title: The dynamics of obstetricians and gynecologists in Japan: a retrospective cohort model using the nationwide survey of physicians data.
abstract: OBJECTIVE
  A shortage of obstetricians and gynecologists (OB/GYNs) in Japan has been highlighted. We conducted a descriptive and retrospective cohort study using data from the Survey of Physicians in Japan, and analyzed the dynamics of OB/GYNs.
  
  
  METHODS
  We calculated the total numbers of OB/GYNs, their average age, the percentage of female OB/GYNs, hospital OB/GYNs, and the number of OB/GYNs in rural areas in 1974, 1984, 1994 and 2004. We determined the number of physicians who participated in and left the specialty of obstetrics and gynecology. The withdrawal rates of OB/GYNs who graduated in 1972, 1982 and 1992 were retrospectively followed using survival analysis.
  
  
  RESULTS
  The overall number of physicians has increased, while the number of OB/GYNs has remained almost unchanged over the past 30 years. The percentage of female OB/GYNs has increased. Fewer new graduates chose obstetrics and gynecology, the withdrawal rate of current OB/GYNs decreased, and their average age (50.8 years) increased. The trend in withdrawal rates did not differ significantly among the generations.
  
  
  CONCLUSIONS
  The gravest problem in the OB/GYNs workforce is the continued decline in newly graduated OB/GYNs. Improvements in working conditions and job satisfaction are considered vital.
authors.affiliation: Department of Planning, Information and Management, The University of Tokyo Hospital, Tokyo, Japan. idea-tky@umin.ac.jp
authors.forename: Hiroo
authors.initials: H
authors.lastname: Ide
authors.forename: Hideo
authors.initials: H
authors.lastname: Yasunaga
authors.forename: Tomoko
authors.initials: T
authors.lastname: Kodama
authors.forename: Soichi
authors.initials: S
authors.lastname: Koike
authors.forename: Yuji
authors.initials: Y
authors.lastname: Taketani
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Imamura
mesh_terms: D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003625:Data Collection; D005260:Female; D006176:Gynecology; D006801:Humans; D007564:Japan; D008297:Male; D009774:Obstetrics; D012189:Retrospective Studies; D013997:Time Factors; D000078329:Workforce