Gynecology Residents Research Articles

043 The pediatric and adolescent training in obstetrics and gynecology in Europe

Objective: The purpose of this study is to evaluate the training of pediatric and adolescent gynecology in obstetrics and gynecology residency programs in Europe. Study design: This study is a cross-sectional explorative survey using an online questionnaire. The questionnaire comprised 19 questions. All questions were based on the pediatric and adolescent training in obstetrics and gynecology section of European Board & College of Obstetrics and Gynecology Project of Achieving Consensus in Training (PACT) training curriculum. Taking part in the survey was voluntary. The questionnaire was shared on the ENTOG social media and through the national representatives of ENTOG. Results: 90 Ob Gyn trainees from 33 different European countries responded to the questionnaire. More than half of these trainees were in the last 2 years of their 5-year training program with 40% in their last. Trainees were asked if they have a log book (curriculum) and if they have pediatric and adolescent gynecology (PAG) as an elective in their log book. 41% of the trainees replied stating they do not have PAG as an elective, 34% stated they do. Only 27% confirmed to have a PAG rotation during their training. Trainees were asked in which years during their training they received training on PAG. Highest rate was 4th year with 11%. 72% (n = 65) responded affirmatively to be able to provide information and advice regarding the diagnosis and its implications of prepubertal vaginal bleeding and adnexal masses in children and adolescents at the end of their training. 58% said they could determine indications for treatment of vulva, vagina, perineum and rectum. 58% of trainees said they will not be able to perform cystoscopy or vaginoscopy at the end of their training. Trainees were asked if they could determine indication for treatment, counsel and discuss all treatment options in 10 different situations. From these 10, highest positive responses were collected for ‘contraception in adolescents with health problems’ with 82%. Conclusion: Pediatric and adolescent gynecology training in Europe is open for improvement. Corrigendum to “043 The pediatric and adolescent training in obstetrics and gynecology in Europe” [Eur. J. Obstet. Gynecol. Reprod. Biol. 273 (2022) E16–E17]European Journal of Obstetrics and Gynecology and Reproductive BiologyVol. 276PreviewThe authors regret that in the final publication not all contributors, but only the presenter to the abstract was mentioned. This does not honor the effort of all contributors, this corrigendum compensates this lack of honor. Full-Text PDF

Impact of COVID-19 pandemic on obstetrics and gynecology residency training program in India: A national online survey.

ObjectiveThe goal of this study was to analyze how the COVID‐19 pandemic affected the Obstetrics and Gynecology (OBG) residency program in India.Study DesignThis was a cross‐sectional questionnaire‐based online survey aimed to assess the impact of the pandemic on the residency training program in Obstetrics and Gynecology. The questionnaire consisted of five sections: demographic details, information regarding COVID‐19 status, clinical work load, teaching and research, and psychological impact.ResultsThe questionnaire was completed by 280 OBG trainees from different medical colleges from India. Training activity in general was reduced considerably during the pandemic, according to 79.6% (n = 223) respondents. According to 13.21% (n = 37) and 5% (n = 14) respondents, reduction in training activity were due to cancelation of elective operations and reduced patient foot fall respectively. In 74.3% (n = 208) of cases, trainees reported worry about meeting the goals of their specialty training. Logistic regression showed that the extent of training reduction was not significantly associated with residents' age (p = 0.806), gender (p = 0.982), marital status (p = 0.363), and status of their duty in COVID‐19 dedicated hospitals (p = 0.110). However, year of residency was a significant predictor of the perception about degree of training reduction.ConclusionThe pandemic imposed a significant impact on OBG residency training in India. During the pandemic, exposure to learning opportunities, surgeries, and teaching were reduced, which may result in a decline in the quality of care offered to women in the future if training deficit is not overcome. At the same time, pandemic also gave birth to newer insights of learning and interaction by online mode.

Cervical Length Ultrasound for the Evaluation of Preterm Labor: A Survey of National Use and Review of Evidence.

