The 55th Annual Clinical Meeting (ACM) of the American College of Obstetricians and Gynecologists (ACOG) was held on May 5–9, 2007, in beautiful San Diego, CA, USA. The meeting provided over 4200 registered attendees with a broad array of educational opportunities and was organized under the theme of ‘Guiding the New Direction of Women’s Health Care’.
The meeting included a wide array of ‘hands-on’ courses in topics ranging from high-risk obstetrics and ultrasonography to gynecologic and pelvic reconstructive surgery. These sessions provided an opportunity for conference attendees to enhance both their clinical skills and their hand–eye coordination. In addition, a wide array of courses and clinical seminars were conducted throughout the ACM, addressing virtually every aspect of obstetrics and gynecology, including issues such as coding and documentation, patient safety, financial planning, the new human papillomavirus vaccine, surgical complications, postpartum depression, recurrent pregnancy loss, menopause-related disorders and numerous other topics. There was truly something for everyone.
On the first day, the ACM main program opened with the President’s Program, the first of nine scientific sessions. Under the guidance of outgoing ACOG President Douglas W Laube (University of Wisconsin, USA), this session included three presentations addressing gender-associated biologic differences, the need for comprehensive women’s health education and the compassionate care of patients.
In the first of these lectures, David P Barash (University of Washington, USA) discussed hypotheses addressing the potential evolutionary advantages of such ‘female mysteries’ as ovulation, orgasm and menopause in a thought-provoking and often humorous presentation. Barash’s address was followed by a passionate speech by former US Surgeon General Joycelyn Elders (University of Arkansas Medical Center, USA) that challenged the healthcare system to improve the education of patients, and of women in particular. Elders emphasized the importance of empowering women through education. She stressed the value of educating women to control their reproduction in order to control their lives. The final presentation of the session was by Dale B Hull (UT, USA) who was paralyzed in a car accident in 1999. He spoke of the challenges that he faced in losing much of his independence and the importance of maintaining compassion in the care of patients. Through extensive rehabilitation, he has regained the ability to walk with a cane.
Other scientific sessions included presentations on a wide array of critical topics facing providers of women’s healthcare. Some of the most respected leaders in women’s healthcare addressed issues such as screening for Down syndrome, thrombophilia in pregnancy, availability of contraceptive services and osteoporosis. During the course of the sixth scientific session, ACOG members and guests were treated to an interesting series of presentations on the theme of ‘The evolving role of cesarean delivery’. The lectures illustrated various and opposing views on the role of cesarean delivery in settings such as twin pregnancy, breech presentation and vaginal birth after cesarean, as well as on the controversial topic of cesarean on maternal request.
The ‘Stump the Professors’ session, a perennial favorite of ACOG attendees, provided four ACOG Junior Fellows with the opportunity to present difficult and unusual clinical cases to four leading professors, who in turn asked probing questions in an effort to develop a differential diagnosis and correctly diagnose each patient. The session was moderated by Joseph Sanfilippo (Magee Women’s Hospital, PA, USA) and the professors included the following: Christos Coutifaris (University of Pennsylvania, PA, USA), former ACOG President Vivian M Dickerson (University of California – Irvine, USA), Laurel W Rice (University of Virginia, USA) and Dwight Rouse (University of Alabama – Birmingham, USA). In two of the cases, the professors correctly diagnosed unusual presentations of cystic fibrosis with bilateral pneumonia and Guillian–Barre syndrome. However, the professors were stumped by the other cases, which involved Epstein–Barr virus presenting with vaginal lesions and stage III ovarian cancer in a patient with Swyer syndrome.
During the course of the meeting, numerous academic sessions were held that focused on original research addressing virtually every area of women’s health. Over 200 posters and 24 research papers were presented demonstrating current research and investigations from around the world.
The first prize-winning paper, entitled ‘How relevant are the American College of Obstetricians and Gynecologists/Society of Gynecologic Oncology Guidelines on referral of adnexal mass?’, was submitted by Amy C Dearking and colleagues (Mayo Clinic College of Medicine, MN, USA). The authors described a prospective evaluation of 837 consecutive patients referred to a gynecologic oncologist for evaluation of a pelvic mass. They found that the ACOG/Society of Gynecologic Oncology guidelines are effective at identifying advanced-stage ovarian cancers but perform less effectively in the identification of early-stage disease, which is probably owing to the lack of clear signs or markers of early ovarian cancers.
