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Resident Education in Complex Obstetric Procedures: Are We Adequately Preparing Tomorrow’s Obstetricians?

Purpose: Describe resident experience with surgical obstetrics and comfort in performing those procedures after graduation.

Background: ACGME milestones and CREOG objectives for OB/GYN residents include obstetrical technical skills. Data is limited on how often graduating residents meet these. 

Methods: Anonymous 27-question e-survey sent to all US OB/GYN residents in 3/2018 via CREOG coordinator-listserv. Complex obstetric procedures included: forceps(FAVD), vacuum(VAVD), cerclage, breech second twin(B2T), breech delivery(BVD), perineal repairs, and cesarean hysterectomy. Technical skills questions included experience as primary surgeon(PS), comfort performing procedures independently(CPI), and for 4thyear residents only-comfort performing procedures post-residency(CPPR). Descriptive statistics used to analyze responses. 

Results: 417 residents completed the survey. Respondents were 88% female, 75% from academic programs, and nearly 50% were post-graduate year(PGY) 3&4.

 Among residents of all levels, many had been primary surgeon in operative vaginal deliveries(51%-FAVD,72%-VAVD) and cerclage(62%), fewer for BVD(21%) and B2T(34%), cesarean hysterectomy(21%), and 4th degree repairs(37%). For PGY 3&4, 85% were CPI VAVD, while only 34% were CPI FAVD. 14% and 37% were CPI BVD and 4th degree repairs respectively. Of the 95 PGY4 respondents, all felt CPPR either VAVD or FAVD. Nearly all felt CPPR a 3rd degree repair(97%), but almost 20% did not feel CPPR a 4th degree repair. 33% did not feel CPPR a cesarean hysterectomy, 28% and 74% did not feel CPPR with B2T and BVD respectively.

Discussions: Though ACGME and CREOG recommend that  graduating residents are able to perform complex obstetric procedures, data suggest that for many graduating chief residents, this is not the case.

Topics: CREOG & APGO Annual Meeting, 2019, Resident, Faculty, Residency Director, Patient Care, Medical Knowledge, GME, Assessment, Maternal-Fetal Medicine, General Ob-Gyn,

General Information

Resident,Faculty,Residency Director,
Patient Care,Medical Knowledge,
Clinical Focus
Maternal-Fetal Medicine,General Ob-Gyn,

Author Information

Sarah Dotters-Katz, MD MMHPE, Duke University; Beverly Gray, MD; R. Phillip Heine, MD; Katie Propst, MD

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