Women attempting to become mothers often start their journey with a visit to an OB/GYN, a doctor who specializes in pregnancy and childbirth. When those women are unable to conceive, they are often referred to a fertility specialist, also called a reproductive endocrinologist or an infertility specialist. The role of the fertility specialist is to evaluate each unique case to determine the cause of infertility and to develop a treatment plan.
According to a recent report, by the Society for Assisted Reproductive Technology more American women than ever before have used medical help to become pregnant. This increase in women seeking medical assistance with pregnancy, as well as the increase in IVF and fertility treatment technology has resulted in a growing need for highly-qualified fertility specialists.
What is a Fertility Specialist?
A fertility specialist is a medical doctor who has taken their training (usually OB/GYN training) further in order to specialize in fertility-related conditions, treatments, and medical procedures. A fertility specialist has spent years studying the reproductive system, various diseases and conditions which can affect fertility, and the available treatments and procedures designed to assist with fertility.
Fertility specialists are primarily trained to:
- Thoroughly evaluate a patient to determine the cause of infertility, usually ordering numerous laboratory and other tests.
- Evaluate test results to determine whether a patient is in the normal range.
- Utilize test results to recommend fertility or other treatments on a case-by-case basis - from simple treatments like medications to increase hormones in women to in-vitro fertilization.
- Monitor treatment progress in each case and adjust the treatment plan when needed.
While evaluation, diagnosis and treatment are large aspects of a fertility doctor's job, getting to know their patients in-depth and offering counsel are also extremely important. Dr. Terence Lee, a Southern California reproductive endocrinologist and medical school professor, speaks on the importance of spending time with patients: "...there is great value in getting to know a patient, because in the field of fertility, there are usually multiple options available for some patients and the choice of the best option is based not solely on cold hard medical criteria, but also on personal preferences of urgency, frugality, risk aversion and religious views."
The Educational Path to Becoming a Fertility Specialist
Approximately 12 years of post-secondary education are required to become a fertility specialist, including graduating from an accredited, 4-year medical school with a MD (doctor of medicine) degree. Typically, a fertility specialist follows the educational path of an OB/GYN before obtaining specialized education.
Step by Step Educational Path of a Fertility Specialist
- Earn a Bachelor's Degree. As with any physician, earning a Bachelor's Degree is the first step in the educational journey. Although there is no required major, future fertility specialists should enroll in a pre-med program or be sure to take the prerequisite courses that most medical schools require. This includes sciences like chemistry, biology, physics, genetics and organic chemistry. Obtaining the highest possible GPA will increase a student's chances of being accepted into medical school.
- Medical School. The next step on a student's journey to becoming a fertility specialist is medical school. Successfully passing the Medical College Admissions Test (MCAT) is required for entry into medical school; this test is a multiple-choice exam that tests basic science knowledge as well as problem-solving and critical-thinking skills. During the first two years of medical school, students will spend time learning pharmacology, anatomy, psychology and a variety of other basic medical subjects. The last two years are spent doing clinical rotations where students work with actual patients under the care of licensed physicians. There are more than 140 accredited medical schools to choose from in the US, all offering excellent programs for future doctors.
- Take Part in a Residency Program. After medical school, future fertility specialists must take part in a residency program that will allow them to hone their knowledge and skills to provide the best possible care for future patients. The residency program for a fertility specialist is the same as that of an OB/GYN. Students will spend time performing OB/GYN duties; seeing patients and responding to emergencies and births. At the end of the residency, students on the fertility specialist path need to become certified as an OB/GYN in order to be certified as a reproductive endocrinologist in the future. This is done through the American Board of Obstetrics and Gynecology and involves a written and an oral examination.
- Obtain a Fellowship. The final step in the thorough education of a fertility specialist is to obtain a fellowship in reproductive endocrinology. Fellowships are intense, allowing future fertility specialists to gain valuable experience, seeing numerous patients with a variety of health conditions - from male infertility to basic endocrinology to a large number of reproductive disorders. At some point in the fellowship, students will act as primary physicians for patients under the watchful eye of licensed fertility specialists. They will also complete a research project. Upon completion of the fellowship, fertility specialists can now become board certified fertility specialists through the American Board of Obstetrics and Gynecology by successfully passing a written and oral examination.
Becoming licensed as a physician is also required, and is done through the United States Medical Licensing Examination, which is divided into three sections. Each section is completed at some point in the fertility specialist's medical education.
- Step 1: The first part of the examination is taken after the second year of med-school. Students will be tested on their knowledge of basic sciences and medical knowledge. This is a multiple choice test which takes just one day to complete.
- Step 2: Upon completion of the fourth year of medical school (or during the fourth year), students can take the second part of the medical examination. This examination is a two-day examination and tests the student's knowledge of clinical procedures and clinical sciences. Medical scenarios will be given to the physician to solve, in addition to a multiple-choice examination.
- Step 3: The final part of the medical exam is given during or after the first year of residency. Multiple-choice questions and simulated scenarios will be given to the physician in order to gauge their clinical knowledge and their knowledge of evaluation, diagnosis and treatment.
Understanding the Career Path
According to US News and World Report, there are just over 1650 reproductive endocrinologists employed throughout the US, with some states employing as few as 1 specialist. Most of these professionals work in private clinics, although some work in hospitals and other healthcare settings. Many fertility specialists collaborate with other doctors if health issues affecting more than one system in the body are causing infertility.
In a private office, a fertility specialist often works with fertility nurses and case managers, seeing patients who have been referred by OB/GYNs or other doctors. They work with patients suffering from a wide variety of conditions causing infertility, from low hormones and uterine or cervical abnormalities in women to abnormal sperm production or function in men. Fertility specialists may also work in other settings, including academic facilities, hospitals, and some outpatient care centers.
Employers often look for job candidates who display the following qualities:
- Outstanding communication and listening skills.
- Excellent attention to detail - fertility medicine is especially demanding of this skill as there are so many variables and potential solutions and problems.
- Compassion and empathy - women who are trying to become pregnant are often very vulnerable and desperate to have a child, and a fertility specialist needs to empathize with their struggle.
- Patience - though fertility medicine is extremely helpful in many cases, it often takes a long time to conceive and give birth, and only about half of all women seeking fertility treatments are able to experience a live birth.
- Thick Skin - though fertility specialists try their best to assist their patients, success is not always the end result. Many times, women blame their specialist out of frustration and sadness, and a fertility specialist needs to be able to roll with the punches.
Fertility specialists can potentially increase their chances of getting hired by considering taking the following steps:
- SOCREI Membership: The Society for Reproductive Endocrinology and Fertility is a fantastic organization to become a part of. Through this organization, fertility specialists can network with others in their field, gain access to industry publications and continuing education sources, and stay abreast of new trends and discoveries within the industry.
- ASRM Membership: The American Society for Reproductive Medicine is another fantastic organization to join, especially for reproductive endocrinologists relatively new to their field. Members have access to continued education sources and peer-reviewed journals, can network with other fertility specialists through the various groups and annual meeting, and can take part in educating legislators and proposing legislation at federal and state levels.
According to a 2012 survey completed by the American Medical Group Association, reproductive endocrinologists earned a median salary of $336,352 per year. Combine this with the above average (24%) job growth rate for these professionals, and it creates an attractive prospect for those considering going into this career field.
Fertility medicine can be one of the most rewarding types of medicine to practice. Entering the field means becoming a highly sought-after professional with the ability to provide care to a wide range of patients experiencing a variety of different issues. The significant growth in this industry, combined with the shortage of trained professionals, translates to excellent compensation, job stability and prospects for these professionals.