Profession & women's health
Gynecologist: history, training and education of a specialty serving women
The gynecologist is the medical specialist in women's genital, hormonal and reproductive health. From adolescence to menopause, they handle monitoring, prevention, screening and the treatment of many conditions, supporting their patients at every major stage of life. Behind this demanding profession lie a thousand-year history and one of the longest training paths in all of medicine. Here is a complete overview of gynecology, from its origins to today's training.
Origins: a women's medicine 4,000 years old
Concern for women's health is nothing new. The oldest known medical document on the subject, the Kahun Gynecological Papyrus, was written in Egypt around 1800 BCE. In just three pages, it already addresses fertility, pregnancy, contraception and diseases of the female reproductive system. Centuries later, Greek and then Roman medicine deepened this knowledge: in the 2nd century CE, Soranus of Ephesus wrote a treatise on gynecology and obstetrics so accomplished that he would long be regarded as the true founder of the discipline.
The word gynecology itself comes from the Greek gunê (woman) and logos (study, discourse): literally, "the study of woman".
From the Middle Ages to the Renaissance
In the 11th century, at the famous School of Salerno, a woman physician named Trotula wrote reference works on women's diseases and childbirth care that would remain authoritative across Europe for centuries. The rise of the first universities — Bologna, Paris, Padua — from the 13th century onward, followed by the invention of the printing press, helped spread anatomical knowledge. Paradoxically, this professionalization came with the gradual exclusion of women from scholarly medicine, long reserved for men.
The birth of modern gynecology
It was in the 19th century that gynecology became a true surgical specialty, with the refinement of instruments such as the speculum and the development of the first major procedures. This period includes pioneering but also controversial figures: the work of the American surgeon James Marion Sims, sometimes called the "father of modern gynecology", is now widely criticized because it was carried out on enslaved women, without consent or anesthesia — a reminder of the ethical issues that run through the entire history of medicine.
Advances then followed one after another: the first hysteroscopy in 1869, then the development of the Pap smear by physician Georgios Papanicolaou from 1928 onward, which would revolutionize cervical cancer screening. In 1951, the first major professional college of obstetrics and gynecology was founded in the United States, a sign of the specialty's international structuring.
The 20th century: the women's health revolution
The last century radically transformed women's care. The arrival of oral contraception and intrauterine devices offered unprecedented control over fertility. Ultrasound, introduced in obstetrics in the late 1950s, opened a direct window onto pregnancy and the pelvic organs. Finally, the evolution from artificial insemination to in vitro fertilization led, in 1978, to the birth of Louise Brown, the first "test-tube baby" in history. Screening, imaging, hormonology, assisted reproduction: modern gynecology was born.
How long have gynecology centers existed?
For centuries, childbirth and women's care belonged to the domestic sphere and to midwives. The first large hospital maternity wards appeared in Europe from the 17th and 18th centuries, followed in the 19th century by hospitals entirely dedicated to women's diseases. Gynecology then gradually became independent from obstetrics to become a specialty in its own right. Today, care is organized around private practices, maternity units graded by risk level, hospital gynecology-obstetrics departments, assisted-reproduction (ART) centers and cancer treatment centers.
Becoming a gynecologist in France: about 11 years of study
In France, gynecology is one of the longest training paths in medicine. It all begins with the first year of health studies, the PASS (specific health-access pathway) or the L.AS (bachelor's degree with health access), which replaced the former PACES in 2020. Then come the clinical-student years (externat), through the sixth year, devoted to theoretical learning and the first hospital placements.
At the end of the sixth year, students sit the national ranking exams (ECN/EDN), a competitive exam whose ranking determines the choice of specialty and the city of residency. Then comes the residency (internat), a paid specialization period during which the student validates their specialized studies diploma (DES). Two paths coexist, a French peculiarity: the DES in medical gynecology (about 4 to 5 years, i.e. nearly 10 years of study in total) and the DES in obstetric gynecology (about 5 years, i.e. nearly 11 years in total), more oriented toward surgery and childbirth. The course ends with the defense of a doctoral thesis in medicine.
Internships, sub-specialization and continuing education
Practice is at the heart of training. From the externat onward, future gynecologists complete many placements in hospital. The residency is structured by rotations in medical gynecology, obstetrics, gynecological surgery, imaging and reproductive medicine. Residents may complete their training with a Cross-Disciplinary Specific Training (FST) — which replaced the former DESC — to sub-specialize. Throughout their career, practitioners also remain subject to a continuing professional development (DPC) obligation to keep their knowledge up to date.
The major branches of gynecology
The specialty covers very diverse areas: medical gynecology (monitoring, contraception, menopause, screening), obstetric gynecology (pregnancy, childbirth, surgery), gynecological oncology (cancers of the uterus, ovary, breast), reproductive medicine and ART (infertility, IVF), senology (breast health), urogynecology and expert ultrasound. This diversity places gynecology at the crossroads of surgery, endocrinology and public health.
Did you know?
Medical gynecology, as a distinct specialty without a mandatory surgical dimension, is a French peculiarity: few countries have an equivalent qualification. Long threatened with disappearance, it was reinstated under pressure from patient associations, who are deeply attached to close, lifelong follow-up.
From ancient Egypt to today's assisted-reproduction centers, gynecology tells the story of a long achievement: a medicine designed for women, carried by ever-better-trained practitioners. A constantly evolving field where science, prevention and listening come together in the service of women's health.