The objective of this study was to survey national utilization of cervical length (CL) ultrasound on labor and delivery (L&D) for the evaluation of preterm labor (PTL) and identify provider attitudes and barriers to utilization. Survey was emailed to Obstetrics and Gynecology Residency and Maternal-Fetal Medicine Fellowship program and advertised via links on obstetric-related Facebook interest groups. The survey was open from August 4, 2020 to January 4, 2021. Characteristics between respondents who did and did not report the use of CL ultrasound for PTL evaluation were compared with chi-square analysis. There were 214 respondents across 42 states. One hundred and thirty-four respondents (63%) reported any use of CL in the evaluation of PTL and eighty (37%) denied it. There was a significant difference in practice location, practice type, delivery volume, and region between those who did and did not utilize CL ultrasound on L&D. Those who did use CL ultrasound were more likely to report no barriers to use (40 vs. 4%, p < 0.001). The most common barriers involved the availability of transvaginal ultrasound (31%), sterilization of transvaginal ultrasound probe (32%), limited availability of persons able to perform/interpret CL imaging (38%). Nineteen percent believed CL ultrasound had little/no utility in clinical practice. Those who did not use CL ultrasound in the evaluation of PTL were significantly more likely to report the feeling that there was little/no utility of CL ultrasound in clinical practice (37 vs. 7%, p < 0.001) and to report transvaginal ultrasound availability as barriers to use (63 vs. 12%, p < 0.001). CL ultrasound is used nationally in PTL evaluation. However, significant barriers limit widespread adoption. These barriers can be addressed through the dissemination of information and practice guidelines, addition of CL ultrasound education in residency training and through CME opportunities after training, and providing support/resources/access for those looking to add this tool to their practice environment. · In a national survey, 63% of obstetricians endorsed any use of cervical length (CL) ultrasound for preterm labor evaluation on labor and delivery.. · The most common barriers involved the availability of transvaginal ultrasound (31%), sterilization of transvaginal ultrasound probe (32%), limited availability of persons able to perform/interpret CL imaging (38%).. · Those who did not use CL ultrasound in the evaluation of PTL were significantly more likely to report the feeling that there was little/no utility of CL ultrasound in clinical practice and to report transvaginal ultrasound availability as barriers to utilization.. · Barriers to utilization of CL ultrasound for preterm labor evaluation can be addressed through practice guidelines, ultrasound education, and support for equipment/training necessary for use..

Simulation-based training using a novel Surabaya hysterectomy mannequin following video demonstration to improve abdominal hysterectomy skills of obstetrics and gynecology residents during the COVID-19 pandemic in Indonesia: a pre- and post-intervention study.

PurposeDuring the coronavirus disease 2019 (COVID-19) pandemic, the number of abdominal hysterectomy procedures decreased in Indonesia. The existing commercial abdominal hysterectomy simulation model is expensive and difficult to reuse. This study compared residents’ abdominal hysterectomy skills after simulation-based training using the Surabaya hysterectomy mannequin following a video demonstration.MethodsWe randomized 3rd- and 4th-year obstetrics and gynecology residents to a video-based group (group 1), a simulation-based group (group 2), and a combination group (group 3). Abdominal hysterectomy skills were compared between before and after the educational intervention. The pre- and post-tests were scored by blinded experts using the validated Objective Structured Assessment of Technical Skills (OSATS) and Global Rating Scale (GRS).ResultsA total of 33 residents were included in the pre- and post-tests. The OSATS and GRS mean differences after the intervention were higher in group 3 than in groups 1 and 2 (OSATS: 4.64 [95% confidence interval [CI], 2.90–6.37] vs. 2.55 [95% CI, 2.19–2.90] vs. 3.82 [95% CI, 2.41–5.22], P=0.047; GRS: 10.00 [95% CI, 7.01–12.99] vs. 5.18 [95% CI, 3.99–6.38] vs. 7.18 [95% CI, 6.11–8.26], P=0.006). The 3rd-year residents in group 3 had greater mean differences in OSATS and GRS scores than the 4th-year residents (OSATS: 5.67 [95% CI, 2.88–8.46]; GRS: 12.83 [95% CI, 8.61–17.05] vs. OSATS: 3.40 [95% CI, 0.83–5.97]; GRS: 5.67 [95% CI, 2.80–8.54]).ConclusionSimulation-based training using the Surabaya hysterectomy mannequin following video demonstration can be a bridge to learning about abdominal hysterectomy for residents who had less surgical experience during the COVID-19 pandemic.

