Obstetrics–Gynecology Educational Achievements in Iran (1979-2017): Trends, Consequences and Future Implications
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Abstract
Background: To study the current trends in Obstetrics–Gynecology (Ob-Gyn) education and workforce in Iran since 1979 and to discuss the consequences and implications.
Methods: This descriptive-analytical study was conducted to describe the Ob-Gyn residency and fellowship growth and workforce profile in Iran (1979-2017).The first-hand data gathered from MOHME and Iran’s Medical Council. The Obstetrician-Gynecologist (Ob-Gyns) per 100000 populations’ ratio and the percentage changes calculated and the trends analyzed.
Results: Between 1979 and 2017, the proportion of trained Ob-Gyns at national universities increased by 86.27%, the number of certified Ob-Gyns increased by 333% and, female Ob-Gyns increased by 1142%.The ratio of active gynecologists per 100,000 people was 5.0 in 1979 and 8.05 in 2017, represents an increase of 70%. Since 1979 the number of active gynecologists has increased by 278 and the number of active female gynecologists has increased by 996%. Since 1990 the maternal mortality per 100,000 live births decreased by 79.9% in Iran. However, since 1980 the Cesarean proportion increased by 203% in Iran.
Conclusion: Ob-Gyn education has undergone remarkable growth. Ongoing research should focus on Ob-Gyn’s geographic distribution, and potential implications of female Ob-Gyns practice pattern and technologies on women’s health.
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2. Tabatabai S, Simforoosh N (2020). Health Care and Medical Education to Promote Women's Health in Iran; Four Decades Efforts, Challenges and Recommenda-tions. Arch Iran Med, 23(7):469-479.
3. Tabatabai S, Simforoosh N (2020). Prefer-ence for Patient -Urologist Gender Simi-larity and Its Implications for Urology Departments: A Systematic Narrative Re-view and Thematic Analysis. Urol J, 17(6): 568-577.
4. IHS Inc.(2015). The Complexities of Physi-cian Supply and Demand: Projections from 2013 to 2025. Prepared for the As-sociation of American Medical Colleges. Washington,
DC: Association of American Medical Colleges. Available from: https://www.kff.org/wp-con-tent/uploads/sites/3/2015/03/ihsreportdownload.pdf
5. Tabatabai S, Javadi MA (2019).Ophthalmic education and ophthalmologists growth trends in Iran (1979–2016).J Ophthalmic Vis Res, 14(2):185-194.
6. Johnson RB, Onwuegbuzie AJ (2004). Mixed methods research: a research par-adigm whose time has come. Educational Researcher, 33(7): 14-26
7. American colleges of surgeons health policy research institute (2010).The Surgical Workforce in the United States: Profile and Recent Trends. Available from: https://docplayer.net/35383-The-surgical-workforce-in-the-united-states-profile-and-recent-trends.html
8. Iranian Obstetrics & Gynecology curriculum development committees (2017) .Obstetrics & Gynecology specialty cur-riculum the Secretariat of the Council on Medical Education and Specialty Training of MOHME. Available from: https://cgme.behdasht.gov.ir/uploads/Sp_ObstetricsGynecology.pdf
9. Accreditation Council for Graduate Medical Education. Minimum thresholds for ob-stetrics and gynecology procedures. Available from:https://www.acgme.org/Portals/0/PFAssets/ProgramRequirements/220_ObstetricsAndGynecolo-gy_2020.pdf?ver=2020-06-29-162338-630 [Accessed May 1, 2019.]
10. Kane SM, Siddiqui NY, Bailit J, et al (2010).Duty hour restrictions, ambulatory experience, and surgical procedural vol-ume in obstetrics and gynecology. J Grad Med Educ, 2(4):530–5.
11. Bruce PJ, Helmer SD, Osland JS, et al (2010). Operative volume in the new era: a comparison of resident operative vol-ume before and after implementation of 80-hour work week restrictions. J Surg Educ, 67(6):412–6.
12. Althabe F, Belizn JM (2006). Caesarean sec-tion: the paradox. Lancet, 368(9546):1472-3.
13. Nagy S(2014). [Changing trends and indica-tions for cesarean section in the last few decades]. Orv Hetil, 155(29):1140–6.
14. Islamic republic of Iran, ministry of health and medical education. Available from http://behdasht.gov.ir/index.jsp?siteid=1&pageid=1508&newsview=184825 [Ac-cessed May 1, 2019]
15. Ahmad-Nia S, Delavar B, Eini-Zinab H, et al (2009). Caesarean section in the Islamic Republic of Iran: prevalence and some sociodemographic correlates. East Medi-terr Health J,15(6):1389-98.
