Gynecology Residency Training Research Articles

Obgyn resident research program practices and outcomes after implementation in an academically affiliated residency program

ProblemUnlike other aspects of Obstetrics and Gynecology (OBGYN) residency training, the research education curriculum and requirements are not standardized. It is unclear what constitutes core curricula in educational research programs, which components are most useful and efficacious, and how to use these findings to adapt existing programs.ApproachA multi-phase approach to (1) garner cross-sectional data from United States OBGYN Residency Program Directors and review previously published literature, (2) use Phase I and input from clinical, research and education faculty to develop a comprehensive program, and (3) evaluate the program for resident research productivity, knowledge and satisfaction.OutcomesPhase I: Sixty-one (31%) Program Directors completed the survey. Most reported ≤ 4 research didactics per year and no dedicated research rotation. Programs with post graduate year (PGY) level specific didactics, a research rotation, or allocated time for the Research Director role noted higher odds of resident research resulting in peer-reviewed publication. Phase II: A Resident Research Program was adapted to include a clinical and research faculty co-directorship and seven additional didactics (all of which were PGY-specific). A departmentally funded resident research grant and a repository to monitor completion of milestones and program requirements have been developed. Surveys were used to track residents’ research competence and satisfaction with the research program. While resident involvement in research activities and satisfaction with opportunities for scholarly activity have improved, resident self-evaluations and mentor evaluations have not. In addition, we have not seen an increase in publications or presentations.ConclusionImplementation of components of a research program associated with increased productivity did not result in increased productivity in our program, however, resident satisfaction with scholarly activity did improve.

Pediatric and Adolescent Gynecology Experience in Obstetrics and Gynecology Residency Training Across the United States

Study ObjectiveThe purpose of this study is to better understand the pediatric and adolescent gynecology (PAG) experience from the obstetrics and gynecology (OBGYN) resident perspective and its impact on physician comfort with caring for younger patients. MethodsThis is a cross-sectional survey study of physicians enrolled in OBGYN residency programs in the United States. For each program, an internet search was also performed to identify the closest PAG providers. Chi-square and Fisher's exact tests were performed to compare categorical variables. This study was IRB approved. Results74 resident responses from 42 unique OBGYN training programs were included. The majority (62%) of programs offered no PAG clinical experience. Of programs with no PAG clinical experience, 45% had unaffiliated self-identified PAG providers within 30 miles of their institution. Only 26% of residents reported having a dedicated PAG rotation. 68% of residents felt they did not have enough PAG exposure in training. Residents who had a dedicated PAG rotation were more comfortable caring for patients <7 years old (p=0.016) and patients 8-14 years old (p=0.019) than residents without a rotation. The majority (88%) of residents believe that PAG experience will be useful for their future practice. ConclusionResidents with PAG training are more comfortable in caring for patients <14 years than those in programs who lack this training. Residencies without PAG-trained staff physicians could consider partnering with PAG-practicing community physicians with the aim of broadening clinical experience. Improvement in PAG education helps provide graduating obstetrician-gynecologists with the necessary knowledge to provide needed care to younger patients.

Multidisciplinary Simulation Improves Resident Comfort With Perinatal Bereavement Care [ID 2683378

INTRODUCTION: Physicians have difficulty delivering bad news because of discomfort and lack of appropriate education. We introduce an initiative to enhance trainee comfort in delivering the diagnosis of intrauterine fetal demise (IUFD) through multidisciplinary simulation training. METHODS: Twelve obstetrics and gynecology residents participated in perinatal bereavement training with a palliative care specialist utilizing the SPIKES framework, followed by an immersive simulation of an IUFD case and debrief with multidisciplinary physicians. Pre- and post-training surveys were administered. This study was approved by the IRB. RESULTS: Participants were equally distributed in training year (58% female, 33% male). 92% had previously delivered the diagnosis of IUFD, yet 50% had no previous bereavement training, and of those with training, most (84%) had less than 2 hours. Wilcoxon signed-ranks tests showed statistically significant increase in comfort level of delivering bad news (Z=66; P=.003), delivering a diagnosis of fetal demise (Z=64; P=.005), and having the skills and foundation to deliver the news of a fetal demise (Z=28; P=.017). Qualitative responses identified acquisition of verbal and nonverbal skills such as direct patient communication, using the word death, and sitting down at the patient’s eye level prior to delivering the news. Most described the experience as real, immersive, and a safe learning environment. One hundred percent would recommend the course to others. CONCLUSION: Perinatal bereavement education in obstetrics and gynecology residency training is lacking. Multidisciplinary, immersive simulation training significantly increased residents’ comfort and perceived preparedness in delivering the diagnosis of fetal demise.

