Residency Training In Obstetrics Research Articles

Ready Day One: What Residents and Program Directors Think is Needed for a Successful Transition to Residency

To evaluate perceived gaps in preparedness, current on-boarding practices, and need for specialty wide resources in the transition to residency training in obstetrics and gynecology (OB/GYN) DESIGN, SETTING, AND PARTICIPANTS: A cross-sectional survey of current U.S. OB/GYN residents and program directors (PDs) at the time of the resident in-training exam was conducted in 2022. Both groups provide demographic information and identified specific knowledge, skills, and abilities in need of more preparation at the start of residency. PDs were queried on perceptions of readiness for their current first year class, educational on-boarding practices, and their preference for standardized curricular materials and assessment tools. Chi-squared and Kruskal-Wallis tests were used to compare perceptions of skills deficits between PDs and residents, and the relationship of preparedness to program type and resident year in training. Response rates for residents and program directors were 64.9% and 72.6% respectively. A majority (115/200, 57.5%) of program directors agreed or strongly agreed with the statement, "In general, I feel that my new interns are well prepared for residency when they arrive at my program." Both groups agreed that basic suturing and ultrasound skills were deficits. Residents identified a need for better preparation in management of inpatient issues while PDs identified time management skills as lacking. There was considerable heterogeneity of program on-boarding practices across the specialty. Most PDs agreed or strongly agreed that a standardized curriculum (80.5%, 161/200) and assessment tools (75.3%, 150/199) would be helpful. OBGYN PDs feel that not all residents arrive prepared for residency and overwhelmingly support the development of standardized transition curricular and assessment tools, similar to the curriculum developed in general surgery. Based on input from PDs and residents, early curricular efforts should focus on basic surgical, ultrasound, and time management skills and on management of inpatient issues.

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.

Editorial introductions.

Current Opinion in Obstetrics and Gynecology was launched in 1989. It is one of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The field of obstetrics and gynecology is divided into ten sections that are reviewed once a year. Each section is assigned one or more Section Editors. They are the leading authorities in their area, who identify the most important topics at that time. Here we are pleased to introduce the Journal's Section Editors for this issue. SECTION EDITORS Deirdre LyellDeirdre LyellDr Lyell is a Professor of Obstetrics and Gynecology in the Division of Maternal-Fetal Medicine at Stanford University, USA, where she serves as the Associate Division Director, Director of the Program in Placental Disorders, and Program Director of the Maternal-Fetal Medicine Fellowship. Dr Lyell is a member of the Child Health Research Institute at Stanford, the March of Dimes Prematurity Research Center at Stanford, and conducts research in clinical obstetrics. From 2013–2016 she served as an alternate P.I. to the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Maternal-Fetal Medicine Unit (MFMU) Network, USA. In 2010 she formed the Program in Placental Disorders at Stanford, a multidisciplinary patient care and research program for women with placenta accreta and cofounded a Placenta Accreta Special Interest Group that meets annually at the Society for Maternal-Fetal Medicine meeting. Dr Lyell earned a Bachelors of Arts and Sciences in History and Biology from Stanford University and a Medical Degree from the George Washington University School of Medicine, USA. She completed residency training in Obstetrics and Gynecology at Brigham and Women's and Massachusetts General Hospitals, USA, and fellowship in maternal-fetal medicine at Stanford University. She is certified by the American Board of Obstetrics and Gynecology in obstetrics and gynecology and maternal-fetal medicine. Mark BoddyMark BoddyDr Mark Boddy received his bachelor's degree from Georgia State University, USA. He received his medical degree from the Medical College of Georgia prior to completing a residency in obstetrics and gynecology at Atlanta Medical Center, USA. He subsequently completed a fellowship in maternal fetal medicine at The George Washington University School of Medicine, USA. He practiced for 17 years in a hospital-based setting while also serving as a Regional Perinatal Director for the State of Georgia. Currently, Dr Boddy is an Associate Clinical Professor at Stanford University School of Medicine, USA and the Medical Director of the Stanford Children's Healthcare Perinatal Diagnostic Center in Salinas, California, USA. His interests include prenatal diagnosis, improving quality of care and patient safety. Martha RodeMartha RodeDr Martha Rode received her bachelor's degree in biology at Harvard University, USA, before attending medical school at the University of California, Los Angeles, USA. She then completed residency and a maternal-fetal medicine fellowship at the University of Pennsylvania in Philadelphia, USA. She has since worked in both academic and hospital-based practices on both the East Coast and Northern California Bay Area in USA. She is currently a Clinical Associate Professor at Stanford Medical School, USA, serving as the Medical Director of the Perinatal Diagnostic Center in Santa Cruz. Her interests include perinatal diagnosis and high-risk obstetrics as well as community physician outreach and continued education. Jane ChuehJane ChuehDr Jane Chueh received her bachelor's degrees in biology and humanities at Stanford University, USA. She attended medical school at University of California San Diego, USA and completed her residency at University of Washington, USA and her fellowships in maternal fetal medicine and clinical genetics at University of California San Francisco, USA. She has worked in both academic and hospital-based practices in the Northern California Bay Area. Currently she is a Clinical Professor at Stanford Medical School, serving as the Director of Prenatal Diagnosis and Therapy at Stanford Children's Health. She enjoys practicing prenatal diagnosis and high-risk obstetrics, collaborating in research projects related to ultrasound and simulation teaching, and mentoring Stanford undergraduates and medical students. Amy VoedischAmy VoedischAmy J Voedisch, MD, MSc, NCMP is a Clinical Associate Professor in the Division of Family Planning, in the Department of Obstetrics and Gynecology at Stanford University, USA. Dr Voedisch attended the Mayo Medical School in Rochester, Minnesota, USA, and completed her OB-GYN residency at Kaiser Permanente Santa Clara, USA. She then went on to a fellowship in family planning at Stanford University, becoming an expert in reproductive health services, with a focus on increasing access to contraception in underserved international areas. She also earned her master's degree in clinical sciences research during her fellowship. Dr Voedisch is an expert in perimenopause and menopause and is a North American Menopause Society Certified Menopause Practitioner (NCMP).

