The existing literature shows that the current obstetrics and gynecology residency training model is not able to produce proficiency in gynecologic surgery. As benign uterine and adnexal disorders become more complex with more treatment options and surgical routes available, new training and professional structures are needed to provide adequate surgical care to gynecologic patients. (J GYNECOL SURG 38:375)
Get full access to this article
View all access options for this article.
References
1.
GlaserLM, BrennanL, KingLP, MiladMP. Surgeon volume in benign gynecologic surgery: Review of outcomes, impact on training, and ethical contexts. J Minim Invasive Gynecol, 2019; 26:279–287.
2.
HallEF, RakerCA, HamptonBS. Variability in gynecologic case volume of obstetrician-gynecologist residents graduating from 2009 to 2017. Am J Obstet Gynecol, 2019; 222:617.e1–617.e8.
3.
DooDW, PowellM, NovetskyA, SheederJ, GuntupalliSR. Preparedness of Ob/Gyn residents for fellowship training in gynecologic oncology. Gynecol Oncol Rep, 2015; 12:55–60.
4.
GuntupalliSR, DooDW, GuyM, et al.Preparedness of obstetrics and gynecology residents for fellowship training. Obstet Gynecol, 2015; 126:559–568.
5.
DuneTJ, BlackwellRH, GriffinA, et al.Ready or not? Obstetrics and gynecology resident preparedness for female pelvic medicine and reconstructive surgery training. Female Pelvic Med Reconstr Surg, 2017; 23:401–408.
TraylorJ, FriedmanJ, RungeM, TsaiS, ChaudhariA, MiladMP. Factors that influence applicants pursuing a fellowship in minimally invasive gynecologic surgery. J Minim Invasive Gynecol, 2020; 27:1070–1075.
8.
EinarssonJI, Sangi-HaghpeykarH. Perceived proficiency in minimally invasive surgery among senior OB/GYN residents. JSLS, 2009; 13:473–478.
9.
KlebanoffJS, MarforiCQ, VargasMV, AmdurRL, WuCZ, MoawadGN. Ob/Gyn resident self-perceived preparedness for minimally invasive surgery. BMC Med Educ, 2020; 20:185.
10.
WrightJD, HerzogTJ, TsuiJ, et al.Nationwide trends in the performance of inpatient hysterectomy in the United States. Obstet Gynecol, 2013; 122(2 Pt 1):233–241.
11.
GresselGM, PottsJR, 3rd, ChaS, ValeaFA, BanksE. Hysterectomy route and numbers reported by graduating residents in obstetrics and gynecology training programs. Obstet Gynecol, 2020; 135:268–273.
12.
BoydLR, NovetskyAP, CurtinJP. Effect of surgical volume on route of hysterectomy and short-term morbidity. Obstet Gynecol, 2010; 116:909–915.
13.
MowatA, MaherC, BallardE. Surgical outcomes for low-volume vs high-volume surgeons in gynecology surgery: A systematic review and meta-analysis. Am J Obstet Gynecol, 2016; 215:21–33.
14.
ShepherdJP, Carter-BrooksCM, KantartzisKL, LeeT, BonidieMJ. The impact of individual surgeon volume on hysterectomy costs. JSLS, 2017; 21:e2016.00112.
15.
ClarkNV, GujralHS, WrightKN. Impact of a fellowship-trained minimally invasive gynecologic surgeon on patient outcomes. JSLS, 2017; 21:e2017.00037.
16.
McDonnellRM, HollingworthJL, ChiversP, CohenPA, SalfingerSG. Advanced training of gynecologic surgeons and incidence of intraoperative complications after total laparoscopic hysterectomy: A retrospective study of more than 2000 cases at a single institution. J Minim Invasive Gynecol, 2018; 25:810–815.
17.
LimCS, MowersEL, MahnertN, et al.Risk factors and outcomes for conversion to laparotomy of laparoscopic hysterectomy in benign gynecology. Obstet Gynecol, 2016; 128:1295–1305.
18.
VreeFE, CohenSL, ChavanN, EinarssonJI. The impact of surgeon volume on perioperative outcomes in hysterectomy. JSLS, 2014; 18:174–181.
19.
WallensteinMR, AnanthCV, KimJH, et al.Effect of surgical volume on outcomes for laparoscopic hysterectomy for benign indications. Obstet Gynecol, 2012; 119:709–716.
20.
LimPC, CraneJT, EnglishEJ, et al.Multicenter analysis comparing robotic, open, laparoscopic, and vaginal hysterectomies performed by high-volume surgeons for benign indications. Int J Gynaecol Obstet, 2016; 133:359–364.
21.
TerziH, BilerA, DemirtasO, GulerOT, PekerN, KaleA. Total laparoscopic hysterectomy: Analysis of the surgical learning curve in benign conditions. Int J Surg, 2016; 35:51–57.
22.
LenihanJPJr., KovandaC, Seshadri-KreadenU.What is the learning curve for robotic assisted gynecologic surgery?. J Minim Invasive Gynecol, 2008; 15:589–594.
23.
WoelkJL, CasianoER, WeaverAL, GostoutBS, TrabucoEC, GebhartJB. The learning curve of robotic hysterectomy. Obstet Gynecol, 2013; 121:87–95.
24.
SiedhoffMT, TruongMD, WrightKN. Gynecologic surgery tracking in obstetrics and gynecology residency. Curr Opin Obstet Gynecol, 2020; 32:298–303.
25.
KlingensmithME, PottsJR, MerrillWH, et al.Surgical training and the early specialization program: Analysis of a national program. J Am Coll Surg, 2016; 222:410–416.
26.
KlingensmithME, AwadM, DelmanKA, et al.Early results from the flexibility in surgical training research consortium: Resident and program director attitudes toward flexible rotations in senior residency. J Surg Educ, 2015; 72:e151–e157.
27.
KlingensmithME.The future of general surgery residency education. JAMA Surg, 2016; 151:207–208.
28.
VargasMV, MiladMP. Matching trends for the fellowship in minimally invasive gynecologic surgery since participation in the National Residency Match Program. J Minim Invasive Gynecol, 2018; 25:1060–1064.
29.
KhoRM.Fellowship in minimally invasive gynecologic surgery: The evolving field behind the name. J Minim Invasive Gynecol, 2018; 25:1115–1116.
30.
MirinAA. Gender disparity in the funding of diseases by theU.S. National Institutes of Health. J Womens Health (Larchmt), 2021; 30:956–963.
31.
EinarssonJI, TimminsA, YoungAE, ZurawinRK. Does a minimally invasive surgery fellowship impact surgical experience among gynecology residents?. J Am Assoc Gynecol Laparosc, 2004; 11:464–466.
ZaritskyE, OjoA, TuckerLY, Raine-BennettTR. Racial disparities in route of hysterectomy for benign indications within an integrated health care system. JAMA Netw Open, 2019; 2:e1917004.
34.
RayburnWF. The Obstetrician-Gynecologist Workforce in the United States: Facts, Figures, and Implications, 2017. Washington, DC: The American Congress of Obstetricians and Gynecologists, 2017.
35.
LarsonEH, AndrillaCHA, KearnyJ, GarbersonLA, PattersonDG. The Distribution of the General Surgery Workforce in Rural and Urban America in 2019. WWAMI Rural Health Research Center, University of Washington, March 2021.