Rapid Cycle Deliberate Practice Versus Traditional Simulation to Improve Resident Performance in Forceps Deliveries

This study aimed to assess the effectiveness of rapid cycle deliberate practice (RCDP) in improving obstetrics and gynaecology residents’ performance and skill retention in forceps-assisted vaginal deliveries. Thirty-three residents were randomly assigned to RCDP or traditional debriefing. Performance was evaluated using an objective structured assessment of technical skills (OSATS) tool. There were no significant differences in immediate performance scores between groups (P = 0.082). At 4–6 months, both groups demonstrated improved performance scores (traditional, P = 0.001; RCDP, P = 0.001). Seventy-six percent of residents in the RCDP group indicated “real-time” feedback was advantageous. Three residents suggested this method was less beneficial at a senior level.

How We Do It: Student Perspectives on Changes to the Obstetrics and Gynecology Residency Application Process

To describe the perspectives of obstetrics and gynecology (OBGYN) residency applicants regarding new standards for the 2019 to 2020 application cycle. An anonymous electronic survey was sent to all OBGYN residency applicants to US programs retrospectively evaluating 5 new recommended standards for the application process. This 15-item survey assessed the importance of the proposed standards and their impact on applicants' anxiety. The OBGYN residency application process is marked by increasing application numbers and no standardization for managing interview offers. The Association of Professors of Gynecology and Obstetrics (APGO) received a 5-year Reimagining Residency grant from the American Medical Association to improve the transition from undergraduate medical education (UME) to graduate medical education (GME) within OBGYN. The multiphase project, "Transforming the UME to GME Transition for Obstetrics and Gynecology- Right Resident, Right Program, Ready Day One (RRR)," began with Standardizing the OBGYN Application and Interview Process (SOAIP). This group recommended 5 new standards for all US OBGYN residency programs and applicants. Applicants for US OBGYN residency programs for the 2019 to 2020 application cycle completed the survey, with a 904/2508 (36.0%) response rate, including 762 complete responses (30.4%). Applicants reported that all 5 of the new standards would cause the least self-perceived anxiety (range 76.8% - 96.5%). The impact of the standards on perceived anxiety varied by student group, with International Medical Graduates (IMGs) and students with USMLE Step I scores <200 describing lesser impact compared to others. Despite these differences, all 5 standards were consistently noted to cause the least anxiety for all groups. Despite varying degrees of effects in different groups, the new OBGYN residency application standards caused the least anxiety for all subgroups of applicants. Implementing universal standards for the OBGYN residency application process was favorably perceived by applicants and caused the least anxiety for applicants.

The Effect of an Educational Intervention on Obstetrics and Gynecology Residents’ Postpartum Depression Knowledge [A45

INTRODUCTION: Up to 15% of women experience postpartum depression (PPD), and maternal suicide is a leading cause of maternal mortality. Obstetrician-gynecologists (ob-gyns) are intimately involved in postpartum care of women and are in a position to help diagnose and manage PPD. Council on Resident Education in Obstetrics and Gynecology (CREOG) learning objectives include goals for residents to diagnose and perform initial management of postpartum complications such as PPD. The objective of this study was to assess if a psychiatry educational intervention (pre-recorded didactic lecture and facilitated discussion) would improve ob-gyn residents’ knowledge and comfort level in diagnosing and managing PPD. METHODS: We performed an educational intervention study including ob-gyn residents at an academic training program. A pre-lecture survey/test was sent to residents. A prerecorded psychiatric didactic session was sent to residents. Participants were instructed to complete the post-lecture survey/test. A facilitated discussion via Zoom at which time presubmitted questions were reviewed and discussed with a psychiatrist was performed. A postdiscussion survey was then sent out. RESULTS: Before the intervention, 32% of residents agreed/strongly agreed that they felt comfortable diagnosing PPD; after the intervention, this increased to 81% of residents. Before the intervention, 25% of residents agreed/strongly agreed that they felt comfortable treating PPD; after the lecture/discussion this increased to 69% of residents. The difference in pre and post test scores was significantly improved (POST-PRE difference of 2.6 with a 95% CI of 1.8-3.5, P&lt;.0001). CONCLUSION: This study helps show the importance of interdisciplinary didactics and interactive learning sessions which can help improve ob-gyn residents’ knowledge and comfort level in diagnosing/managing PPD in patients.

