APGO

Jennifer E. Dietrich, MD, MSc
Baylor College of Medicine, Houston, TX

Study Objectives: Gynecologic problems in the pediatric population often differ from that of the adult population and thus require specific knowledge as well as surgical and communication skills, in light of the age of the patients. Few OB/GYN residency programs offer exposure to Pediatric and Adolescent Gynecology (PAG). Among 104 programs recently surveyed, 63% reported no formal or dedicated PAG Clinic and 85% reported no outpatient PAG rotation. Fellowship training in PAG has been available since the 1980’s in an apprenticeship model. In the last few years a more formal fellowship structure has arisen, with an increased interest in PAG training programs in North America. Therefore, the need for coordinated curricula for specialized postgraduate training arose. This abstract describes the process of curriculum development for fellowships in PAG.

Methods: Program directors from the existing PAG fellowships met formally in 2010 at the annual meeting of the North American Society of Pediatric and Adolescent Gynecology (NASPAG), the society dedicated to education of healthcare providers about PAG. Several fellowship programs had created their own educational guidelines to comply with their Graduate Medical Education and ACGME requirements for competency evaluation. These existing educational efforts and expertise in the field was shared and compiled by a small working group and modified by all PAG fellowship directors at Cincinnati Children’s Hospital Medical Center, Baylor College of Medicine, Washington University, Kosair Children’s-Louisville, University of Missouri-Kansas City, University of Toronto, University of Michigan, Georgetown University and University of Ottawa. This led to the creation of a common PAG fellowship curriculum, based on the CREOG Educational Guidelines for residency training in PAG, but with a level of complexity specifically designed for the PAG fellow.

Results: A comprehensive educational curriculum that covers all areas of PAG was designed. Keys for documenting developing skills throughout the fellowship and recommended reading materials were added. The second developed tool was a surgical log that covers all the procedures in the PAG arena. With the onset of yearly fellowship director meetings among 9 current programs in North America as well as curriculum development, there has been increased interest in the formation of new PAG training sites given the 1:8 match rate. Finally, the NRMP is now used for the common fellowship match process.

Conclusions: The development of a formal PAG curriculum, approved by all fellowship directors, has increased the visibility of the PAG subspecialty training and has aided with the formation of more PAG fellowships with more consistent training of fellows. Eventually this may allow Pediatric and Adolescent Gynecology to develop into a separate highly specialized field similar to the way in which pediatric urology and pediatric surgery programs have subspecialized in order to better serve children and adolescents.

Key Words: Fellowships, Pediatric and Adolescent Gynecology, curriculum