A Comparison of Residency Program Directors' Expectations and Council on Resident Education in Obstetrics and Gynecology Objectives for Surgical Education

Abstract

PURPOSE: To determine residency program directors' (RPDs') expectations for independent performance of urogynecologic procedures during residency and to compare these expectations to the Council on Resident Education in Obstetrics and Gynecology (CREOG) Educational Objectives. BACKGROUND: Expectations for residents' performance of urogynecologic procedures are not standardized. METHODS: An anonymous Qualtrics survey was emailed to all accredited obstetrics and gynecology RPDs in the continental United States. RPDs provided their own professional and program demographic data and indicated whether they expected residents to independently perform each of 27 urogynecologic procedures. RESULTS: There was a 24.8% (n=59) response rate to the online survey with notable differences between RPD's expectations and CREOG objectives regarding several surgical procedures. While CREOG recommends independent performance of anterior and posterior repair, vaginal suspension, vaginal hysterectomy and transobturator slings, a significant number of RPDs did not expect mastery of these procedures during residency. Approximately 30% of RPDs expected residents to perform open sacralcolpopexy and vesicovaginal fistula repair, while CREOG recommends understanding these without procedural mastery. There was no difference in surgical expectations between RPDs at programs affiliated with a urogynecology fellowship and those without such an association. CONCLUSION: Although community needs vary by region and setting, CREOG objectives serve as the standard for resident surgical education, and this study highlights discordance between those objectives and RPDs' expectations for resident performance. Time invested in training for advanced procedures may limit opportunities for residents to master procedures expected by CREOG, and failure to train residents in fundamental procedures may result in substandard care for our patients.