The COVID-19 pandemic and OBGYN residency training: We have a problem and it’s not just masks

BackgroundThe COVID-19 pandemic has left no one untouched. Resident trainees have been driven to reconsider virtually every component of their daily lives. The purpose of this pilot study is to evaluate the impact of the COVID-19 pandemic on Obstetrics and Gynecology (OBGYN) residency training and education.MethodsA cross-sectional pilot study was conducted between 2/2022 and 5/2022. A survey was created and distributed to OBGYN residents. The survey queried the effects of the pandemic on OBGYN residents’ procedure skills training and mental health.ResultsA total of 95 OBGYN residents across programs affiliated with each American College of Obstetricians and Gynecologists (ACOG) district participated in the survey. Among them, just over half (n = 52, 55%) self-identified as under-represented minorities. A significant majority, 80% (n = 81), felt their gynecological training was inadequate, with 70% of fourth-year residents expressing a lack of confidence in their ability to independently practice gynecology after graduation. This lack of confidence among fourth-year residents suggests a notable disparity in readiness for independent gynecological practice, linked to meeting ACGME requirements before completing their residency (p = 0.013). Among the residents who reported a negative impact of the pandemic on their mental health (n = 76, 80%), about 40% (n = 31) had contemplated self-harm or knew a colleague who considered or attempted suicide (p < 0.001). This issue was especially pronounced in residents experiencing burnout (n = 44, 46%), as nearly half (n = 19, 43%) reported suicidal thoughts or knew someone in their program who had such thoughts or engaged in self-harm (p = 0.048).ConclusionsResidents expressed concerns about reduced hands-on gynecological training and doubts about their readiness for independent practice post-residency, highlighting the need for enhanced support through mentorship and revised training curriculums. Additionally, despite the availability of mental health resources to address pandemic-induced burnout, their underuse suggests a need for more accessible time for residents to use at their discretion and flexible training schedules that encourage mental health support resource utilization.

Measuring the intangibles of obstetrics and gynecology residency training: a comparative analysis across specialties

Measuring the intangibles of obstetrics and gynecology residency training: a comparative analysis across specialties

Rapid cycle deliberate practice: application in forceps simulation training for gynecology and obstetrics residents

Background Rapid Cycle Deliberate Practice (RCDP) has gained prominence in recent years as an innovative teaching method in simulation-based training for adult and pediatric emergency medical skills. However, its application in the training of forceps delivery skills among obstetrics and gynecology residents remains unexplored. This study aimed to assess the impact of RCDP in this domain. Methods Conducted in March 2021, this randomized controlled study involved 60 second-year obstetrics and gynecology residents undergoing standardized training. Participants were randomly assigned to the RCDP group or the traditional teaching method (TTM) group, each comprising 30 residents. The RCDP group followed the RCDP practice mode, while the TTM group adhered to conventional simulation teaching. Post-training assessment of operational proficiency was conducted immediately and after one year. Independent operational confidence and training satisfaction were evaluated through questionnaire surveys and the Satisfaction with Simulation Experience (SSE) scale. Data analysis utilized SPSS 23.0. Results The RCDP group displayed significantly higher immediate post-training forceps operation scores compared to the TTM group (92.00 [range: 90.00–94.00] vs. 88.00 [range: 86.75–92.00]; z = 3.79; p < .001). However, no significant difference emerged in forceps operation scores after one year (86.00 [range: 85.00–88.00] vs. 85.50 [range: 84.00–88.25]; z = 0.54; p = .59). The RCDP group exhibited notable performance improvement over the TTM group (z = 3.49; p < .001). Independent operation confidence showed no significant discrepancy (p > .05). Importantly, the RCDP group reported higher satisfaction scores, particularly in the Debriefing and Reflection subscale (44.00 [range: 43.00–45.00] vs. 41.00 [range: 41.50–43.00]; z = 5.24; p < .001), contributing to an overall superior SSE score (z = 4.74; p < .001). Conclusions RCDP exhibits immediate efficacy in elevating forceps delivery skills among residents. However, sustained skill enhancement necessitates innovative approaches, while RCDP’s value lies in tailored feedback and reflection for enriched medical education.

