LAS VEGAS – The geographic distribution of female pelvic medicine and reconstructive surgery fellowships approved by the Accreditation Council for Graduate Medical Education varies widely in the United States, results from an analysis demonstrated.
Such variation "may limit the choices for residents wishing to pursue further training in female pelvic medicine and reconstructive surgery," Dr. Tyler Muffly said in an interview during a poster session at the annual meeting of the American Urogynecologic Society. "It also means that patients in some areas are going to have to travel further to get to a referral center."
In an effort to determine the distribution of first-year female pelvic medicine and reconstructive surgery (FPMRS) fellowship positions according to population within states and within districts of the American Congress of Obstetrics and Gynecology, Dr. Muffly and his associates used data from the 2010 U.S. Census and from the number of 2012 female pelvic medicine and reconstructive surgery fellowship positions available through the match, which were obtained from the Accreditation Council for Graduate Medical Education (ACGME). They rounded off population data to the nearest 1,000 persons.
Dr. Muffly of the division of female pelvic medicine and reconstructive surgery (FPMRS) at the University of Colorado, Aurora, reported that there was a mean of 9.6 FPMRS fellowship positions per ACOG district and a mean of 2.3 FPMRS programs per ACOG district. More than two-thirds of fellowship programs were located east of the Mississippi River (67.5% vs. 32.5% west of that spot), with the greatest number clustered in ACOG District V, which consists of Michigan, Indiana, Ohio, and Kentucky (20.8%).
Dr. Tyler Muffly
The researchers observed a significant difference between ACOG districts based on the number of FPMRS fellowship programs (P = .04) as well as a difference in total population between districts (P less than .0001). Specifically, Florida (ACOG District XII) had the highest proportion of women overall (P = .001) while California (ACOG District IX) had the highest proportion of postmenopausal women (P less than .001).
When Dr. Muffly and his associates analyzed the distribution of FPMRS fellowship positions within ACOG districts, a statistically significant difference was observed in the number of FPMRS fellowship positions per district (P = .03). For example, there were only 8 positions in ACOG District VIII (Arizona, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, Washington, and Wyoming), compared with 16 positions in ACOG District III (Delaware, New Jersey, and Pennsylvania).
"The findings suggest that future FPMRS fellowships might be started in the West or in high-density states like Florida or California where there are many postmenopausal women," Dr. Muffly concluded. "There are fellowships in all 11 ACOG districts. Physicians in the West or in the high plains states might have to look a little harder for a fellowship or a referral center for female pelvic medicine and reconstructive surgery."
Dr. Muffly said he had no relevant financial disclosures.