Selecting the future in obstetrics and gynaecology: are we stuck in the past?

Background: Selection of specialist trainees in obstetrics and gynaecology has traditionally been hospital based. Aims: To report the outcomes of a state-wide selection process and suggest possibilities for future trainee selection. Methods: Applicants were screened for interview using a standardised curriculum vitae (CV) and referee reports, and the highest-ranked applicants were offered an interview. Scores from CV, interview and references were collated to give an overall score for each candidate. The candidates were then ranked in order of merit and integrated training program (ITP) hospitals ranked their preferences for candidates. The candidates were then offered positions based on a preference-matching system. Scores for selection components were correlated. Selection matching and trainee retention rates are reported. Results: In a 4 year period, 155 unique applicants made 183 applications, 65% were interviewed and 43% offered a position; 76% of the successful candidates were preference matched to theirs and the ITP's first choice. The retention rate to date is 92%. Conclusion: A state-wide selection process offers a transparent and meritorious means of selection of trainees in obstetrics and gynaecology. It has significant advantages over an individual hospital-based selection process for both trainees and hospitals. Outcome data for the optimal trainee to be selected are difficult to define. Reporting and reviewing data with a national selection process are imperative. The current selection process does not address issues that may be important for selection such as manual dexterity or psychological preparedness for the speciality of obstetrics and gynaecology.