Dear CUCOG Member,

I’m writing in solidarity with the CREOG initiative to delay fellowship starts and to report that members of the Executive Committee of CUCOG decided to implement the delay with our fellowships starting in 2022 with full implementation by 2023.  We have worked with our fellowship directors, our incoming fellows and our GME leadership to work out the logistics of the delay and will be starting our fellowships on August 1^st.  We would like to encourage other chairs to consider this change which may have a major positive impact for residents/fellows.

This issue is controversial with compelling arguments for delay as well as some legitimate concerns.  The major arguments in favor of delay are:

• Allow incoming fellows to relocate, rest and reflect on residency and next stage of training prior to fully engaging in the new role.
• Afford residents time to prepare for the ABOG Qualifying Board Examination
• Separate start dates of new residents and fellows to create a more stable learning environment.

Concerns include lack of pay and a lapse in insurance coverage with the hiatus between the end of residency and fellowship start.  It is encouraging to note that insurance coverage via Cobra can be obtained retroactively so costs would only be incurred if needed during the short time period between residency and fellowship.

Notably, OB-GYN resident and ACOG junior fellow feedback has been overwhelmingly positive about this proposed change. 

• Future fellows were asked about the pay and insurance gap and strongly endorsed preference to tolerate the pay and insurance gap to have a month transition (see attached survey data from the CREOG in-service exam).
• They also stated that a delayed start might influence their decision to rank a fellowship.
• Fellows from other subspecialities, including all surgical subspecialties, Orthopedic subspecialties and Pediatric subspecialties, that went through a similar process to delay their start dates, have been highly positive about the delay.

Our CREOG colleagues have put significant effort into this initiative, including views of multiple stakeholders and this week, the CREOG Council voted unanimously to support an August 1 fellowship start. 

We look forward to discussion about the delay at our annual CUCOG meeting,

Sincerely,

Eve Espey, MD

Past President, CUCOG