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Program Directors Opinions on Hysterectomy Training Practices for Residents

Objectives:

The route and method (abdominal, vaginal, laparoscopic, robotic) selected for hysterectomy are influenced by clinical indication as well as patient demographic factors, geographic region, physician training and other nonclinical factors. Program directors (PDs) must focus on preparing residency graduates who are competent to perform each type of hysterectomy when in independent practice. In addition, recently approved ACGME minimum case requirements for program accreditation have generated controversy among PDs. This study surveys a national sample of PDs to assess residents’ hysterectomy volumes and PD perceptions of competency and training practices.

Study Design:

A 10-item survey was sent to PDs of all Ob/Gyn residency programs in the US and Canada electronically in March 2012. Non-responders were contacted with two subsequent emails. The response rate was 69% (N= 168/243).

Results:

The majority of PDs felt that the average resident requires at least 20-30 procedures for each hysterectomy type as surgeon to be competent, and 90% thought their residents were competent at graduation. PDs reported the following hysterectomy medians for their 2011 graduates: 20 vaginal, 50 abdominal, 36 laparoscopic and 10 robotic. Experience as surgeon occurred primarily in the PGY-3 and PGY-4 years, with the exception of abdominal hysterectomy primarily in the PGY-2 year.

Conclusion:

The majority of PDs believe their graduating residents are able to independently perform all hysterectomy types. The numbers PDs list for competency are higher than the ACGME minimum program accreditation requirements for laparoscopic and vaginal hysterectomy.

Topics: 2013, Resident, Residency Director, Patient Care, GME, General Ob-Gyn,