This revised Residency Leave Policy is effective immediately and will apply to graduates in the current academic year (2019-2020).
Candidates for certification are required to complete 48 months of graduate medical education in an Obstetrics and Gynecology residency program(s) that is ACGME-accredited. This is the approved length of training by the American Board of Medical Specialties for certification in Obstetrics and Gynecology.
Most residents will be training in a setting that follows an academic year calendar that starts each year on July 1 and concludes on June 30. In many cases, the academic year will consist of either 12 one-month or 13 four-week blocks, and training will be completed in four years. The academic years will be referred to as PGY1-4. In other situations, the training may be extended for additional months or completed over five or more years.
Residency Training in Canada
The length of training requirement also can be met by completing no fewer than 60 months in a clinical Obstetrics and Gynecology program(s) accredited by the Council of the Royal College of Physicians and Surgeons of Canada (CRCPSC). A minimum of 48 months of that training must be in Obstetrics and Gynecology. No credit for training outside of Canada may be counted toward meeting the 60-month training requirement.
Osteopathic Residency Training
Residents who complete 48 months in an American Osteopathic Association (AOA)-accredited program that achieves ACGME initial accreditation before their graduation are eligible for ABOG Obstetrics and Gynecology certification.
No credit will be given for Obstetrics and Gynecology residency training in programs accredited by any other organization, including ACGME-International.
Approved Leave from Residency
This policy applies to leaves of absence for medical, parenting, and/or caregiver leave. This policy is designed to align with circumstances covered by the Family and Medical Leave Act (FMLA), which allows for reasonable unpaid leave for certain family and medical reasons. These reasons may include:
• The birth and care of a newborn, adopted, or foster child
• The care of an immediate family member (child, spouse, or parent) with a serious health condition
• The resident’s own serious health condition
This leave policy does not apply to other personal leave and/or interruptions from a residency (e.g., prolonged vacation/travel, unaccredited research experience, unaccredited clinical experience, military or government assignment outside the scope of the specialty, etc.). This policy likewise does not apply to periods of time for which a resident does not qualify for credit by reason of resident’s failure to meet academic, clinical, or professional performance standards.
Extension of Training Beyond the End of an Academic Year
If completion of training dates change, residents are eligible for certification dependent on one of the following:
- If they are anticipated to complete training by September 30, they may apply for and take the Qualifying Examination that academic year.
- If they will not complete their residency by September 30, they will not be eligible to take the Qualifying Examination in the original academic year. Such graduates will be eligible to apply for the next academic year’s Qualifying Examination.
Residents are expected to take allotted personal (vacation and/or sick) time according to local institutional policies. Foregoing personal time (vacation or sick leave) by banking such time in order to shorten the required 48 months of residency or to “make up” for time lost due to sickness or other absence is not permitted.
Leaves of Absence or Interruption in Training
Leaves of absence and vacation may be granted to residents at the discretion of the Program Director consistent with local institutional policy and applicable laws. The number of days that equals a “week” is a local issue that is determined by the institution and Program Director, not ABOG. Vacation weeks may be taken as part of approved leave or in addition to approved leave.
Yearly Leave: The total of such vacation and leaves for any reason — including, but not limited to, vacation, medical leave, parenting leave, caregiver leave, or personal leave — may not exceed 12 weeks in any single year of residency. If the maximum weeks of leave per residency year are exceeded, the residency must be extended for a duration of time equal to that which the resident was absent in excess of 12 weeks in the PGY1, PGY2, PGY3, and PGY4.
Total Leave: In addition to the yearly leave limits, a resident must not take more than a total of 24 weeks (six months) of leave over the four years of residency. If this limit is exceeded, the residency must be extended for at least the duration of time that the individual was absent in excess of 24 weeks. Such extensions of training must have an educational plan outlined for the continued training with specific educational and clinical experience goals and objectives to be achieved for the chief (senior) resident year.
Unaccrued personal time may not be used to reduce the actual time spent in a residency, nor to “make up” for time lost due to leave. Time missed for educational conferences does not count toward the leave thresholds.
Core Clinical Experience
All residents must have core clinical training that includes the breadth and depth of Obstetrics and Gynecology and its subspecialties. The Program Director is required to attest to the resident's satisfactory performance, competence, and completion of the program (see Residency Training Affidavit FAQs). The Program Director is expected to sign on behalf of the program, not as an individual.
Residents are required to maintain a record of the number and type of obstetric and gynecologic procedures performed to demonstrate the adequacy of their operative experiences. Residents are required to submit their clinical experiences in the ACGME Case Log system following the instructions and policies outlined.
