Purpose: We evaluated associations between number of FPMRS cases in residency with graduates’ perceived preparation, comfort to practice independently, and current practice patterns.
Background: ACGME requires 25 incontinence and pelvic floor procedures as graduation minimums though specifically states these minimums don’t signify competence. Continued practice develops competency and increased comfort. With increasing FPMRS subspecialists, it is unclear whether generalists will practice/offer these procedures.
Methods: Anonymous, electronic, cross-sectional survey of MAHEC OB/GYN graduates (2007-2019), analyzed with Spearman correlation: reported number of cases in training and last 12 months, training quality ratings (1-5: very poor-very good); comfort ratings (1-4: very uncomfortable-very comfortable).
Results: 35/49 (71.4%) graduates responded (2007-2019); 71.4% have full scope practices. Reported cases for anterior/posterior repairs, slings, vaginal supports and urodynamics in residency were moderate-highly related to comfort the first year post-graduation (rho=0.567, 0.643, 0.464, 0.744, p≤0.001). Current volume was highly related to current comfort (0.732-0.861, p< 0.001); few (17-36%) reported current practice. Respectively, medians(min-max) per procedure: 10(30-99), 15(4-30), 5(0-50) and 10(2-50) in residency and 0 (0-<40) for all this year. Urodynamics performed, training quality, and comfort ratings were negatively related to graduation years (rho=-0.411 to -0.557; p< 0.039).
Discussions: Our generalist OB/GYN graduates reported minimally adequate exposure to simple FPMRS procedures in residency with positively associated comfort levels in year one post-residency. Most reported no or very low volume currently with strongly associated comfort. This suggests a need to increase resident experience and offer CME simulation to retain competency and facilitate comfort, or alternatively, consider training tracks in residency for trainees who plan to pursue FPMRS.
Topics: CREOG & APGO Annual Meeting, 2021, Resident, Faculty, Residency Director, Patient Care, Medical Knowledge, GME, Assessment, Female Pelvic Medicine & Reconstructive Surgery,
Lauren Knowlson, MD, MAHEC; Amelia Cline, MD; Shelley Galvin, MA; Elizabeth Buys, MD
