Purpose: To identify solutions to improve OBGYN training in residency programs.
Background: With growing concerns regarding low-volume surgeons, a critical need to evolve OBGYN training is evident. Educators have presented many options, but implementation is limited by differing stakeholders. We sought input from practicing and training OBGYNs across sub-specialties and residency settings to understand multiple perspectives.
Methods: Residency program directors, faculty, PGY-4s, and recent graduates were surveyed anonymously via REDCap. Participants were invited to submit free-text recommendations. Submissions were coded into categories. Descriptive statistics were performed, and data analyzed using two-sample test-of-proportions with p< 0.05 conferring statistical significance.
Results: Of 105 respondents, 64 submitted recommendations. Ninety-four unique recommendations were coded into 6 categories: Tracking (38%), Increasing Gynecology-to-Obstetrics Ratio (20%), Curriculum Changes (simulation, attending-specific education, adjustment of duty hours, and trainee-specific ACGME minimums) (14%), Lengthening Residency to 5 years (11%), Splitting OB and GYN Residencies (8.5%), and Other (shorter fellowships, trainee ambition and independence, no tracking) (8.5%). Among the top 4 categories, percentage of faculty versus trainee/graduate recommendations differed significantly only for Lengthening Residency (27% vs 6% respectively, p=0.022). Between Subspecialists and Generalists, significant differences were identified between Lengthening Residency (10% vs 42% respectively, p=0.006) and Tracking (63% vs 25 respectively, p=0.016). No Generalists recommended Splitting Residencies.
Discussions: Recommendations reflect the current frustrations faced by practicing and training OBGYNs and highlight the need for a multifaceted approach to reform. Such input should be serially elicited on a broader scale to inform changes and optimally maintain the competence of graduating trainees in a rapidly-evolving clinical specialty.
Topics: CREOG & APGO Annual Meeting, 2023, Resident, Faculty, Residency Director, Residency Coordinator, Medical Knowledge, Systems-Based Practice & Improvement, Practice-Based Learning & Improvement, GME, General Ob-Gyn,
Samhita Nelamangala, MD, MBA; Vanderbilt University Medical Center; Shivani Murarka, MD; Niharika Ravichandran, MD; Mary Baker, M.D., M.B.A.; Nicola White, MD; Carl Zimmerman, M.D.
