Reproductive Endocrinology and Infertility (REI) for Medical Students
Most medical students are introduced to reproductive endocrinology without realizing it during their core curriculum reproductive biology course. Basically, RE is the study of the physiology and pathophysiology of hormones in the female body. This encompasses a very wide variety of subjects such as regulation of the menstrual cycles to diseases such as polycystic ovarian syndrome (PCOS), congenital adrenal hyperplasia (CAH) and hypothyroidism to name a few. Most medical students are not exposed to infertility topics until their clinical rotation on OB/GYN.
What training does it take to be a REI?
REI is a subspecialty of OB/GYN. So, after completion of 4 years of medical school, you will complete 4 years of OB/GYN training and then 3 years of REI Fellowship. REI Fellowship training is divided into 18 months of clinical training and 18 months of research training. Clinical training is fairly well standardized among the various training programs. Research training can vary with some programs having an emphasis on clinical research and others an emphasis on basic lab research. Some programs offer both.
What does an REI do?
Clinical practice for most REI doctors includes a combination of reproductive endocrinology and infertility. In most cases, infertility practice predominates with REI physicians considered the experts in advance fertility care with techniques such as in vitro fertilization. Other REI physicians may practice with an emphasis on reproductive endocrinology issues. Like all OB/GYN subspecialties, REI physicians also perform surgery. Common surgeries include abdominal myomectomies (removal of fibroid tumors), tubal anastomosis, operative laparoscopy for tubal disease, endometriosis and pelvic adhesions, hysteroscopic myomectomy, incision of uterine septum, lysis of adhesions and removal of polyps. Some REI physicians perform complicated surgeries for congenital abnormalities including creation of neo-vagina and resection of vaginal septum. REI physicians in academic practice often continue research efforts with both clinical and basic science research a possibility. Others participate in medical education.
How do I learn more about REI?
Some medical schools have routine rotations through REI during the OB/GYN rotation. If not, then most medical schools offer an elective in Reproductive Endocrinology. There are many on-line resources to learn about REI, starting with the American College of Obstetrics and Gynecology (ACOG) at www.acog.org
. ACOG offers several publications with a favorite being Prolog: Reproductive Endocrinology and Infertility. This booklet teaches by presenting clinical vignettes followed by a targeted discussion of the topic. Another source is the American Society of Reproductive Medicine, www.asrm.org
. Contrary to the title, this large organization has many international members. Although membership is required for access to some web content, there are many interesting topics visible to non-members. Other options include www.medscape.com/medicalstudents
where a search for Reproductive Endocrinology brings up a plethora of topics.