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Access to infertility care in a low-resource setting: bridging the gap through resident and fellow education in a New York City public hospital

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Abstract

Purpose

Improving access to care is an issue at the forefront of reproductive medicine. We sought to describe how one academic center, set in the background of a large and diverse metropolitan city, cares for patients with extremely limited access to reproductive specialists.

Methods

The NYU Reproductive Endocrinology and Infertility (REI) Fellowship program provides a “fellow-run clinic” within Manhattan’s Bellevue Hospital Center, which is led by the REI fellows and supervised by the REI attendings of the NYU Langone Health system. A description of the history of the hospital as well as the logistics of the fertility clinic is provided as a logistical template for implementation.

Results

The fellow-run fertility clinic at Bellevue hospital is held on two half days per month seeing approximately 150 new patients per year. The fertility workup, counseling, surgery, as well as ovulation induction, and early pregnancy management are offered within the construct of the fellowship and residency at NYU. Barriers to care and ways to circumvent those barriers are discussed in detail.

Conclusion

By utilizing the ambition and construct of the OB/GYN programs, we greatly improve care for an otherwise underserved patient population by offering an efficient and optimal infertility workup and treatment in a population that would otherwise be without care. We utilize the framework of graduate medical education to provide autonomy, experience, and mentorship to both residents and fellows in our programs in an effort to provide a solution to combating inequity in infertility care.

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Acknowledgments

The authors gratefully acknowledge the patients and staff at the Bellevue Hospital Center.

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All authors contributed to the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Jennifer K. Blakemore.

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The authors declare that they have no conflict of interest.

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All procedures performed in this study were in accordance with the ethical standards of the institution.

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There were no human subjects as part of this manuscript and therefore no need for informed consent.

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Blakemore, J.K., Maxwell, S.M., Hodes-Wertz, B. et al. Access to infertility care in a low-resource setting: bridging the gap through resident and fellow education in a New York City public hospital. J Assist Reprod Genet 37, 1545–1552 (2020). https://doi.org/10.1007/s10815-020-01781-y

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  • DOI: https://doi.org/10.1007/s10815-020-01781-y

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