Becoming A Board-Certified Fertility Doctor

All about fertility doctors and what it takes to become one.

I often get asked “Who should I see?”, “How should I choose my doctor?”, and “What does it mean to be a fertility physician?” Let’s go over what it takes to become a fertility doctor and why it’s important to know your doctor’s credentials.

Becoming A Fertility Physician

Let’s start with the fact that it takes a long time to become a fertility doctor. This is one thing I think people forget, and even people in medicine don’t realize it. When I decided to become a doctor, I didn’t even know that reproductive endocrinology and infertility was a field. It starts with an undergraduate degree and medical school, which is eight years. Then you do a four-year OBGYN residency, which focuses on pregnancy, delivery, gynecologic care, and other sub-specialties. After that you have to match into a three-year fellowship, which is very competitive. Only about forty spots exist all over the country, and most places only have one fellow a year. You usually have to do substantial research or clinical experience to show that you are interested in this competitive field. Due to the fact that spots are limited, most of us have to move. You have to go where there is enough volume, faculty, and research to get adequate training. The interesting thing about the three-year fellowship is that at least eighteen months has to be research. It’s important to realize how much knowledge we gain about endocrinology, hormones, study designs and statistics so we can learn about scientific evidence and what matters. This is so important in our field because REI is always changing. Topics like embryos, research, genetics, biopsies, and pregnancy complications are hot topics in the news, so we have to stay on top of it. Our job is to be able to interpret the data and relay it to patients so they can make choices in alignment with their goals. My primary job is to evaluate you and give you the information you need to appropriately evaluate your choices. It’s not to make you do IVF or to get you pregnant. I don’t have a magic ball to know who will get pregnant and who won’t. Because of that, it’s important I arm patients with all of the information they need to make a choices that are best for them. You don’t know where this journey is going to lead you, and you have to feel good about the choices you are making.

Research

Research in fellowship is required because ABOG (American Board of OGBYN), who gives us board certification, requires 18 months of research and a substantial thesis project. The thesis is a publishable research project you complete during fellowship which you must write, send to journals, and defend in your boards. During fellowship, I did clinical research, which is observing populations and seeing what happens to them. I did my fellowship at UNC with Dr. Anne Steiner, who is a powerhouse in natural fertility research. She sparked my interest in understanding women who are trying to conceive and what makes them more likely to get pregnant. In my ideal world, I would put my job out of business because people wouldn’t need my help meaning they are equipped with information and made choices that would help them get pregnant naturally. Unfortunately, that’s not going to happen because the rate of infertility is only rising, and my job is getting busier. But I have always had a passion for natural fertility. I chose my program because the research program was highly fascinating to me and one of the reasons why I started an Instagram and eventually my podcast and YouTube channel. I wanted to give people information they needed so they would less likely need my help.

BOARD CERTIFICATION

Like I mentioned, fellowship was half clinic and half research. During the clinical work you are doing lots of retrievals and transfers, IVF plans, and seeing a lot of patients. My program gave us tons of autonomy which I loved because that’s what I had during my residency at Parkland. I realized that I learn more by doing versus watching. After you complete residency and fellowship, you have to get board certified. Those of us in REI are double board certified in OBGYN and REI. That is important. Someone can call themselves a fertility doctor and not be a double board certified fertility physician. You want somebody who has gone through all of that training. Board certification in our field is tough. For general OBGYN you take a three hour written exam, collect cases for a calendar year, and then you sit for an oral board examination. It is an intimidating and scary process. It is divided into 3 sections that are each about an hour. Somebody is looking through your cases and asking questions about those cases and their standardized cases. For general OBGYN it is divided into gynecology, obstetrics, and office. You have two people sitting in front of you that are excellent physicians asking you questions. You must pass this before you sit for your REI boards. For REI boards, you have to sit for a three hour proctored exams, collect cases for a calendar year, and do oral boards. It’s very similar to general OBGYN boards, but because the field is small, you have some huge names sitting in front of you. Also, the sections are a little different. You have three different case lists that are endocrinology, infertility, and surgery. Then you have three different sections that are each an hour long. They are infertility and surgery, endocrinology, and thesis and statistics. It is a very intense process. After all of this, you find out whether you are board certified or not. Some people don’t pass and have to retake them and there are also limits to how many times you can take them. If somebody is board eligible and they are 10 years out of training, that is not a good sign. Also, if they are not board eligible because they did not do a fellowship that is not good. Yes, OBGYNs do get a small training on REI but it is typically only a few months. Even though they can advertise as an OBGYN and fertility practice, it does not mean they are board certified.

As you now know, this is a long process that requires a lot of knowledge and understanding of the field. This is why it’s so important to know who your doctor is and what qualifies them to be a fertility doctor.

In summary:

College degree

Medical school (4 years)

OBGYN residency (4 years) + OBGYN board certification

REI fellowship (3 years) + REI board subspecialization