Rapid Cycle Deliberate Practice Versus Traditional Simulation to Improve Resident Performance in Obstetrical Emergencies

Rapid Cycle Deliberate Practice (RCDP) is a novel simulation strategy wherein participants cycle between deliberate practice and feedback within the simulation scenario to achieve skill acquisition. Our aim was to assess the effectiveness and feasibility of RCDP in improving obstetrics and gynaecology residents’ performance and skill retention compared to traditional debriefing in a forceps assisted vaginal delivery (FAVD) simulation.

PD30-12 COMPARISON OF UROGYNECOLOGICAL TRAINING AMONG US UROLOGY AND OBSTETRICS AND GYNECOLOGY RESIDENTS AND THE IMPACT FPMRS FELLOWSHIP AND DEDICATED ROTATION TIME HAVE ON TRAINING

You have accessJournal of UrologyCME1 May 2022PD30-12 COMPARISON OF UROGYNECOLOGICAL TRAINING AMONG US UROLOGY AND OBSTETRICS AND GYNECOLOGY RESIDENTS AND THE IMPACT FPMRS FELLOWSHIP AND DEDICATED ROTATION TIME HAVE ON TRAINING Michael Hung, Ashley Huber, Rosen Jeong, and Jason Kim Michael HungMichael Hung More articles by this author , Ashley HuberAshley Huber More articles by this author , Rosen JeongRosen Jeong More articles by this author , and Jason KimJason Kim More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002578.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Board certified Female Pelvic Medicine and Reconstructive Surgeons (FPRMS) include physicians from both obstetrics and gynecology (Ob/Gyn) and urology backgrounds. We sought to explore differences in experiences and comfort level for common FPMRS procedures between both training programs. A secondary goal was to examine the impact of a FPMRS rotation or presence of FPMRS fellowship. METHODS: We created and distributed an anonymous, IRB approved, survey to residents graduating in 2020. The survey assessed general case numbers and self-rated comfort with performing a given procedure. Comparisons between Ob/Gyn and urology residents for each procedure was performed using Mann-Whitney U tests. RESULTS: Responses were recorded from 6.6% (n=90) of Ob/Gyn residents and 7.7% (n=25) of urology. Ob/Gyn residents performed significantly more vaginal apical support and anterior/posterior colporrhaphies compared to urology residents(p<0.01). Urology residents performed more urethral bulking, midurethral slings, autologous fascial slings, sacral nerve stimulators, bladder botox, vesicovaginal fistula repairs, and urodynamics(p < 0.01). Ob/Gyn and Urology programs were noted to have an associated FPMRS fellowship 22% (n= 20) and 24% (n=6) of the time, respectively. There was no statistical difference in the training of Urology residents at programs with or without fellowship. Ob/Gyn residents at programs with fellowships were found to have more exposure to autologous slings (0.62 vs 0.24 p=0.004) but less exposure to midurethral slings (1.44 vs 2.18 p=0.001) and vaginal apical support (2.21 vs 1.72 p=0.025). CONCLUSIONS: A comprehensive picture of resident’s experience with FPMRS procedures suggest that urology residents have more experience, and overall, more comfort with performing many common FPMRS procedures without formal fellowship training. However, it is notable that Ob/Gyn residents have significantly more experience and comfort with transvaginal procedures. Additionally, there is minimal impact of a fellowship and dedicated rotation in the exposure/comfort to FPMRS procedures. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e515 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Michael Hung More articles by this author Ashley Huber More articles by this author Rosen Jeong More articles by this author Jason Kim More articles by this author Expand All Advertisement PDF DownloadLoading ...