Obstetrics and Gynecology residency training in transgender care: a national survey of residents and program directors

Aim: Obstetricians and gynecologists (OB-GYN) routinely care for transgender patients though most OB-GYN practitioners do not have any transgender care-specific training. The pervasive lack of training and education leads to dire health consequences for transgender patients. Residents and program directors within U.S. OB-GYN residency programs have been surveyed separately. To our knowledge, this is the first study that compares responses from residents and program directors related to their training. Our study aims to assess OB-GYN residents’ and program directors’ levels of comfort, preparedness, and knowledge in caring for transgender patients. Methods: Electronic surveys were sent to 183 OB-GYN residency programs. Resident and program director surveys consisted of questions regarding experiences with transgender care, perceptions about current transgender care training, and levels of comfort, preparedness, and knowledge in caring for transgender patients. Data were collected via Qualtrics and analyzed using IBM SPSS Statistics. Results: Responses were collected from 37 program directors and 94 residents across five regions defined by the Council on Resident Education in Obstetrics and Gynecology (CREOG). Over 67% of program directors reported not having an established transgender care training curriculum in their program. Among those without an established curriculum, 89% of program directors reported plans to implement one within the next year. Average levels of comfort, preparedness, and knowledge in caring for transgender patients was low for both groups, with residents scoring lower on these variables. Most program directors (89%) were amenable to using standardized training materials as part of their transgender care curriculum, if available. Conclusion: While a majority of U.S. OBGYN residency programs do not have an established transgender care training curriculum, most would use standardized training materials to implement one. This is important given that the current knowledge of transgender care amongst both program directors and residents is low. This study contributes to the limited pool of data that aims to support the development of curricula within OB-GYN residency programs to improve care and reduce health inequities for transgender patients.

Program evaluation of postgraduate obstetrics and gynecology training in Lao people’s democratic republic - using the CIPP model

BackgroundThe obstetrics and gynaecology (OB-GYN) residency training program in Lao People’s Democratic Republic (PDR) began in 2003 based on the Millennium Development Goals (MDGs) and ‘Reproductive, maternal, newborn, and child health interventions (RMNCH) strategies and action plan’. However, the training program had not been properly evaluated previously. The purpose of this study is to evaluate the current postgraduate OB-GYN residency training program in Lao PDR by using CIPP model to identify the current problems (the strengths and weaknesses) and suggest a future plan to promote continuous improvement.MethodThe context, input, process, and product classification (CIPP) model was used to develop criteria and indicators. A mixed-methods approach was used for this study. To capture instructional material for quantitative analysis, a Google survey with 38 items and a t-test were used to determine a significant difference in responses between residents and lecturers (N = 120). Based on qualitative analysis, an in-depth interview was done (four questions based on study outcomes, including satisfaction, strengths and weaknesses, and future opportunities), and six interviews provided different viewpoints on the course. The SPSS software program was used to measure validity, with p-values = 0.05.ResultsThe overall average response rate was 97.5%. Two significant differences in program perspectives were revealed between lecturers and residents, difficulties in maintaining the course (professors 3.66 ± 1.03 and residents 3.27 ± 0.98, p = 0.04) and learning outcomes achieved (professors 3.57 ± 0.85 and residents 3.14 ± 0.95, p = 0.01 The overall average for the context part of the questionnaire was under 3.00, with the lowest scores for overlapped learning outcomes and difficulties in maintaining the course. The input part, lack of the classroom, skills lab and staff; the process part, lecturer to collect student opinions and the product part on learning outcomes.ConclusionCurriculum improvement based on the program evaluation results, including regular evaluation and feedback, will advance the residency training program based on the RMNCH strategy and contribute to the promotion of maternal health in the Lao PDR.