Neither the length of training nor clinical experience volume are substitutes for development of clinical and technical competence. However, with inadequate clinical experiences and/or insufficient surgical volume, it may not be possible to develop or assess clinical competency. ABOG is concerned about and will be monitoring the success of graduates completing a residency in less time and its effect, if any, on OB GYN certification.
Since certification is not completed until after a year of independent practice, some learning and skill development may, of necessity, continue beyond the residency.
Yearly Leave: An interruption of more than 24 weeks (six months) in any academic year of training must be reported to ABOG by the Program Director. The report must include an explanation for the absence from training, a block diagram of completed clinical experience, a plan for resuming training, and a proposed educational plan describing the clinical rotations and goals and objectives for the remaining training. In most cases, such an interruption should lead to an extension of training by an additional academic year. There must be a description of the proposed chief (senior) resident year experience. ABOG will review the report focusing on the breadth and depth of training experience and either approve or disapprove the educational plan of residency training.
Total Leave: Residents who take more than six months of leave within the first 48 months of their residency must have a review of their proposed residency training. The Program Director must submit a block diagram displaying the clinical rotations completed for review and approval by ABOG. Particular attention will be directed to the core clinical experience, surgical experience as a PGY4, and achievement of independent practice (described in next section below). If ABOG determines that there are deficiencies in training, ABOG may require extra months of clinical experience to be eligible for certification.
Residents who take more than six months of leave within the first 48 months of their residency also must have their clinical experience log reviewed to verify that they have met the contemporary OB GYN program graduate minimum clinical procedural experiences. ABOG may also establish minimum clinical and procedural experiences for eligibility for OB GYN certification. If ABOG determines that there are deficiencies in training, ABOG may require extra months of clinical and/or surgical experience to be eligible for specialty certification.
Chief Resident Conditional Independence Experience
Either the PGY3 or PGY4 year of a residency (or the final 24 months) must include the responsibilities of a chief (senior) resident in accordance with the ACGME program requirements. Residents who receive credit for time spent in a non-ACGME-approved residency program must serve their senior year as a PGY4.
The clinical and academic experience as a chief resident must be structured to prepare the resident for an independent practice of OB GYN. This chief resident experience, with appropriate supervision, should promote a high level of responsibility and independence. The chief resident clinical experience must include development of technical competence and proficiency in the management of patients with complex gynecological conditions, management of complicated pregnancies, and the performance of advanced procedures.
Revised Policy Date: February 11, 2020
Examples of When Extensions Are Required (or Not Required)
A resident takes three weeks of leave in PGY1, 12 weeks in PGY2, three weeks in PGY3, and three weeks in PGY4. This is a total of 21 weeks. There is no required extension of the residency.
A resident takes three weeks of leave in PGY1, 4 weeks in PGY2, five weeks in PGY3, and 12 weeks in PGY4. This is a total of 24 weeks. There is no required extension of the residency.
A resident takes three weeks of leave in PGY1 and PGY2, 16 weeks of leave plus two weeks’ vacation in PGY3, and three weeks in PGY4. This is a total of 27 weeks. This exceeds the yearly threshold by six weeks and the total threshold by three weeks. The residency must be extended by six weeks with an educational plan submitted and approved by ABOG.
A resident takes eight weeks of leave in PGY1, PGY2, and PGY3 and six weeks of leave in PGY4. This is a total of 30 weeks. The residency program must be extended by six weeks with an educational plan submitted and approved by ABOG.
A resident takes four weeks of leave in PGY1 and 24 weeks medical leave in PGY2. This exceeds the yearly threshold by 12 weeks and is a 24 weeks interruption in residency. This requires a report to ABOG of the residency completed through the PGY2; a proposal for extending the PGY2; and an educational plan for the PGY3, PGY4, and chief resident experience that will be reviewed. The residency must be extended by 12 weeks.
A resident takes four weeks of leave in PGY1, 12 weeks in PGY2, four weeks in PGY3, and 12 weeks in PGY4. This is a total of 32 weeks. The residency training must be extended by eight weeks with an educational plan submitted and approved by ABOG.
A resident takes three weeks of leave in PGY1, four weeks in PGY2, four weeks in PGY3, 24 weeks (six months) personal time off before starting the PGY4 and plans four weeks of vacation in PGY4. This is a total of 15 weeks leave. It is also an interruption of 24 weeks in the residency. This requires a report to ABOG of the residency completed through the PGY3 and an educational plan for the PGY4 plus chief resident experience that will be reviewed. The residency graduation date will be extended by 24 weeks.