30 per cent of present residents that they will enter subspecialities is far in excess of available fellowships or ultimate need. Fellowships leading to subspecialty certification should be approved by the Residency Review Committee, and numbers should be limited to best estimate of need.