Statement of Support for August 1 Fellowship Start Date

American Association of Gynecologic Laparoscopists (AAGL) | American College of Obstetricians and Gynecologists (ACOG) | American Urogynecologic Society (AUS) |  Council of University Chairs of Obstetrics and Gynecology (CUCOG) | Council on Resident Education in Obstetrics and Gynecology (CREOG) |  North American Society for Pediatric and Adolescent Gynecology (NASPAG) | Society of Family Planning (SFP) | Society of Gynecologic Oncology (SGO) | Society for Reproductive Endocrinology and Infertility (SREI)

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Updated March 6, 2023

For a number of years, physicians in leadership from the field of obstetrics and gynecology have undertaken robust discussions about the logistical challenges that obstetrics and gynecology residents face in transitioning from residency to fellowship. With roughly 35% of residents pursuing additional training after graduating from their residency programs, the tight turnaround from residency completion to the start of fellowship can complicate the completion of residency obligations and the start to fellowship training.

With this in mind, the leadership of the Council on Resident Education in Obstetrics and Gynecology has engaged the obstetric and gynecologic subspecialty fellowship community regarding this issue. Following extensive listening, review, and consideration, the Council on Resident Education in Obstetrics and Gynecology has proposed shifting the start of fellowship programs by one month, from July 1 to August 1. This proposal has met with support from both from the Council of University Chairs of Obstetrics and Gynecology and the American Board of Obstetrics and Gynecology, which has agreed to move the corresponding Qualifying Examination from late June to late July.

Postponing the fellowship start date to August 1 would convey significant benefits to obstetric and gynecologic subspecialty fellows while introducing few hurdles:

• It would provide residents with time to move locations and complete new fellowship orientation activities, including skills boot camps if necessary.
• It would ensure that seasoned fellows are present in the hospital during July to work with new residents, potentially improving both patient care and the experience of incoming residents.
• With the decision of the American Board of Obstetrics and Gynecology to move the qualifying examination date to late July, delaying the fellowship start date would afford residents time to study for this critical examination without being in resident training. Residents would thus be able to complete this phase of the certification process before starting fellowship training.
• Although they have recognized the downside of the loss of a month’s salary and the need to arrange for health insurance coverage, obstetric and gynecology residents have reported that these challenges are outweighed by the benefits of the later start date. Feedback from junior fellows of the American College of Obstetricians and Gynecologists has been positive.

Of note, a delayed fellowship start date of August 1 has been in place for many American Board of Surgery fellowships since 2014. To support this change, the American Board of Surgery moved the General Surgery Qualifying Examination to July in 2016. It is appropriate for the specialty of obstetrics and gynecology to join our surgery colleagues in making this decision.

While we recognize that an August 1 start date may not be feasible in all circumstances, the undersigned organizations from across the specialty and subspecialties of obstetrics and gynecology strongly endorse moving towards a fellowship start date for clinical activities of August 1.

Supporting Organization Presidents: Nita A. Desai MD, MBA, President, (AAGL Fellowship Board of Directors), Iffath Hoskins, MD, FACOG (ACOG), Elizabeth R. Mueller, MD (AUS), Eve Espey MD, MPH (CUCOG), Judith Simms-Cendan, MD (NASPAG), Angela Dempsey, MD, MPH (SFP), Stephanie V. Blank, MD (SGO), Ruben Alvero, MD, Immediate Past President (SREI)