What do you want your job to be when you are finally done training? Why do you want a fellowship?  Is it more surgical experience? Do you want to advance the knowledge base of the subspecialty?  Do you want to learn to treat women with pelvic floor disorders better than you learned in residency?  Do you want to learn more about designing and conducting quality research?   Do you want to obtain a graduate degree?  These are all very important questions to consider before you start applying to the various fellowship programs.

Some people want to be a gynecologist AND do some urogynecology, these people may be happier with a 1-2 year "apprenticeship" than a formal fellowship program which stresses research. It is OK to break the mold and do your own thing, but it is a lot easier to do that if you know what you want. Some additional information to take into consideration:

Step 1 – Gather More Information: Find out more about the specialty and fellowship programs by visiting the Fellowship Programs section of the AUGS Website.

Here you will find a list of ABOG accredited programs in female pelvic medicine and reconstructive surgery, non-accredited programs and international programs.

You can also visit the Society for Urodynamics and Female Urology (SUFU) Website for a list of programs that are sponsored by SUFU but separate from ABOG/ABU accredited programs.
Accredited, non-accredited and international programs are also listed annually in the International Urogynecology Journal.

Step 2 – Decide on the type of program: Accredited vs. Non-Accredited does it matter? Some of the best programs are (or were) non-accredited, although those numbers are dwindling as the push to be accredited heats up. So what is the difference?
 
Accredited programs are required to give you one year of protected time for research, two graduate level courses (people usually take one semester of biostat and one of epi), rotations with urology and colorectal and have a thesis requirement. These programs must meet the training requirements set forth by the ABOG/ABU, and adhere to standards such as the 80-hour work week.  You often are not allowed to bill in an accredited fellowship, so this may impact the level of autonomy you have. As of 2006, all fellowship directors for an accredited fellowship program must have completed their fellowship at an accredited program.
 
Non-accredited programs typically have their fellows bill their time. Since it is expensive to have a fellowship program some programs find the money for the program by having their fellows bill. Often this takes the form of doing some OB call. There are some fantastic programs that are non-accredited, but there are some shaky ones as well. The only risk is if the field becomes a recognized subspecialty during the time you are a fellow. If that is the case, you want the program to be able to apply for accreditation, however you still may be eligible to sit for the written exam – this is all speculation at this point in time.  Some programs can meet all the ABOG requirements, some can't.
 
Additional programs exist that are non-accredited programs that are "under the radar". These are typically led by excellent surgeons who personally select their fellows. The only way to find out about these is to ask. Some of these programs are outstanding, some are not. Most are structured like an apprenticeship. Some of programs do not utilize the NRMP. This may interest you more if: (1) you want clinical training only, (2) you are geographically restricted, or (3) you want a program that is shorter than three years.
 
Step 3 – Follow updates on the Board Certification Status. Currently, Urogynecology is not an officially recognized subspecialty by the American Board of Medical Subspecialties, thus there is no board-certification at this time. When (and if) it first becomes available, there will be a grace period in which qualified candidates (rules to be determined) can apply for certification (this is called grandfathering into the subspecialty) and coming from a non-accredited program will not count against you. Once the grace period closes, only graduates from accredited fellowships will be board-eligible.  If you decide to train at an unaccredited fellowship, you will need to pay very close attention to any announcements or deadlines.

Step 4 - Begin Preparing for a Fellowship in Female Pelvic Medicine and Reconstructive Surgery. During each year of your post-graduate work, there are various steps you should take to help prepare you for a fellowship.  Click here to find out what those steps are.