Objective: To examine in detail the geographic distribution of reproductive endocrinology and infertility (REI) fellowships in the United States.
Design: Ecological.
Setting: University-based REI fellowship program.
Patient(s): None.
Intervention(s): None.
Main outcome measure(s): Number and location of REI fellowship positions.
Result(s): A significant association was found between the number of REI fellowship positions and the number of categorical postgraduate year-1 (PGY-1) obstetrics and gynecology (OBGYN) residency positions within states. No association was observed among the land area, population, or population density within states. However, despite the fact that in the East, as in the United States overall, there was no association between population density and number of fellowships, West of the Mississippi River, as the population density increased, the number of REI fellowships increased linearly (test for heterogeneity = 0.007).
Conclusion(s): First-year REI fellowship positions in the United States are correlated with the number of categorical PGY-1 OBGYN residency positions within a state. The geographically uneven distribution of fellowship positions may limit the choices for OBGYN residents wishing to pursue further training in REI.