16. Wagner M (2000). Choosing caesarean sec-tion. Lancet, 356(9242):1677-80.
17. Azami-Aghdash S, Ghojazadeh M, DehdilaniN, et al (2014). Prevalence and causes of cesarean section in Iran: sys-tematic review andmeta-analysis. Iran J Public Health, 43(5): 545–555.
18. Pittini R, Oepkes D, Macrury K, et al (2002).Teaching invasive perinatal proce-dures: assessment of a high fidelity simu-lator-based curriculum. Ultrasound Obstet Gynecol, 19(5):478–83.
19. Cassel, CK, Holmboe, ES (2008). Profes-sionalism and accountability: the role of specialty board certification. Transactions of the American Clinical and Climatological Associ-ation, 119, 295–304.
20. Rayburn WF (2017).The obstetrician-gynecologist workforce in the United States: facts, figures and implications. 7th ed. Washington (DC): American Congress of Obstetricians and Gynecologists, United States, p:189. NLM ID:101542193
21. Simforoosh N, Tabatabai S, Ziaee SA (2014). Achievements in postgraduate urologic education in Iran: A quantitative study. Urol J, 10(4):1119-25.
22. Bettes BA, Strunk AL, Coleman VH, et al (2004). Professional liability and other ca-reer pressures: Impact on obstetrician-gynecologists’ career satisfaction. Obstet Gynecol , 103(5 Pt 1):967-73.
23. Tabatabai, S (2013). Effects of Physician-Patient Electronic Communications on the Quality of Care. International Journal of Reliable and Quality E-Healthcare (IJRQEH), 2(2): 54-62.
24. Anderson BL, Hale RW, Salsberg E(2008). Outlook for the future of the obstetri-cian-gynecologist workforce. Am J Obstet Gynecol, 99(1):88.e1-8.
25. KolarsJC (2001). Forecasting physician sup-ply and demand. Med Educ, 35:424-425.
26. Hollier LM, Promecene PA, Owens MY, et al (2015). Women's Health Care Teams and the Future of Obstetrics and Gyne-cology. Obstet Gynecol, 26(6):1285-1289.
27. Poley S, Belsky D, Gaul K, et al (2009). Lon-gitudinal Trends in the U.S. Surgical Workforce, 1981-2006. Bull Am Coll Surg, 94(8):27-31.
28. Grover A, Orlowski J M, and Erikson C E(2016).The Nation's Physician Work-force and Future Challenges. Am J Med Sci, 351 (1): 11-9.
29. Tabatabai S, Ziaee S A, Simforoosh, N (2014). Evidence-based health human re-sources planning and medical profes-sionals’ education in Iran. BMC Health Services Research, 14: 123.
30. Noori Hekmat S, Hashemi H, Haghdoost A, et al (2018). Specialized and Geographic Distribution of Specialists in Iran in 2016 and its Estimates in 2026. IRJE, 13(5) :122-132 .
2. Tabatabai S, Simforoosh N (2020). Health Care and Medical Education to Promote Women's Health in Iran; Four Decades Efforts, Challenges and Recommenda-tions. Arch Iran Med, 23(7):469-479.
3. Tabatabai S, Simforoosh N (2020). Prefer-ence for Patient -Urologist Gender Simi-larity and Its Implications for Urology Departments: A Systematic Narrative Re-view and Thematic Analysis. Urol J, 17(6): 568-577.
4. IHS Inc.(2015). The Complexities of Physi-cian Supply and Demand: Projections from 2013 to 2025. Prepared for the As-sociation of American Medical Colleges. Washington,
DC: Association of American Medical Colleges. Available from: https://www.kff.org/wp-con-tent/uploads/sites/3/2015/03/ihsreportdownload.pdf
5. Tabatabai S, Javadi MA (2019).Ophthalmic education and ophthalmologists growth trends in Iran (1979–2016).J Ophthalmic Vis Res, 14(2):185-194.
6. Johnson RB, Onwuegbuzie AJ (2004). Mixed methods research: a research par-adigm whose time has come. Educational Researcher, 33(7): 14-26
7. American colleges of surgeons health policy research institute (2010).The Surgical Workforce in the United States: Profile and Recent Trends. Available from: https://docplayer.net/35383-The-surgical-workforce-in-the-united-states-profile-and-recent-trends.html
8. Iranian Obstetrics & Gynecology curriculum development committees (2017) .Obstetrics & Gynecology specialty cur-riculum the Secretariat of the Council on Medical Education and Specialty Training of MOHME. Available from: https://cgme.behdasht.gov.ir/uploads/Sp_ObstetricsGynecology.pdf
9. Accreditation Council for Graduate Medical Education. Minimum thresholds for ob-stetrics and gynecology procedures. Available from:https://www.acgme.org/Portals/0/PFAssets/ProgramRequirements/220_ObstetricsAndGynecolo-gy_2020.pdf?ver=2020-06-29-162338-630 [Accessed May 1, 2019.]
