Bright seashells on the sand.

In obstetrics and gynecology residency education is a fixed prescription, whereas the world of practice leads physicians in diverse directions. Nonetheless, obstetrics and gynecology has so far resisted the proliferation of subspecialties. The future scope of our specialty will be defined by the changing healthcare needs of women. These will be driven by changing demographics and an emphasis on preventive and primary care. Residency education and, to a lesser extent, forms of practice will have to change to meet women's needs.