Tagged: The Use of Social Media in the Recruitment of Obstetrics and Gynecology Residents, Pre- and Post-pandemic [A62

INTRODUCTION: As the residency application process adapts, social media may provide insight to the community behind a residency program. No studies have assessed applicant’s perception of the utility of social media as a tool during the pursuit for their match into obstetrics and gynecology residency. METHODS: Applicants who interviewed at a single academic institution during the 2019-2020 and 2020-2021 interview seasons completed an anonymous online survey. Responses were analyzed using chi-squared and Mann-Whitney statistical analysis. RESULTS: The survey response rate was 64.6% (n=45) of 65 applicants in 2019 and 80% (n=48) of 60 applicants in 2020 who interviewed at this institution. All applicants reported using some type of social media, with Facebook and Instagram being the most utilized. Social media was used to learn about residency programs significantly more in 2020 (P=.001). Applicants used social media significantly more to look up programs prior to applying/interviewing at that institution in 2020 (P=.000). Applicant perception of a program was felt to be significantly impacted by social media presence in 36% (n=15) of those surveyed in 2019, compared to 60% (n=29) in 2020 (P=.031). Significantly more applicants felt that a residency program social media presence was an important recruitment strategy in 2020 compared to 2019 (P=.006). The virtual match increased applicant uses of social media in the application process in 80% of respondents (n=38). CONCLUSION: Social media is a novel and essential tool for residency programs to showcase their culture. Our study highlights the utility of social media for resident applicant recruitment in the ever changing post-pandemic application milieu.

Race.Culture.OBGYN: Creating a Database of Diversity, Equity, and Inclusion Resources for Obstetrics and Gynecology Residency Programs [A60

INTRODUCTION: Multiple studies repeatedly demonstrate that people of color suffer poorer obstetrical and gynecological outcomes in the United States. To improve physician awareness on these inequities, the American College of Obstetricians and Gynecologists released a Committee Opinion on Race and Ethnic Disparities recommending that all obstetrics and gynecology residency programs address inherent bias and systemic racism. However, competing resident educational requirements leaves limited time for a diverse diversity, equity, and inclusion (DEI) education beyond the occasional lecture. The Race.Culture.OBGYN initiative seeks to increase the frequency and quality of GME level DEI education by making it applicable to already existing didactics and clinical duties. METHODS: The Race.Culture.OBGYN initiative has curated a wide variety of resources for specific clinical conditions in every subspecialty in obstetrics and gynecology. The resources are curated on an open access website to allow graduate medical education (GME) programs to incorporate DEI knowledge into specific didactic lectures with ease. Our hypothesis is that residents will feel more comfortable applying DEI education to daily clinical encounters. A national survey of the current statuses of DEI education at residency programs and an evaluation of the resources on the website will be collected. RESULTS: The Race.Culture.OBGYN project has curated resources and has now expanded into creating a podcast series to elevate voices of resident physicians doing DEI work locally. Survey results are pending. CONCLUSION: By creating a single hub of condition-based resources, this project reminds us the issues are more pervasive, present in all aspects of clinical care. Through this, the initiative hopes to transform DEI education for obstetrics and gynecology residents.

The Newcomer Well Woman Clinic: A Cross-Sectional Evaluation of an Innovative Care Model to Support the Sexual and Reproductive Health Needs of Refugee Women

The Newcomer Well Woman Clinic (NWWC) was developed as a partnership between primary care physicians and obstetrics and gynaecology residents to ensure timely provision of sexual and reproductive healthcare for refugee patients. Since 2015, NWWC has provided monthly clinics offering contraceptive counselling, cervical cancer screening, and intrauterine device insertions with accompanying education sessions. This study aimed to evaluate women’s experiences at the clinic and with interpretation services.

The Impact of X-Waiver Training Within Obstetrics and Gynecology Residency Programs on Improving Access to Medication-Assisted Treatment in Pregnancy [A51

INTRODUCTION: The opioid epidemic is a crisis within the country, with 136 Americans dying daily from opioid overdose. One of the hardest hit areas is the Appalachian region. Despite medication-assisted treatment (MAT) with methadone or buprenorphine being considered standard of care, studies find that pregnant women in this region face significant barriers to receiving this lifesaving treatment from both insurers and providers. While the number of providers in the country with X-waivers has increased dramatically, the availability of providers willing to prescribe in pregnancy is disproportionate to the severity of the epidemic. METHODS: We surveyed 91 obstetrics and gynecology residency programs within Appalachian states to assess if X-waiver training was a part of their residency training. We then collected the geographic locations of program graduates from 2016 to 2021 to assess the impact that this training could have provided to the region. RESULTS: Despite working in regions disproportionately impacted by the opioid epidemic, the majority of obstetrics and gynecology residency programs do not provide X-waiver training to their residents. Many residents who train in residency programs located in the Appalachian regions work/have worked in the region after graduation. Our results will be displayed graphically along with mapping illustrations. CONCLUSION: Residents of the Appalachian region face barriers accessing adequate health care. This disparity is more prevalent among pregnant women. Coordinated efforts by obstetrics and gynecology residency programs to allow access to X-waiver licensure among residents in training could make a significant impact by improving access to MAT among pregnant women and lead to improved maternal and fetal outcomes.

