Purpose: To determine graduates’ perception of their
proficiency in gynecologic operations and the relevance of these procedures to
their current practice
Background: Program directors must certify that graduates are competent
to practice without supervision after residency. Achieving proficiency in
gynecologic surgery after 4 years is challenging. Evaluating the current
surgical curriculum is critical
Methods: A survey of 40 graduates from a single academic
instituition was conducted. 36 gynecologic procedures were listed. Each
procedure corresponded to two four-point scales (strongly agree to strongly
disagree). One scale was headed with preparation to independently perform the
operation, and the other questioned the relevance of the procedure in their
current practice. A third scale reviewed the need for additional training, and
the case/volume per year. A subgroup analysis was done to evaluate the
preferred route of hysterectomy and the rationale if vaginal hysterectomy was
avoided
Results: The response rate was 67.5%. All respondents felt
prepared to perform 25% (9/36) of procedures. More than 50% did not feel
competent performing laparoscopic single site hysterectomy, laparoscopic
myomectomy, sling, utero-sacral ligament suspension, vesico-vaginal fistula
repair, colpocleisis, and office hysteroscopy. Vaginal hysterectomy was
relevant for 78% of graduates, however, 89% performed fewer than 10 cases per
year, and 55% would benefit from additional training. More than 50% of
graduates would choose a non-vaginal route of hysterectomy, and interestingly,
93% of those based their decision on lack of comfort with the procedure
Discussions: While several gynecologic surgeries are relevant to recent graduates’ practices, some may not feel competent performing these procedures after residency. Vaginal hysterectomy is not commonly performed among graduates, largely due to inexperience with the procedure
Topics: CREOG & APGO Annual Meeting, 2020, Resident, Faculty, Clerkship Director, Clerkship Coordinator, Residency Director, Residency Coordinator, Patient Care, Systems-Based Practice & Improvement, Practice-Based Learning & Improvement, GME,
Mateo Leon,
MD; Mayo Clinic; Andreina Colina, MD; Erica Chapman,
MD; Jenny Duret-Uzodinma,
MD; Joseph Lucci, MD; Elizabeth Nugent, MD