Editorial introductions.

Editorial introductions.

The Psychological Impact of COVID-19 on Medical Students Interested in Obstetrics and Gynecology [A57

INTRODUCTION: The COVID-19 pandemic has caused mental health distress among health care professionals. This study aimed to evaluate the psychological impact of COVID-19 on medical students interested in obstetrics and gynecology at medical schools in two early epicenters of COVID-19. METHODS: This study was approved by the Weill Cornell Medicine Institutional Review Board. An online questionnaire was distributed to allopathic medical students in Washington and New York. The survey assessed mental health from March to April 2020 via the Patient Health Questionnaire, Generalized Anxiety Disorder Questionnaire, and questions on self-rated mental health. RESULTS: Out of 1,139 students who completed the survey, 63 reported a plan to pursue residency training in obstetrics and gynecology. Forty-six (74%) reported an overall deterioration in mental health, 34 (59%) reported depressive symptoms, and 38 (65%) reported anxiety symptoms. Seventeen (28%) students met criteria for major depressive disorder and 16 (27%) for anxiety disorder. Twenty-three (37%) reported at least one close contact with symptoms or diagnosis of COVID-19 and 7 (11%) reported at least one close contact with COVID-19-related death. Commonly cited self-care tactics included staying in touch with friends/family (92%), entertainment (81%), and fitness (65%). When compared to the overall population of students, there were no significant differences in responses for students interested in obstetrics and gynecology. CONCLUSION: Students in this study experienced high levels of depressive and anxiety symptoms. Medical trainees are already at an increased risk for depression and anxiety relative to the general population, making it critical for medical schools to understand students’ perspectives and prioritize mental health.

Editorial introductions.

Editorial introductions.

Resident and program director confidence in resident preparedness for operative vaginal deliveries in Obstetrics and Gynecology Training Programs in the United States