Satisfaction With Abortion Training in an Abortion-Restrictive State.

Background With increasingly disparate patient access to abortion care and resident access to abortion training opportunities following the Dobbs v Jackson Women's Health Organization decision, educators must better understand how legal restrictions affect obstetrics and gynecology (OB/GYN) resident training experiences and residents' desire to provide abortions. Objective To characterize how resident perceptions of abortion restrictions affect satisfaction with training and intent to provide abortion. Methods We recruited OB/GYN residents training in Ohio, a state restrictive to abortion, to complete surveys capturing training experiences between 2019 and 2020. Logistic regression models were used to estimate associations between perception of the legal climate on training and satisfaction with training and intent to provide abortions. To provide additional context to survey responses, we reviewed open-ended responses to the effect of the legal climate on training. Results Of 343 eligible residents, 88 (26%) responded from 13 of 15 programs (87% of programs). Most (73%) felt that the legal climate affected their training, and these respondents were more likely to be unsatisfied with their training (adjusted odds ratio [aOR] 16.6; 95% CI 2.83-97.22). We found no association between perception of legal climate on training and intent to provide abortions. In open-ended responses, most residents described a desire for more abortion training and barriers to patient care. Some highlighted the positives of training in a restrictive environment, which allowed for an improved understanding of the skills required for patient advocacy. Conclusions Many residents felt that the legal climate in Ohio affected their abortion training, a perception that was associated with decreased satisfaction with training.

Needs assessment of menopause education in United States obstetrics and gynecology residency training programs.

This study aimed to assess the variance in menopause education, educational resources, and the needs of obstetrics and gynecology (ObGyn) residency programs by conducting a national survey of program directors (PDs). In 2022, an institutional review board-approved Web-based Qualtrics survey was designed and distributed electronically to 145 US ObGyn residency PDs. The survey consists of 15 questions. The main outcomes are reported using descriptive statistics. The survey was completed by 99 of 145 PDs (68.3%). Almost all participants (92.9%) strongly agreed that residents nationwide should have access to a standardized menopause curriculum that could be utilized in their programs. Only 31.3% reported having a menopause curriculum in their residency program. Of the programs with a menopause curriculum, 96.8% reported using lectures, 77.4% reported assigned readings, and 74.2% had either dedicated menopause clinics or other clinics with a high volume of menopausal patients. Of all programs surveyed, only 29.3% reported that trainees had dedicated time assigned to a menopause clinic. A total of 83 of 99 PDs agreed or strongly agreed that their programs needed more menopause educational resources, and most (89.7%) stated they were likely or very likely to use self-paced menopause modules that include performance feedback if available. Data from the needs assessment questionnaire revealed that menopause education and resources vary across residency programs, with the majority lacking a dedicated menopause curriculum. Most PDs expressed a desire for more educational resources and standardized training materials, and preferred to access an online national menopause curriculum.

Anticipated Impact of Dobbs v Jackson Women's Health Organization on Training of Residents in Obstetrics and Gynecology: A Qualitative Analysis.

On June 24, 2022, the Supreme Court of the United States in the case of Dobbs v Jackson Women's Health Organization ended constitutional protection for abortion, thus severely restricting access to reproductive health care for millions of individuals. Concerns have arisen about the potential impact on medical students, residents, and fellows training in restricted areas and the effect on gynecologic training and the future provision of competent comprehensive women's health care in the United States. To qualitatively explore the anticipated impacts of the Dobbs ruling on training in obstetrics and gynecology (OB/GYN). A participatory action research approach employing methods of qualitative analysis was used. Trainees and leaders in national OB/GYN professional and academic organizations with missions related to clinical care and training of medical students, residents, and fellows in OB/GYN participated. Two focus groups were held via Zoom in July 2022. Using an iterative process, transcripts underwent coding by 2 independent researchers to identify categories and common themes. Themes were organized into categories and subcategories. An additional reviewer resolved discrepancies. Twenty-six OB/GYN leaders/stakeholders representing 14 OB/GYN societies along with 4 trainees participated. Eight thematic categories were identified: competency, provision of reproductive health care, residency selection, inequity in training, alternative training, law-based vs evidence-based medicine, morality and ethics, and uncertainty about next steps. This qualitative study of leaders and learners in OB/GYN identified 8 themes of potential impacts of the Dobbs ruling on current and future training in OB/GYN.

