The ACGME Common Program Requirements have significant revisions that are effective July 1, 2019. One addition outlines the amount of time a fellow in a subspecialty fellowship program may be assigned to the independent practice of Obstetrics and Gynecology. The proposed text states the following:
IV.E. Fellowship programs may assign fellows to engage in the independent practice of their core specialty during their fellowship program.
IV.E.1. If programs permit their fellows to utilize the independent practice option, it must not exceed 20 percent of their time per week or 10 weeks of an academic year. (Core)
[This section will be deleted for those Review Committees that choose not to permit the independent practice option. For those that choose to permit this option, the Review Committee may further specify.]
Background and Intent: Fellows who have previously completed residency programs have demonstrated sufficient competence to enter autonomous practice within their core specialty. This option is designed to enhance fellows’ maturation and competence in their core specialty. This enables fellows to occupy a dual role in the health system: as learners in their subspecialty, and as credentialed practitioners in their core specialty. Hours worked in independent practice during fellowship still fall under the clinical and educational.
The Review Committee for Obstetrics and Gynecology is in the process of making its final decision on the independent practice option.
The ABOG realizes the importance of maintaining knowledge, judgment and technical skills in OB GYN during fellowship training. There is considerable overlap of the specialty of OB GYN and its subspecialties. However, many fellows will likely be seeking to prepare for their OB GYN Certifying Examinations during their fellowship training and will be seeking to meet eligibility requirements during their subspecialty training.
The ABOG has requirements for eligibility for subspecialty certification that must be met in order to begin the certification process. Each fellow must meet a required number of month-long clinical, research and elective rotations during 36 months of training.
The ABOG has allowed fellows to participate in non-subspecialty clinical activity or practice up to ½ day (4 hours) per work week (Monday-Friday) averaged over a 4-week period during required research rotations. Starting in July 2019, the ABOG will extend this allowance to all subspecialty fellowship rotations. These allowances do not apply to moonlighting, weekends or call. Fellows may not be assigned to weeks, months or blocks of clinical assignments or rotations to meet this allowance. Fellows may not be assigned to night float rotations to meet this allowance.
Fellows may not aggregate this allowance to complete training early or make up extensions in training for any reason. Failure to meet the subspecialty’s 36-month training requirements will necessitate an extension of a fellow’s training to meet certification standards.
