OB fellowship outcomes 1992-2010: where do they go, who stops delivering, and why?
OBJECTIVE
This study describes characteristics and the evolution of the careers of graduates from a 1-year post-residency fellowship program whose primary objectives included clinical skills in Cesarean section. Besides obstetrical practice, rural service and attainment of faculty appointment were used as surrogate measures of fulfilling an underserved need for family medicine obstetrics.


METHODS
For 18 years, the authors maintained contact with all 80 physicians completing 1-year fellowships in family medicine obstetrics in Memphis and Nashville. The founding chair of these programs surveyed each physician and maintained a network of contacts to study outcomes such as graduation, service location, hospital privileges, retention, and career changes.


RESULTS
The study tracked 100% of the sample and documented high rates of fellowship completion (74/80 [93%]), Cesarean privileges (71/74 [96%]), and service in a rural community for at least 2 years (47/74 [64%]). The fellowship was also associated with participation as faculty (36/74 [46%]).


CONCLUSIONS
This paper produces the first and longest-term data describing attrition over time and examines the reasons why fellowship-trained family physicians stop doing maternity care. It is the only series with a 100% response rate and provides longitudinal data on the outcomes of these fellowship programs. Attrition was highest at rural sites. Workforce planners and fellowship designers might benefit from these considerations.
Medicos para la Familia, Memphis, TN 38119, USA. wmrodney@aol.com
W MacMillan
WM
Rodney
Conchita
C
Martinez
Millard
M
Collins
Greg
G
Laurence
Carl
C
Pean
Joe
J
Stallings
D002983:Clinical Competence; D003625:Data Collection; D005257:Fellowships and Scholarships; D005260:Female; D006801:Humans; D008297:Male; D009774:Obstetrics / Q000193:education*; D010820:Physicians / Q000600:supply & distribution*; D011365:Professional Practice Location; D013337:Students, Medical / Q000706:statistics & numerical data; D013714:Tennessee