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Recruiting to the OB/GYN Team. Dee E. Fenner, M.D. 2004 APGO President. APGO. JUST ONE MORE STUDENT!!!. Do we have a “problem”. NOT a crisis Maybe not even a problem But certainly a disturbing trend A symptom of the times and our specialty that we must address IT.

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recruiting to the ob gyn team

Recruiting to the OB/GYN Team

Dee E. Fenner, M.D.

2004 APGO President




do we have a problem
Do we have a “problem”
  • NOT a crisis
  • Maybe not even a problem
  • But certainly a disturbing trend
  • A symptom of the times and our specialty that we must address IT.
market analysis swot
Market Analysis“SWOT”
  • What is your product?
  • What is your market share?
  • What is your market?
    • Has it changed?
  • What is the competition?
  • What are your strengths and weaknesses?
  • Obstacles?
  • Threats?

What is your product?

We areObstetricians and Gynecologists.

We are Women’s Health Care providers.

We are Surgeons.

We are reproductive biologists.

We are high risk pregnancy specialists and gynecologic oncologists.

what is your market share how has it changed
What is your market share?How has it changed?
  • We are recruiting from only HALF the medical students……
women prefer female obstetrician gynecologist
Women prefer female Obstetrician/Gynecologist?
  • 40% prefer female
  • 10% prefer male
  • 50% Want a “good” doctor

Cockburn J. BJOG 1996;103:2-3

Chandler PJ Mil Med 2000; 165:938-940

Fennema K. J Fam Pract 1990;30:441-446

myths and misperceptions
Myths and Misperceptions?
  • Male graduates couldn’t find jobs?
  • Male Ob/gyns paid less?


  • Deans telling male students not to apply
  • Chairs telling male students not to apply
Women’s attitudes to the sex of medical students in a gyn clinic: cross sectional surveyO’Flynn N. BMJ 2002;325:683-684.
  • 33% of women refused to see a medical student
  • 42% accepted any student
  • 25% would not see a male student

The impact of Perceived gender bias on Obstet and Gynec skills acquisition by third-year medical studentsEmmons SL. Academic Medicine 2004;79:326-332

  • 78% of men felt gender negative effect
  • 67% of women felt gender positive effect
  • Males felt they would NOT be able to achieve a good grade.
    • Minimal difference is exams and deliveries
    • No difference in grades
Gender Bias Against Male Obstetrician-Gynecologists in Women’s MagazinesKincheloe LR. Obstet Gynecol 2004;104:1089
  • Females ob/gyns interviewed more than men in magazines
  • Females 20 times more likely to have an identifying picture
  • Negative comments about physicians –especially ob/gyn more like to use male pronouns (17% vs. 77%)
what is the competition
What is the competition?
  • The “controllable lifestyle” specialties?
specialty lifestyles
“Specialty Lifestyles”

Schwartz RW. Acad Med 1990;65:207-210.

Influence of Controllable Lifestyle on Recent Trends in Specialty Choice of US Med StudentsDorsey ER. JAMA 2003;290:1173-1177
  • ∆ 1996 to 2002 US Med Grads
  • Lifestyle, work hours, yrs. Residency, potential income
  • Log linear models
  • Lifestyle = 37% Income = 9%

Work hours = 2% Yrs of res. = 4%

what impacts career choice
What impacts career choice?
  • Extracurricular clinical experiences
  • Premed and undergrad experiences
  • Yr 1 and 2 exposure
  • Role models
when do they decide
When do they decide?
  • 15% of students chose specialty before medical school
  • 45% during the first TWO years
  • But 20 to 40% of students change their mind during the third year
  • 40% during the third year

Markett RJ. J Fam Prac 1983;17:295

Zeldow PB. Med Educ 1992;26:327

Kassebaum DG. Acad Med 1995;70:938

Considering obstetrics and gynecology as a specialty: current attractors and detractorsMetheny WP. Obstet Gynecol 1991;78:308-312
  • 11 medical schools
  • 50% response

Attractors Detractor

Female Insurance

Healthy patients life-style

Reproductive issues

Surgical procedures


statistically significant and nonsignificant factors in influencing one to choose ob gyn
Statistically significant and nonsignificant factors in influencing one to choose OB/GYN

Creighton University Grads 1991-2001

Fogarty CA. AJOG 2003;189:652-654.

What influences medical students to pursue careers in obstetrics and gynecology?Schnuth R. AJOG 2003;189:639-643
  • ½ of 205 medical students at MI State
  • 64% women, 35% men
  • Females felt negative factors for entering ob/gyn: length of training, stress, time demands, insurance costs, time on call
  • Males were most interested in opportunities to perform surgery and not concerned about pressure, length of training, insurance or time on call
what are our strengths
What are our strengths?
  • Mentors like YOU
  • Dedication
  • Quality education

79% of the students that choose a surgical specialty do so because of a mentor and faculty influence.

Bland KI, Ach Surg 2002;137;259-267

2001 aamc senior survey gq vs nrmp ob gyn match
2001 AAMC Senior Survey (GQ)VS. NRMP OB/GYN Match

Question 10 : Do you consider the OB/GYN clerkship to be excellent?

On a 4-point Likert Scale, what were the top programs, as defined by over half of the medical students marking 1.

11/125 US Medical Schools met this criteria

2001 aamc senior survey gq vs nrmp ob gyn match1
2001 AAMC Senior Survey (GQ)VS. NRMP OB/GYN Match
  • Comparing the top 11 schools by the GQ to the number of students from each US Medical School choosing OB/GYN –
  • 7/11 of the TOP GQ schools were in the top 15% of schools by recruitment numbers



weaknesses obstacles
  • Bad mouthing
  • Legal impact
  • Bad press
  • “Perception” of unhappiness?
bad mouthing
“Bad Mouthing”
  • 17% of males vs. 6% of females were discouraged from ob/gyn. Schnuth 2003
  • 2/3 of OB/GYN chairs discourage male students to enter field. (APGO survey)
Surgeons, I have to say honestly, they shred each other to pieces. That was a big turn-off. I can stand sleep deprivation for 10 years, but I can’t stand five minutes with the way they get at each other; to be rude to each other, to be rude to the house officers who couldn’t fight back, and to be rude to the students who couldn’t say anything in defense.

Mutha S. Acad Med 1997;72:635-640.

OB/GYN was not far behind surgery in negative comments!!

  • Recruitment “Playbook”
  • Medical student task force
  • Letters to the chairs
  • Working with ACOG and LCOG
  • CUCOG task force
  • “Benchmarking” top clerkships