Elimination of 24-Hour Call Shifts in an Obstetrics and Gynecology Residency Training Program [ID: 1375098

INTRODUCTION: Resident duty hour restrictions have resulted in improved resident safety with mixed results on patient safety. There are limited data about 24-hour shifts in obstetrics and gynecology. This project studies resident wellness and performance after eliminating 24-hour call shifts. METHODS: This is a preliminary analysis of a quality improvement project. Physicians were surveyed before and after implementation of a call schedule that reduced 24-hour shifts to 14-hour shifts. Resident performance was assessed by self-reported and attending-reported ability to perform tasks. RESULTS: At preintervention survey, 13 out of 16 residents and 8 out of 17 attendings favored eliminating 24-hour call shifts. Attendings had more confidence in residents' performance on 24-hour shifts than residents did (P&lt;.02) when stratified by task and residency year. At 3-month follow-up, all residents (19/19) preferred 14-hour shifts. Residents reported improvements in wellness (13/13), sleep (13/13), and burnout (10/13). Residents felt more confident in their ability to perform a vaginal delivery (11/13), cesarean birth (12/13), or communicate effectively (11/13) with 14-hour compared to 24-hour shifts. Thematic analysis showed that residents felt happier and better able to care for patients. Two residents cited improved ability to learn, while only one resident cited lost learning opportunities. CONCLUSION: Data suggest that obstetrics and gynecology residency programs should eliminate 24-hour shifts to improve resident wellness and performance, while decreasing burnout. Final follow-up data (to be collected March 2023) will assess whether attendings see a change in resident performance.

Exploring the hidden curriculum in the University of Alberta postgraduate obstetrics and gynecology residency training program

Following accreditation of the University of Alberta Obstetrics and Gynecology residency training program, concerns regarding the informal teaching environment, known as “hidden curriculum” (HC) were identified. The ongoing research aims to identify, understand, and rectify the HC through positive change within the department.

The association between abortion restrictions and patient-centered care for early pregnancy loss at US obstetrics-gynecology residency programs

Early pregnancy loss is a common medical problem, and the recommended treatments overlap with those used for induced abortions. The American College of Obstetricians and Gynecologists recommends the incorporation of clinical and patient factors when applying conservative published imaging guidelines to determine the timing of intervention for early pregnancy loss. However, in places where abortion is heavily regulated, clinicians who manage early pregnancy loss may cautiously rely on the strictest criteria to differentiate between early pregnancy loss and a potentially viable pregnancy. The American College of Obstetricians and Gynecologists also notes that specific treatment modalities that are frequently used to induce abortion, including the use of mifepristone in medical therapy and surgical aspiration in an office setting, are cost-effective and beneficial for patients with early pregnancy loss. This study aimed to determine how US-based obstetrics and gynecology residency training institutions adhere to the American College of Obstetricians and Gynecologists recommendations for early pregnancy loss management, including the timing and types of interventions, and to evaluate the relationship with institutional and state abortion restrictions. From November 2021 to January 2022, we conducted a cross-sectional study of all 296 US-based obstetrics and gynecology residency programs by emailing them and requesting that a faculty member complete a survey about early pregnancy loss practices at their institution. We asked about location of diagnosis, use of imaging guidelines before offering intervention, treatment options available at their institution, and program and personal characteristics. We used chi-square tests and logistic regressions to compare the availability of early pregnancy loss care based on institutional indication-based abortion restrictions and state legislative hostility to abortion care. Of the 149 programs that responded (50.3% response rate), 74 (49.7%) reported that they did not offer any intervention for suspected early pregnancy loss unless rigid imaging criteria were met, whereas the remaining 75 (50.3%) programs reported that they incorporated imaging guidelines with other factors. In an unadjusted analysis, programs were less likely to incorporate other factors with imaging criteria if they were in a state with legislative policies that were hostile toward abortion (33% vs 79%; P<.001) or if the institution restricted abortion by indication (27% vs 88%; P<.001). Mifepristone was used less often in programs located in hostile states (32% vs 75%; P<.001) or in institutions with abortion restrictions (25% vs 86%; P<.001). Similarly, office-based suction aspiration use was lower in hostile states (48% vs 68%; P=.014) and in institutions with restrictions (40% vs 81%; P<.001). After controlling for program characteristics, including state policies and affiliation with family planning training programs or religious entities, institutional abortion restrictions were the only significant predictor of rigid reliance on imaging guidelines (odds ratio, 12.3; 95% confidence interval, 3.2-47.9). In training institutions that restrict access to induced abortion based on indication for care, residency programs are less likely to holistically incorporate clinical evidence and patient priorities in determining when to intervene in early pregnancy loss as recommended by the American College of Obstetricians and Gynecologists. Programs in restrictive institutional and state environments are also less likely to offer the full range of early pregnancy loss treatment options. With state abortion bans proliferating nationwide, evidence-based education and patient-centered care for early pregnancy loss may also be hindered.