The Effects of the United States Medical Licensing Examination STEP 1 Pass/Fail Scoring Change for Obstetrics and Gynecology Residency Applicants [A58

INTRODUCTION: The National Board of Medical Examiners (NBME) recently approved the transition of the United States Medical Licensing Examination (USMLE) STEP 1 exam from a three-digit numeric scoring to a pass/fail format, effective January 26, 2022. The change will ideally result in a more holistic review of residency applicants, but the realized impacts remain to be seen. We aimed to examine the implications of the scoring change on future obstetrics and gynecology residency applicants. METHODS: Surveys were distributed to obstetrics and gynecology residency program directors (PD) for all 291 Accreditation Council for Graduate Medical Education-accredited residency programs. The survey assessed their viewpoints about the STEP 1 exam and asked respondents to rank the importance of variables used in assessment of potential applicants before and after the change to pass/fail. The survey was approved by the University of Alabama at Birmingham Institutional Review Board. RESULTS: We received 70 responses (response rate=24.0%). While most (60%) PDs believe that STEP 1 scores do not accurately predict a resident’s clinical performance, the majority (68.6%) disagreed that students will be better prepared clinically following the change to pass/fail. Clerkship grades were ranked as the most important variable in evaluating applicants both before and after the transition to pass/fail. Number of abstracts/presentations/publications and volunteer experiences saw the greatest increases in rank of importance with pass/fail as opposed to before. CONCLUSION: Despite the shortcomings of the STEP 1 exam in predicting clinical performance and the opportunity for more holistic review, obstetrics and gynecology PDs are skeptical of a transition to pass/fail scoring. The change will necessitate that alternative variables play a greater role in evaluation of residency applicants.

Projected Implications of Overturning Roe v Wade on Abortion Training in U.S. Obstetrics and Gynecology Residency Programs.

In June 2022, the U.S. Supreme Court is expected to issue a decision on Dobbs v Jackson Women's Health Organization, a direct challenge to Roe v Wade. A detailed policy analysis by the Guttmacher Institute projects that, if Roe v Wade is overturned, 21 states are certain to ban abortion and five states are likely to ban abortion. The Accreditation Council for Graduate Medical Education requires access to abortion training for all obstetrics and gynecology residency programs. We performed a comprehensive study of all accredited U.S. obstetrics and gynecology residency programs to assess how many of these programs and trainees are currently located in states projected to ban abortion if Roe v Wade is overturned. We found that, of 286 accredited obstetrics and gynecology residency programs with current residents, 128 (44.8%) are in states certain or likely to ban abortion if Roe v Wade is overturned. Therefore, of 6,007 current obstetrics and gynecology residents, 2,638 (43.9%) are certain or likely to lack access to in-state abortion training. Preparation for the reversal of Roe v Wade should include not only a recognition of the negative effects on patient access to abortion care in affected states, but also of the dramatic implications for obstetrics and gynecology residency training.

A survey of specialty choice among obstetrics and gynecology residents in Japan, Korea, and Taiwan.