Operative vaginal delivery is used to expedite a safe vaginal delivery in the second stage of labor and is considered an essential part of residency training in obstetrics and gynecology. To assess the self-reported readiness of obstetrics and gynecology residents in the United States to perform vacuum-assisted vaginal delivery and forceps-assisted vaginal delivery compared with the perceptions of program directors. The Council on Resident Education in Obstetrics and Gynecology surveyed the residents in all US training programs about their readiness to perform forceps-assisted and vacuum-assisted deliveries. The program directors were simultaneously surveyed about the readiness of their cohort to perform operative deliveries with and without attending oversight. The primary outcome of the survey was the residents' self-reported confidence in their ability to autonomously and independently perform operative deliveries. Α total of 5084 out of 5514 (92.9%) resident physicians and 241 out of the 292 (83%) residency program directors completed the survey. Eighty-seven percent (95% confidence interval, 84.9-88.9) of the graduating residents reported feeling that they could autonomously perform a vacuum-assisted vaginal delivery, compared with 49.5% (95% confidence interval, 46.6-52.4) for forceps-assisted vaginal delivery (P<.01). Similarly, whereas 95.9% (95% confidence interval, 94.6-97.0) of the residents felt that they could confidently perform an emergency vacuum-assisted vaginal delivery, only 42.3% (95% confidence interval, 39.4-45.2) felt confident performing an emergency forceps-assisted vaginal delivery (P<.01). The residency program directors significantly overestimated their residents' confidence in independently performing an emergency forceps-assisted vaginal delivery or vacuum-assisted vaginal delivery than the residents themselves (54% [95% confidence interval, 47.1-60.5] vs 24% [95% confidence interval, 22.5-24.9] and 98.6% [95% confidence interval, 97.0-100] vs 71.9 [95% confidence interval, 70.6-73.2] respectively P<.01). Trainees in military-based residency programs and those interested in pursuing a career as generalists or maternal-fetal medicine specialists reported significantly higher preparedness to perform a forceps-assisted vaginal delivery. Graduating obstetrics and gynecology residents report feeling less prepared to independently perform a forceps-assisted vaginal delivery than a vacuum-assisted vaginal delivery. The program directors had more confidence in the ability of their residents to perform an operative vaginal delivery than the residents themselves.

Should Catholic Academic Health Centers Sponsor Residency Training in Obstetrics and Gynecology?

Should Catholic Academic Health Centers Sponsor Residency Training in Obstetrics and Gynecology?

Editorial introductions

Current Opinion in Obstetrics and Gynecology was launched in 1989. It is one of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The field of obstetrics and gynecology is divided into nine sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce the Journal's Section Editors for this issue. SECTION EDITORS Joseph AquilinaJoseph AquilinaJoseph Aquilina, FRCOG, MFFP, is a consultant obstetrician and gynaecologist at Barts Health NHS Trust based St. Bartholomew's and the Royal London Hospitals, UK, and Honorary Senior Lecturer in Obstetrics and Gynaecology at Queen Mary University of London, UK. He is the Lead Clinician for Fetal Medicine Clinical Academic Group and runs a one-stop menstrual disorders clinic at St Bartholomew's Hospital. Mr Aquilina obtained his primary medical degree in Malta and then moved to the UK for his basic postgraduate training in Bristol, and in London at King's College and Greenwich Hospitals, UK. He subsequently undertook research and subspecialty training in feto-maternal medicine/gynaecological ultrasound as a lecturer at St.Bartholomew's and Royal London Medical School, Queen Mary Westfield College, based at Homerton Hospital, UK. He is recognised as a preceptor for training in gynaecological scanning by the Royal College of Obstetricians and Gynaecologists, UK. His special interests include polycystic ovarian syndrome, prediction of pre-eclampsia and the application of ultrasound in the diagnosis and management of benign gynaecological conditions. Paul D. BlumenthalPaul D. BlumenthalPaul D. Blumenthal, MD, MPH, is Professor of Obstetrics and Gynecology at Stanford University School of Medicine, USA. He directs the Stanford Gynecology Service and the Division of Family Planning Services and Research at Stanford. He also directs SPIRES, the Stanford Program for International Reproductive Education and Services, an initiative providing technical assistance and training to family planning programs in a wide variety of countries across Africa, Asia and Central America. For over 30 years, Dr Blumenthal has been an advisor to multiple international agencies such as Gynuity Health Projects, Ipas, Pathfinder, FHI360, Path, Jjpiego, the Population Council, the RCOG and the World Health Organization, and served as the Special Advisor to Minister of Health and Family Planning of the Republic of Madagascar. He currently serves as the Global Medical Director for Population Services International. Dr Blumenthal is committed to the development and implementation of innovative approaches to reproductive health issues in both the domestic and international arenas. Kavita MishraKavita MishraDr Kavita Mishra is a urogynecologist at Stanford University School of Medicine, USA, where she is an Assistant Professor of Obstetrics and Gynecology. She completed her medical degree at the University of California, San Francisco, USA, and residency training in Obstetrics and Gynecology at Brown University, USA. She subsequently completed an ABOG/ABU-approved Fellowship in female pelvic medicine and reconstructive surgery at Brown University. She has subspecialty board certification in FPMRS. She performs reconstructive surgery for pelvic organ prolapse and urinary incontinence using robotic, laparoscopic, and vaginal approaches. She currently sees patients with complex pelvic floor disorders at Stanford's multidisciplinary Pelvic Health Center with specialists from colorectal surgery, female urology and GI motility. Her research interests include epidemiology of pelvic floor disorders and mesh complications. She is involved in the Pelvic Anatomy Group of the Society of Gynecologic Surgeons.