Simulation to improve trainee knowledge and comfort in managing maternal cardiac arrest

Maternal cardiac arrest is a rare outcome, and thus there are limited opportunities for specialists in obstetrics and gynecology to acquire the skills required to respond to it through routine clinical practice. This study aimed to evaluate gaps in medical education in maternal cardiac arrest and whether a simulation-based training program improves resident knowledge and comfort in the diagnosis and treatment of maternal cardiac arrest. A 2-hour training for obstetrics and gynecology residents at an academic medical center was conducted, consisting of a didactic presentation, defibrillator skills station, and 2 high-fidelity simulations. Consenting residents completed a 21-item pretest followed by a 12-item posttest exploring knowledge of and exposure to maternal cardiac arrest. The McNemar and Wilcoxon signed-rank tests were used to compare pre- and posttest data. Of 21 residents, 15 (71.4%) had no previous education about maternal cardiac arrest, and 17 (81.0%) had never responded to a maternal code. Participants demonstrated increased knowledge about maternal cardiac arrest after the session, providing more correct answers on the reversible causes of pulseless electrical activity arrest (median 4 vs 7 correct responses; P<.01). After the training, more residents were able to identify the correct gestational age to perform a cesarean delivery during maternal cardiac arrest (19.0% vs 90.5%; P<.01) and the correct location for this procedure (52.4% vs 95.2%; P<.01). All residents reported that maternal cardiac arrest training was important and that they would benefit from additional sessions. Median composite comfort level in managing maternal cardiac arrest significantly increased after participation (pretest, 24.0 [interquartile range, 21.5-28.0]; posttest, 37.0 [interquartile range, 34.3-41.3]; P<.01). Residents report limited exposure to maternal cardiac arrest and desire more training. Simulation-based training about maternal cardiac arrest is needed during residency to ensure that graduates are prepared to respond to this high-acuity event.

Classroom-Based Learning in an Academic Obstetrics and Gynecology Residency Training Program.

Classroom-based learning such as academic half days (AHDs) are complementary to workplace learning in postgraduate medical education. This study examined three research questions: the purpose of AHDs, elements of an effective AHD, and factors that make AHD sustainable. We conducted a case study of the AHD in a large Obstetrics and Gynecology residency program at the University of British Columbia. Residents were interviewed in 2013 (n = 11) and 2018 (n = 7) and the program administrator was interviewed in 2018. The themes in each research question were identified by modified inductive analysis. Residents expressed that the purposes of AHD included: providing organization and an overview for their knowledge acquisition; preparation for their Royal College specialty exam; and to provide a venue for peer support and mentorship. Elements of an effective AHD include the repetition of key concepts; formative assessments such as quizzes, a suitable balance of faculty input and resident active participation, and protection from clinical duty during AHD. Regarding the sustainability of AHD, themes included: addressing barriers to faculty participation, providing administrative support for logistical needs, and providing feedback to faculty. This work provides important insights into the purpose, effectiveness, and sustainability of AHDs for those who design and implement classroom learning for residents.