The percentage of medicine graduates opting for residency in obstetrics and gynecology (OB/GYN) has been decreasing in developed countries, including in Taiwan, Japan, and Korea. This multicountry study surveyed the OB/GYN residents affiliated with the Taiwan Association of Obstetrics and Gynecology (TAOG), the Japanese Society of Obstetrics and Gynecology (JSOG), and the Korean Society of Obstetrics and Gynecology (KSOG) to evaluate the factors affecting the choice of pursing OB/GYN. A 17-item questionnaire surveying the factors influencing the choice of pursuing a major medical specialty was translated into Japanese, Korean, and Chinese and administered to postgraduate OB/GYN residents between July 1, 2020, and August 31, 2020. Data on the participants' sex, age, and level of residency were collected. Responses were compared between countries and sexes. Residents of all three countries chose OB/GYN based on personal interest, and a sense of accomplishment in saving people's life. Other positive factors include improved quality of life; higher salaries; and more opportunity for new techniques, research, and promotion. The negative factors included medical litigations, longer work hours, and unsafe working environments. Korean residents had lower ratings in several items, including "support from family," "safety of working environment," and "effectiveness of the alternative dispute resolution system," which, unlike Japan and Taiwan, is not a no-fault compensation system for childbirth accidents. The study findings can guide strategy making, such as decreasing workload and yet maintain training quality, to increase the number of medical students pursuing OB/GYN residency.

Distributions of Residency Interviews With the Implementation of Virtual Interviews and Standardization of Interview Offer Dates

Virtual interviews were widely implemented alongside many other changes in the 2021 residency application process. We investigated how these many interventions may have influenced interview distributions and completions. Cross-sectional survey distributed electronically to obstetrics and gynecology (OBGYN) residency applicants in February 2021. Distributions of interview invitations, interviews completed, and percent of interview offers completed were compared to the previous application cycle. The odds ratios of receiving interviews were calculated based on applicant characteristics including test scores, number of applications, and race/ethnicity. All OBGYN residency applicants registered through the Electronic Residency Application Service. The 915 (36%) of 2577 total OBGYN applicants who responded to the survey. US allopathic medical students received fewer interview offers in 2021 (median 13 [interquartile range 9-19]) compared to 2020 (median 15 [interquartile range 11-20]). There was no difference in the absolute numbers of interviews completed. A United States Medical Licensing Exam Step 1 score ≥221 resulted in more than a five-fold increase in adjusted odds of receiving at least 12 interviews for allopathic students. Black or African American US allopathic seniors had a 2.3 odds ratio for receiving at least 12 interview invitations compared to White non-Hispanic or Latino US allopathic seniors, adjusted for Step 1 score and the number of programs applied to. Interview offers released on standardized dates had a mitigating effect on completing more interviews among allopathic seniors with at least 12 interview invitations. Virtual interviews did not change the overall number of interviews completed. Standardization of interview offer dates mitigated excessive virtual interviewing, yet additional measures are needed to curb interview inflation and the effects on interview distributions.

Ascertaining the Effects of Tissue Sealers on Minor Laparoscopic Procedures between Obstetrics and Gynecology Residents: A Prospective Cohort Study.

Background and Objectives: The type of instrumentation used during laparoscopic surgery might impact on the learning curve of resident surgeons. The aim of this study was to investigate differences in operator satisfaction and surgical outcomes between tissue sealers and classic bipolar instruments during gynecological laparoscopies performed by residents. Materials and Methods: A prospective cohort study conducted at two tertiary university hospitals between March 2019 and March 2021, on consecutive procedures: salpingo-oophorectomies (Group 1) and salpingectomies (Group 2), subdivided according to the utilized device: radiofrequency tissue sealers (Groups A1 and A2) or bipolar forceps (Groups B1 and B2). Results: 80 procedures were included. Concerning salpingo-oophorectomies, better visibility (8.4 ± 0.8 vs. 7.3 ± 0.9; p = 0.03), reduced difficulty (5.4 ± 1.2 vs. 7.0 ± 1.4; p = 0.02), improved overall satisfaction (9.2 ± 0.4 vs. 7.6 ± 1.0; p = 0.02) and reduced procedure time (7.8 ± 3.4 vs. 12.6 ± 3.1; p = 0.01) were reported by residents using tissue sealers. Intraoperative blood loss (12.2 ± 4.7 mL vs. 33.2 ± 9.7 mL; p = 0.01) and 24 h postoperative pain (4.5 ± 1.1 vs. 5.7 ± 1.8; p = 0.03) were lower in group A1 than B1. For salpingectomies, a significant reduction in duration was found in A2 compared to B2 (7.2 ± 3.4 min vs. 13.8 ± 2.2 min; p = 0.02). Tissue sealers enhanced visibility (8.1 ± 1.1 vs. 6.7 ± 1.4; p = 0.01), difficulty (6.5 ± 1.1 vs. 7.5 ± 0.9; p = 0.04) and improved satisfaction (9.3 ± 0.5 vs. 7.5 ± 0.6; p = 0.01). Moreover, hemoglobin loss and postoperative pain were reduced in A2 relative to B2 [(8.1 ± 4.2 % vs. 4.5 ± 1.1%; p = 0.02) and (5.1 ± 0.9 vs. 4.1 ± 0.8; p = 0.03), respectively] Conclusions: The use of sealing devices by residents was related to reduced difficulty as well improved visibility and overall satisfaction, with improved surgical outcomes.