In a paper entitled ‘Final results from the European Active Surveillance (EURAS) study’, JC Dinger and colleagues (ZEG-Center for Epidemiology and Health Research, Berlin, Germany) conducted a prospective evaluation of nearly 60,000 women to compare the risk of serious adverse events among users of oral contraceptives and nonusers. They found no increase in serious adverse events in oral contraceptive users and suggested that serious adverse events associated with nonuse, such as pregnancy, delivery and abortion, may actually increase the risk of serious health events, suggesting a beneficial public-health effect of oral contraceptives. This paper received the second prize.
Additional award-winning papers addressed screening for intimate partner violence, screening for gestational diabetes and pregnancy following bariatric surgery.
The ACOG Advisory Council held a series of lectures addressing critical issues affecting the field of obstetrics and gynecology. Normal Gant (Executive Director of the American Board of Obstetrics and Gynecology) described the requirements of the new ‘Maintenance of Certification’, which will begin to affect the ability of the vast majority of obstetrician–gynecologists (ob–gyns) to maintain board certification. He stressed that these new guidelines are intended to promote the efforts of physicians to engage in lifelong learning. In addition, Howard Blanchette (Chair of the Obstetrics and Gynecology Residency Review Committee) spoke on the continued effort to improve ob–gyn residents’ education in primary and preventive care and he stated that ob–gyns should increasingly foster and focus on health, rather than disease. Lastly, a third-year resident, Monique Ruberu (PA, USA), presented the results of her survey of ob–gyn residents. She noted that, while the current generation of residents valued education and patient care, they are increasingly demanding a renewed ability to balance both their professional and personal lives.
The popular 2-day course entitled ‘The business of medicine’ was well attended for the second consecutive year. This session was directed at residents and young physicians and provided an overview of the financial issues that impact both the personal and professional lives of physicians in general and ob–gyns in particular. The sessions included information on personal financial planning, insurance needs and employment contract evaluation.
For a second consecutive year, the ACM included programs directly intended for medical students. A session entitled ‘Ob–Gyn as a Career: Residency Training and Dimensions of Practice’ offered the approximately 300 medical students in attendance an informal opportunity to learn about a career in obstetrics and gynecology and how to secure a residency position in the field. In addition, over 24 residency programs from across the country participated in an Ob–Gyn residency fair and ACOG provided a medical student lounge free of charge.
On the final morning of the meeting, Kenneth L Noller was inaugurated as the 58th President of ACOG. Noller is currently the Chairman of Obstetrics and Gynecology at Tufts University (MA, USA) and has been a long-time leader within ACOG. After an inspiring speech regarding Ob–Gyns serving as the champions of healthcare for women and recent changes in health administration, he and the members on stage marched off to the tune of ‘We are the champions’ by Queen, complete with dry ice and a loud round of applause. Earlier during the meeting, the annual induction of new ACOG Fellows was performed.
While the focus of the meeting was clearly on women’s healthcare, there was no shortage of recreational opportunities available to both the meeting attendees and their families. A ‘block party’ welcoming all attendees and their families was held in the trendy Gaslamp district of downtown San Diego, where food, drinks and live music created a truly festive atmosphere. In addition, ‘Camp ACOG’ provided a fun way for the children of ACOG members to enjoy their time at the ACM. For those interested in pursuing recreational activities outside of the meeting, including the families of the meeting attendees, ACOG arranged a wide variety of day trips and other activities in the San Diego area. On the final evening of the meeting, Douglas Laube and his wife Janet hosted the sold-out President’s Reception and Dinner Dance on the deck of the USS Midway, home of the Aircraft Carrier Museum.
By the conclusion of the 55th ACOG ACM, attendees had enjoyed a great opportunity to learn about current and future directions in the fields of obstetrics and gynecology. In addition, they had been exposed to important new research from around the globe addressing every area of women’s health, all in the setting of beautiful San Diego, with its wonderful climate and multitude of recreational opportunities.