Social factors influence on anxiety, depression level and psychological trauma of obstetrics and gynecology residents during COVID-19 pandemic

Background and aimThe novel coronavirus disease 2019 (COVID-19) has enforced obstetrics and gynecology (ObGyn) residency training process to undergo wide changes including lessons modifications, yet their mental health were not evaluated. Hence, this study aimed to evaluate the influence of social factors on anxiety, depression level, and psychological trauma of ObGyn residents during the COVID-19 pandemic as well as the impact of COVID-19 to residency training program. MethodsA cross-sectional study was conducted in three institutions in Indonesia: the University of Indonesia, the University of Lambung Mangkurat, and the University of Syiah Kuala. A total of 169 ObGyn residents agreed to participate and were enrolled in this study. ResultsTotal 169 residents were eligible with a mean age of 26–42 years. 76.9% of the residents were exposed to COVID-19 patients during clinical rotation. Approximately half of them (52.6%) thought COVID-19 has brought negative effects. Long-distance learning was considered of good quality by 40.2% of participants. The majority experienced enough resting periods, nearly half of them (45.5%) were concerned about the impact of being a less competent specialist. ConclusionOverall, no significant statistical relationship were revealed between social factors and depression, anxiety and psychological trauma in ObGyn residents during COVID-19 pandemic.

75 (PB-075) Poster - The place of videos illustrating the techniques of breast surgery in the procedural training of residents in gynecology

Background: In Tunisia, breast cancer is the leading cancer in women representing 30% of all female cancers. Mastery of breast surgery techniques is one of the objectives of the overall training of gynecology residents and one of the main skills required of medical specialists in gynecology.

The Impact of Covid-19 Pandemic on Obstetrics and Gynecology Residency Programs and Perspectives on Adaptive Ways of Training in Ethiopia

Background: The impact of Covid-19 on healthcare system and trainings has been tremendous and unpredictable. In addition to service re-organization, teaching institutions will have to devise adaptive mechanisms to cope up with the disruption in medical education and residency training. Objectives: to assess the effect of Covid-19 pandemic on obstetrics and gynecology residency program and explore residents’ &amp; program directors’ perspectives on alternative academic approaches in Ethiopia. Methods: This is a cross sectional mixed method study which was conducted at 12 institutions engaged in obstetrics and gynecology residency training in Ethiopia from May to June 2020. Quantitative data were collected from 240 residents employing an online platform (Google Forms) and focus group discussion was conducted using the ZOOM video-conferencing platform with eleven chief residents and eight program directors. Quantitative data analysis was performed using Stata 15 statistical software while thematic synthesis approach was used for the qualitative data analysis assisted by Atlas’s 7 for windows. Ethical clearance was obtained from IRB of Saint Paul’s Hospital Millennium Medical College. Results: All levels of residents from all residency sites were represented. The level of residents’ engagement in various routine clinical services vary depending on the type of service during COVID-19 pandemic period. Residents’ involvement in routine ANC, high risk clinics are “slightly” reduced while in Gynecology OPDs, the reduction was “severe”. There was no effort made to address the psychological impact of the pandemic on residents. The level of reduction in didactic and clinical teaching (rounds, case presentations, seminars, management sessions ranged from “some” to “complete interruption” for most of the residents at different years of training. Although the reduction in obstetric practical exposure (normal delivery, cesarean delivery) was “slight”, there was “sever” reduction to “complete suppression” (&gt;80%) in major gynecologic surgeries primarily affecting final year residents. Research activities are completely halted in most of the institutions. Generally, adaptive methods to sustain the residency training were implemented in very few of the institutions. Conclusions: There was significant disruption in all domains of the residency training following the report of the first case of COVID-19 in Ethiopia. The preparedness and response of the programs was very poor and there was limited effort in implementing adaptive teaching methods in almost all of the institutions.

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.