Development and implementation of a comprehensive postgraduate ultrasound curriculum for residents in obstetrics and gynecology: a feasibility study

BackgroundIn obstetric and gynecological practice, ultrasound is the essential diagnostic tool. Nevertheless, few clinics have standardized and structured training curricula for young obstetricians in the field of obstetric and gynecological ultrasound. Since ultrasound is best learned hands-on in small supervised groups, we developed and implemented a comprehensive ultrasound curriculum for all postgraduate residents of our department using a peer-teaching concept.MethodsWe used Kern‘s six-step model of curricular development comprising (1) problem identification and general needs assessment, (2) needs assessment of the targeted learners, (3) goals and objectives, (4) educational strategies, (5) implementation, and (6) evaluation and feedback.ResultsAssistant physicians in the 1st and 2nd year of training received a theoretical and practical ultrasound basic course (six modules) in addition to their obligatory clinic rotations. The six main topics were prioritized according to service relevance and included the main features according to DEGUM, EBCOG and ISUOG. The units focused on a three-level training based on the AMEE levels: theoretical knowledge, well-founded theoretical knowledge and basic practical skills under guidance and self-employment of practical skills.ConclusionStructured and standardized sonographic training allows young gynecology and obstetrics residents to conceptually grasp and practically implement topic-related themes. Furthermore, the course concept demonstrates the high inter-rater agreement among DEGUM-certified examiners. More research is needed to analyze the learning outcomes for residents and the improvement of the patient's outcome by establishing such an ultrasound curriculum.

The Leadership Landscape: The Role of Gender in Current Leadership Positions in Obstetrics and Gynecology Departments

To describe the proportion of female faculty in departmental administrative and educational leadership roles in Obstetrics and Gynecology departments. Cross-sectional observational study (II-3). Accredited Obstetrics and Gynecology residency programs. A total of 288 accredited residency programs were identified from 2019 to 2020 with 1237 individuals in leadership positions. Similar to a 2012 to 2013 survey by Hofler etal, residency program websites and corresponding fellowships (Maternal Fetal Medicine, Female Pelvic Medicine and Reconstructive Surgery, Reproductive Endocrinology and Infertility, and Gynecologic Oncology), departmental websites, and divisional websites were queried for those in administrative and educational leadership positions. Information regarding gender (as determined by the surrogates of name and photographic gender expression), medical and academic degrees, academic rank, and subspecialty certification was abstracted. Within administrative leadership roles, women comprised 29% of chairs, 46% of vice chairs, and 47% of division directors, all significantly lower than men in administrative leadership (p <.001). In educational leadership, women made up 71% of medical school clerkship directors, 58% of residency directors, and 50% fellowship directors. Women were more likely to hold educational leadership positions (56% vs 40%; p <.001), although men were more likely to hold administrative leadership positions (68% vs 52%; p <.001). Among subspecialties, there was greatest gender equity within Female Pelvic Medicine and Reconstructive Surgery. Female leaders were more likely to have received additional academic degrees (e.g. MBA, MPH) than their male counterparts (19% vs 13%; p=.002). Women continue to be underrepresented in administrative leadership positions. Compared with 2012 to 2013, there is only a 9% increase in proportion of women chairing and 10% vice chairing Obstetrics and Gynecology departments; however, the increase is more substantial in other positions, such as division directors (17%). Our findings demonstrate ongoing gender disparity in the highest levels of departmental leadership and the need to further improve on diversity and gender equity within leadership roles.