Certified subspecialists in reproductive endocrinology and infertility assess, diagnose and manage female and male infertility, differences in sexual differentiation, disorders of puberty, menstrual disorders and reproductive endocrine disorders, gender dysphoria, premature menopause and normal menopause.
This can include:
Though varied, the work is generally predictable with few emergencies. A typical clinical day may include consultations interspersed with minor procedures, with theatre lists set aside for more complex surgery. Achieving successful outcomes require collaboration with a multidisciplinary team that includes embryologists and laboratory scientists, andrologists, nurses, practice staff, anaesthetists, and other surgical and medical specialists.
Some reproductive medicine subspecialists choose to continue in obstetric practice as well, though many do not.
Certified subspecialists in reproductive endocrinology and infertility generally have:
As a consultant, the job provides excellent work-life balance and a range of clinical, research and leadership opportunities.
It is expected that you will have a leadership role as a subspecialist, for example as the Medical Director of an Assisted Reproductive Technology (ART) unit. This includes managing a team, overseeing clinical guidelines and practice, ensuring adherence to the relevant legislation, and being responsible for the clinical management of patients within the unit. There are also opportunities to take on leadership roles in the public health sector.
As a clinician, you will generally spend a substantial proportion of your time working in assisted reproduction. This is primarily undertaken in the private sector, where you will provide continuity of care to individuals and couples throughout their journey. Managing patient expectations and dealing with poor outcomes is an essential aspect of the work. Other clinical aspects of the role can include paediatric and adolescent gynaecology, transgender and gender diverse medicine, fertility preservation, reproductive surgery, minimally invasive gynaecological surgery, and management of male infertility.
Many subspecialists will have active research careers, and serve as local, national and international experts in the field.
To become a certified subspecialist in reproductive endocrinology and infertility (CREI), you must be a Fellow of the Royal Australian and New Zealand College of Obstetrics and Gynaecology (FRANZCOG) in addition to completing the three-year CREI subspecialist training program. More information on the six-year FRANZCOG training program can be found here. You can start the CREI training program during your last two years of FRANZCOG training, however most trainees will start during their final year. This means the total training time to become a fully qualified subspecialist is usually eight or nine years.
Entry to training is competitive and is through a national selection process. Training is undertaken at approved sites across Australia; there is currently one approved site in Western Australia. The program entails clinical and surgical experience, a written exam, an oral exam, and a research component. Trainees are currently required to spend at least six months in a second clinical site, usually interstate or overseas. There is the option to have one non-clinical academic year credited towards training time. Training sites generally include multiple hospitals and clinics in the private and public sectors.
Most certified subspecialists in reproductive endocrinology and infertility work in private practice, with many also working in public hospitals and leading research. The career prospects are excellent, with fewer than 100 subspecialists across Australia and New Zealand. Many gynaecologists will work in fertility units and offer IVF, however the additional training required to be a certified subspecialist in reproductive endocrinology and infertility prepares you for a career as an expert and a leader in the field.
