Discrepancy in Gynecologic Case Volumes and Surgical Participation of Obstetrics/Gynecology Residents

Abstract

Objective:

Gynecology residents have self-reported deficits in preparation for surgical practice, particularly in robotic training. The primary source of surgical training is active participation in an operating room, which can be documented in a resident's case log. Educators and trainees may assume an institution's case volume reflects residents' participation, but there is no standard way to hold attending physicians accountable for surgical education, case-by-case. This study examined the percent of major gynecologic cases that allowed active trainee participation over 3 months at a major academic medical center.

Materials and Methods:

A baseline assessment of obstetrics/gynecology residents' participation in gynecologic surgical cases was conducted over 3 months at a large, urban academic medical center. All open and robotic gynecologic cases were recorded by the residency education team. Trainees were asked to document if a resident was present in a surgical case and that resident's level of participation in the procedure.

Results:

Of 324 open and robotic gynecologic surgeries, 74% were covered by residents. Of the 240 cases in which residents participated, 71% could be entered into clinical case logs, and 29% permitted minimal to no active participation. Thus, residents were only able to log active participation in 53% of all open and robotic gynecologic cases in the 3-month timeframe.

Conclusions:

Operative case volume at an academic medical center does not necessarily reflect resident participation and surgical training experience; there is a need to incorporate surgical-teaching skills into faculty-development programs and to emphasize the importance of active participation, case by case, in residency training further. (J GYNECOL SURG 20XX:000)