10. Kane SM, Siddiqui NY, Bailit J, et al (2010).Duty hour restrictions, ambulatory experience, and surgical procedural vol-ume in obstetrics and gynecology. J Grad Med Educ, 2(4):530–5.
11. Bruce PJ, Helmer SD, Osland JS, et al (2010). Operative volume in the new era: a comparison of resident operative vol-ume before and after implementation of 80-hour work week restrictions. J Surg Educ, 67(6):412–6.
12. Althabe F, Belizn JM (2006). Caesarean sec-tion: the paradox. Lancet, 368(9546):1472-3.
13. Nagy S(2014). [Changing trends and indica-tions for cesarean section in the last few decades]. Orv Hetil, 155(29):1140–6.
14. Islamic republic of Iran, ministry of health and medical education. Available from http://behdasht.gov.ir/index.jsp?siteid=1&pageid=1508&newsview=184825 [Ac-cessed May 1, 2019]
15. Ahmad-Nia S, Delavar B, Eini-Zinab H, et al (2009). Caesarean section in the Islamic Republic of Iran: prevalence and some sociodemographic correlates. East Medi-terr Health J,15(6):1389-98.
16. Wagner M (2000). Choosing caesarean sec-tion. Lancet, 356(9242):1677-80.
17. Azami-Aghdash S, Ghojazadeh M, DehdilaniN, et al (2014). Prevalence and causes of cesarean section in Iran: sys-tematic review andmeta-analysis. Iran J Public Health, 43(5): 545–555.
18. Pittini R, Oepkes D, Macrury K, et al (2002).Teaching invasive perinatal proce-dures: assessment of a high fidelity simu-lator-based curriculum. Ultrasound Obstet Gynecol, 19(5):478–83.
19. Cassel, CK, Holmboe, ES (2008). Profes-sionalism and accountability: the role of specialty board certification. Transactions of the American Clinical and Climatological Associ-ation, 119, 295–304.
20. Rayburn WF (2017).The obstetrician-gynecologist workforce in the United States: facts, figures and implications. 7th ed. Washington (DC): American Congress of Obstetricians and Gynecologists, United States, p:189. NLM ID:101542193
21. Simforoosh N, Tabatabai S, Ziaee SA (2014). Achievements in postgraduate urologic education in Iran: A quantitative study. Urol J, 10(4):1119-25.
22. Bettes BA, Strunk AL, Coleman VH, et al (2004). Professional liability and other ca-reer pressures: Impact on obstetrician-gynecologists’ career satisfaction. Obstet Gynecol , 103(5 Pt 1):967-73.
23. Tabatabai, S (2013). Effects of Physician-Patient Electronic Communications on the Quality of Care. International Journal of Reliable and Quality E-Healthcare (IJRQEH), 2(2): 54-62.
24. Anderson BL, Hale RW, Salsberg E(2008). Outlook for the future of the obstetri-cian-gynecologist workforce. Am J Obstet Gynecol, 99(1):88.e1-8.
25. KolarsJC (2001). Forecasting physician sup-ply and demand. Med Educ, 35:424-425.
26. Hollier LM, Promecene PA, Owens MY, et al (2015). Women's Health Care Teams and the Future of Obstetrics and Gyne-cology. Obstet Gynecol, 26(6):1285-1289.
27. Poley S, Belsky D, Gaul K, et al (2009). Lon-gitudinal Trends in the U.S. Surgical Workforce, 1981-2006. Bull Am Coll Surg, 94(8):27-31.
28. Grover A, Orlowski J M, and Erikson C E(2016).The Nation's Physician Work-force and Future Challenges. Am J Med Sci, 351 (1): 11-9.
29. Tabatabai S, Ziaee S A, Simforoosh, N (2014). Evidence-based health human re-sources planning and medical profes-sionals’ education in Iran. BMC Health Services Research, 14: 123.
30. Noori Hekmat S, Hashemi H, Haghdoost A, et al (2018). Specialized and Geographic Distribution of Specialists in Iran in 2016 and its Estimates in 2026. IRJE, 13(5) :122-132 .
| Files | ||
| Issue | Vol 50 No 10 (2021) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v50i10.7509 | |
| Keywords | ||
| Obstetrics-gynecology Specialty education Workforce Growth Gynecologist gender | ||
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How to Cite
1.
Tabatabai S, Simforoosh N, Azimi Khatibani SE. Obstetrics–Gynecology Educational Achievements in Iran (1979-2017): Trends, Consequences and Future Implications. Iran J Public Health. 2021;50(10):2085-2094.
