Among the many factors that have altered the practice of obstetrics-gynecology are the following: the numbers of obstetrician-gynecologists, the increasing percentage of women entering the specialty, the expansion of ambulatory services with a simultaneous reduction in hospital admissions, a decrease in gynecologic surgical procedures, a stabilized number of total births with an anticipated increase in those to socially deprived and unmarried women, an increasing number of elderly women, general social and behavioral changes, and increasing outside control of practice. A proposal is presented for improving the education of residents and obstetrician-gynecologists in practice. © 1989 The American College of Obstetricians and Gynecologists.
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