Reentry Into Clinical Practice in Obstetrics and Gynecology

Reentering into the clinical practice of obstetrics and gynecology requires formalized programs that provide direct supervision and meaningful evaluation. The American College of Obstetricians and Gynecologists selected “Reentry Into Practice” as the subject for the 2012 Issue of the Year. Physician reentry programs in obstetrics and gynecology are driven by the fact that there is a projected physician shortage, and there are physicians who voluntarily leave clinical practice for a period of time. In planning formal reentry programs, evidence-based practice and highest regard for patient safety must be considered. Our department initiated a reentry fellowship program in 2010. This article describes the process of how we developed our program, the challenges encountered, and the solutions used to overcome these challenges. The formal instruction, evaluation, and documentation of competency are presented. Process improvement has been based on feedback and evaluation from the reentry fellows and from staff and residents. Bringing physicians back into the clinical realm will depend on the success of new programs implementing the guidelines recommended by national regulatory bodies. The guidelines recommend that the programs are accessible, collaborative, comprehensive, ethical, flexible, individualized, innovative, accountable, stable, and responsive. Our reentry program has been successful in helping fellows reestablish clinical practice and is a way to incorporate hands-on competency-based experiences for the reentering obstetrician–gynecologist (ob-gyn).rnReentering into the clinical practice of obstetrics and gynecology requires formalized programs that provide direct supervision and meaningful evaluation.rnAbout Maria Manriquez MD FACOGrnHer service commitments include multiple leadership positions with the American College of Obstetricians and Gynecologists and as an oral examiner for the American Board of Obstetricians and Gynecologists.rnDr. Manriquez continues clinical practice, focusing on substance use disorders in pregnancy and parenting women. Her research and advocacy focus is aimed at investigating innovations in prenatal care models addressing maternal morbidity and mortality, preterm delivery rate and substance use disorders in pregnancy.rnOutside of her roles within medicine, Dr. Manriquez said family is most important to her. She is married to Moses Sanchez and has three children. “I like to say I birthed my best friend,” she said. Her daughter, Bernadine Sadauskas, is the department administrator for Frederic Zenhausern, PhD, MBA, and the Center for Applied NanoBioscience and Medicine, which Dr. Zenhausern directs. “We live next door to each other,” Dr. Manriquez said of her daughter. “We opened up the backyard between our houses. My three grandchildren live next door. We are well-rooted in our faith. Outside of that, I love to travel, and I like to write. I enjoy what I do in women’s health and serve my patients at MIHS.”rnDr. Manriquez is able to prescribe buprenorphine, a partial opioid agonist that is used to treat opioid addiction, and manages patients who need this care in pregnancy. She plans to sit for boards in Addiction Medicine this fall. She developed and is co-program director for Reentry into the Obstetrics and Gynecology Clinical Practice at Maricopa Integrated Health System.rnShe has been active in numerous leadership roles within and outside of the College, including the American College of Obstetricians and Gynecologists.