Background: The Accreditation Council for Graduate Medical Education (ACGME) has established minimum number standards for select surgical procedures for graduating residents in surgical training programs, including Obstetrics and Gynecology. These numbers reflect the lowest acceptable clinical volume of procedures performed as primary surgeon per graduating resident for program accreditation. The primary surgeon must perform >50% of the surgical case. Many OB/GYN residency programs are concerned about their ability to meet the minimum numbers standards. Due to increased emphasis on and availability of conservative treatment options for abnormal uterine bleeding, the volume of hysterectomies performed each year is decreasing. There is also a trend toward minimally invasive routes of hysterectomy including vaginal, laparoscopic, and robotic, but residents are expected to achieve competence in all.
Methods: A 41-question survey on Survey Monkey was sent to 123 OB/GYNs in Omaha via email. The survey assessed the type of setting (academic or private) in which the surgeon practices, how often surgeries are performed typical for an obstetrician and gynecologist, and factors that influence whether or not they allow a resident to perform as a primary on the case.
Results: 45 (37 percent) OB/GYNs responded to the survey. Of those who responded, 59 percent practice in a private setting and 41 percent in an academic setting. 53 percent said that previous experience with the resident very strongly influenced whether they let a resident primary their case. Factors that were not associated with whether a physician let a resident be the primary surgeon included knowledge of previous simulation experience, the surgeon’s comfort with his own skills, and suspected difficulty of the case. When the number of cases a surgeon performs were compared with how often a resident gets to primary a case, only robotic assisted total laparoscopic hysterectomies was statistically significant.
Discussions: We hope to use this information to modify residency rotations and program structure to optimize resident participation in surgical cases by better understanding the needs and concerns of supervising physicians.
Keywords: Resident Education
Topics: CREOG & APGO Annual Meeting, 2016, Resident, Faculty, Residency Director, Systems-Based Practice & Improvement, Interpersonal & Communication Skills, Practice-Based Learning & Improvement, GME, CME, Assessment, Faculty Development, General Ob-Gyn,
Jesse Loeffler, MD, University of Nebraska Medical Center; Jennifer Griffin Miller, MD
