Editorials

Gynaecology—medical or surgical?

BMJ 1996; 312 doi: https://doi.org/10.1136/bmj.312.7031.592 (Published 09 March 1996) Cite this as: BMJ 1996;312:592
  1. S K Smith
  1. Professor of obstetrics and gynaecology Department of Obstetrics and Gynaecology, University of Cambridge Clinical School, Rosie Maternity Hospital, Cambridge CB2 2SW

    A more medical approach could reduce inappropriate surgical procedures

    Historically, obstetrics and gynaecology brought together medically interested obstetricians and surgically interested gynaecologists,1 2 but gynaecology has always been seen as a surgical specialty. However, the increasing complexity of the subject and women's enhanced awareness of their reproductive health have opened up four subspecialties within obstetrics and gynaecology—reproductive medicine, maternofetal medicine, urogynaecology, and gynaecological oncology—all of which involve growing elements of medical expertise. So, should gynaecology remain a surgical specialty, or has it changed so much over the past 30 years that its training requirements need to be reviewed? And might a more medical approach to gynaecological disease lead to fewer women undergoing inappropriate surgical interventions?

    One of the great achievements of obstetrics and gynaecology has been to establish a specialty in which women and not a disease or organ are the focus. There can be few …

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