1943 Resident Preparedness for Minimally Invasive Surgery: A Nationwide Survey of Senior OB/GYN Residents

Abstract

Study Objective Evaluate the readiness of senior U.S. Ob/Gyn residents to perform minimally invasive surgery. Furthermore, we specifically hope to evaluate their readiness to perform complex minimally invasive gynecologic surgery as well as their perceptions of the minimally invasive gynecologic surgery subspecialty Design Nationwide survey study Setting U.S. accredited Obstetrics and Gynecology residency programs Patients or Participants United States senior (3rd and 4th year) Ob/Gyn residents Interventions Voluntary participation in a 58-item survey Measurements and Main Results We received 158 survey responses with 84 (53.2%) responses coming from 4th year residents and 74 (46.8%) responses from 3rd year residents. The majority of resident respondents graduated from an allopathic medical school (139; 88%), identify as female (129, 81.6%), and are attending an Academic-University based program (96, 60.8%). The majority of respondents (67.7%) have not and do not plan on applying for a surgical fellowship in Ob/Gyn. Overall, the majority of residents (71.5%) feel their residency training adequately prepared them to be a competent minimally invasive surgeon. However, only 50% feel prepared to perform a laparoscopic hysterectomy on a uterus greater than 12 weeks size, and 12% feel prepared to offer a laparoscopic hysterectomy for a uterus above the umbilicus. Less than one-third of residents (29%) feel prepared to offer a vaginal hysterectomy on a uterus 12-week size or greater, and only 17% of residents feel comfortable performing a laparoscopic myomectomy. For endometriosis surgery 76% of senior residents do not feel prepared to offer excisional surgery. Of the residents not interested in a surgical fellowship 45% do not plan on referring complex gynecologic cases to a fellowship trained minimally invasive surgeon. Conclusion The overwhelming majority of senior U.S. Ob/Gyn residents do not feel prepared to provide minimally invasive surgery for complex gynecologic cases. Despite this discomfort nearly half of these residents do not plan on referring their patients to a competent minimally invasive surgeon.