[Career development in gynaecology and obstetrics: Retrospective study of practitioners trained in Tours (2000-2021)]

Abstract

Objective: To describe the proportion of obstetrician-gynecologists trained in the Centre-Val de Loire region still practicing obstetrics, particularly on-call duties, after completion of training, and to identify practice patterns and factors associated with discontinuation.

Methods: A cross-sectional observational study was conducted among physicians who completed obstetrics and gynecology training between 2000 and 2021. A 69-item online questionnaire collected sociodemographic, professional, and satisfaction data from professionals. Statistical analyses included paired comparisons and bivariate tests (P<0.05).

Results: Of 106 eligible physicians, 77 responded (72.6%), 80.5% were women, and 48.1% were aged 40-50 years. The proportion performing obstetrics with deliveries decreased from 87.7% at career start to 65.1% (P<0.01). On-site duty dropped from 90.8% to 65.1% (P<0.01), and full-time weekly work from 87.7% to 77.8% (P<0.01). Main reasons for stopping on-call duties included improving work-life balance (53.6%), family reasons (42.9%), and shifting to gynecological practice (35.7%). Discontinuation of delivery activity was significantly associated with age (>40 years, P<0.01).

Conclusion: A substantial proportion of obstetrician-gynecologists trained in this region left hospital obstetrics during their career, potentially exacerbating shortages in perinatal care. Incentive and organizational measures are needed to sustain the attractiveness and viability of hospital obstetrics.

Keywords: Career change; Conditions de travail; Gardes; Gynécologie-obstétrique; Obstetrics; Obstetrics and gynecology; Obstétrique; On-call duty; Working conditions; Évolution professionnelle.