Scientific advances, societal trends, and the education and practice of obstetrician-gynecologists.

Specialization in medicine in the United States began in Colonial America and expanded rapidly, spurred by increasing scientific information and advancing technology. By 1972, when the American Board of Obstetrics and Gynecology instituted subspecialty divisions, it had become impossible for the general obstetrician-gynecologist to remain competent in all areas of our specialty. Changes we can anticipate are a decreasing need for operations and hospital care coupled with increasing emphasis on primary health care for women. Most of our resident education programs have not yet reflected the need to begin to prepare obstetrician-gynecologists for a role that will be quite different from their present one.