Aim of Subspecialist Training

The aim of training is to improve the care of patients with disorders of reproductive function in collaboration with other care providers.

Established trainers acknowledge that to train a sub-specialist is to be capable of:
  • improving knowledge, practice, teaching, research and audit
  • co-ordinating and promoting collaboration and organization of the service
  • providing leadership in the development and research within the subspecialty

  • The number of training positions should be strictly regulated by the relevant national body in order to provide sufficient expertise
  • The training program should be organised within a multidisciplinary centre and should be organised by a sub-specialist or an accredited sub-specialist. (Initially there will be a transitional period when accreditation for training will be given by the national appointing authority to a Specialist in Obstetrics and Gynaecology with proven scientific and clinical expertise in reproductive medicine. Subsequently, only individuals with training in the subspecialty should hold such a position)
  • The training centre should use guidelines and protocols finalised by national professional bodies reviewed at regular intervals
  • Training as a sub-specialist in reproductive medicine does not imply an exclusive activity in that field.

Means and requirements for training

Entry requirements:

  • a recognised specialist qualification in Obstetrics & Gynaecology or have completed a minimum of five years in an approved training program
  • the availability of a recognised training position.
An adequately remunerated position in a recognised training program is a basic condition. Each Fellow must be allocated an appointed tutor for guidance and advice, preferably on a 1:1 basis.
For each country, the number of training positions should reflect the national need for subspecialists in reproductive medicine as well as the facilities and finance available for training.
Training should be directed towards achieving competence. Fellows should participate in all hospital activities such as the care of out-patients and in-patients, on call duties, performing endoscopic surgery, assisted reproductive techniques such as ovulation induction, insemination, IVF/ICSI and participating in educational activities, including the teaching of other health professionals. Participation in audit and clinical and/or basic research is essential.
Arrangements for postgraduate training must be compatible with national employment legislation in relation to remuneration, hours of work and rights of employees in such matters as sick leave, maternity and paternity leave and compulsory military service.
Duration of subspeciality training should include a minimum of two years in an approved programme and should cover the clinical and research aspects of the following areas:

  • Andrology
  • Early Pregnancy
  • Endocrinology
  • Genetics
  • Reproductive biology
  • Reproductive surgery
  • Ultrasound imaging
  • Psychology and counselling
Training should be structured throughout with clearly defined targets to be met after specified intervals. An educational plan should be drawn up in consultation with the Fellow at the beginning of each attachment and progress should be monitored regularly by mean of the log book.
A Fellow may spent some training time in another (1 or 2) centre(s) recognised by EBCOG and ESHRE after approval by the national committee.


Assessment of training

In all European countries approval of training and trainers should be the responsibility of a national or regional authority which has the power to withdraw recognition if necessary.
Approval of institutions as training centres should be based on :

  • Annual statistics -Internal quality control and audit
  • Organised teaching sessions
  • Availability of: 
    - Multidisciplinary team regularly involved in the management of reproductive medicine
    -Reproductive biologist
    -Ultrasound unit
    -Optional: unit of genetics and urology
  • Fulfillment of defined criteria for minimum activity:
    100 new infertility cases per year for a first Fellow and 60 more for a second one would be the minimum number necessary to provide quality of care, fellowship training and research. Active participation in Reproductive Medicine courses, in particular those recognised by EBCOG, advised by ESHRE; completion of a log book of clinical experience in Reproductive Medicine; peer review publications in a nationally recognised journal.
On completion of training, Fellows should have performed the minimum number of diagnostic and therapeutic procedures and technical acts under supervision, and be able to carry these out independently, competently and safely.

A representative of the EBCOG/ESHRE Postgraduate Training and Assessment Working Party may be an observer on the national or federal assessment committee.

EBCOG in conjunction with the European Society of Human Reproduction and Embryology is willing to organise an evaluation visit to a sub-specialist unit if requested.