Innovations in Medical Education: Faculty Development Framework for Improved Outcomes in Residency Training in Obstetrics and Gynecology

Innovations in Medical Education: Faculty Development Framework for Improved Outcomes in Residency Training in Obstetrics and Gynecology

Fellow Perceptions of Residency Training in Obstetrics and Gynecology

To evaluate the perceptions of current and former fellows in obstetrics and gynecology (OBG) subspecialties of their readiness for fellowship training. A previously used survey was modified and distributed in 2016 to current and former fellows in gynecologic oncology, maternal-fetal medicine, reproductive endocrinology-infertility, and female pelvic medicine and reconstructive surgery. The survey explored domains of professionalism, independent practice, psychomotor ability, clinical evaluation, and scholarship. A standard Likert scale was employed and domains/responses were tailored to each subspecialty. Standard statistical models were utilized. A total of 478 fellows responded to the survey. Nearly 75% of fellows from each specialty reported feeling prepared or very prepared for fellowship. More than 65% of fellows from each specialty reported feeling very prepared to perform core surgical procedures. More than 90% of respondents reported having opportunities during residency to independently develop a plan of action for patients on labor and delivery. Fewer respondents reported opportunities to independently manage postoperative complications-40.7% of gynecologic oncology and 44.7% of female pelvic medicine and reconstructive surgery reported having such opportunities, whereas 91.9% of maternal-fetal medicine respondents reported having had such opportunities. While 46.4% of respondents received education on scientific writing during residency, 80% reported writing a manuscript as a resident. The majority of current and former fellows in OBG subspecialties report feeling prepared for fellowship in terms of clinical and surgical skills. Their feedback reveals opportunities for improvement of independent practice in gynecologic scenarios, as well as formal education on scientific research, for OBG residencies.

Editorial introductions

Current Opinion in Obstetrics and Gynecology was launched in 1989. It is one of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The field of obstetrics and gynecology is divided into nine sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce the Journal's Section Editors for this issue. SECTION EDITORS Deirdre J. LyellDeirdre J. LyellDr Lyell is a Professor of Obstetrics and Gynecology in the Division of Maternal-Fetal Medicine at Stanford University, where she serves as the Associate Division Director, Director of the Program in Placental Disorders, and Program Director of the Maternal-Fetal Medicine Fellowship. From 2013–2016 she served as an alternate P.I. to the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Unit (MFMU) Network. In 2010 she formed the Program in Placental Disorders at Stanford, a multidisciplinary patient care and research program for women with placenta accreta and cofounded a Placenta Accreta Special Interest Group that meets annually at the Society for Maternal-Fetal Medicine meeting. Dr Lyell has previously designed and executed multicenter, randomized clinical trials, including “Magnesium sulfate versus nifedipine for tocolysis of preterm labor: a randomized, controlled trial” and “Maintenance nifedipine tocolysis compared with placebo: a randomized controlled trial” which won the 2009 A.C.O.G. Roy M. Pitkin Award “for one of four most outstanding manuscripts in Obstetrics & Gynecology in the previous year.” She is a member of the Child Health Research Institute at Stanford, the March of Dimes Prematurity Research Center at Stanford, and conducts a wide range of research in clinical obstetrics. Dr Lyell earned a Bachelors of Arts and Sciences in History and Biology from Stanford University and a Medical Degree from the George Washington University School of Medicine. She completed residency training in Obstetrics and Gynecology at Harvard (Brigham and Women's and Massachusetts General Hospitals), and fellowship in Maternal-Fetal Medicine at Stanford University. She is certified by the American Board of Obstetrics + Gynecology in Obstetrics and Gynecology and Maternal-Fetal Medicine. Martha RodeMartha RodeDr Martha Rode received her bachelor degree in Biology at Harvard University before attending medical school at the University of California, Los Angeles. She then completed residency and a Maternal-Fetal Medicine fellowship at the University of Pennsylvania in Philadelphia. She has since worked in both academic and hospital-based practices on both the East coast and Northern California Bay Area. She is currently a Clinical Associate Professor at Stanford Medical School, serving as the Medical Director of the Perinatal Diagnostic Center in Santa Cruz. Her interests include perinatal diagnosis and high risk obstetrics as well as community physician outreach and continued education. Mark BoddyMark BoddyDr Mark Boddy received his bachelor degree from Georgia State University. He received his medical degree from the Medical College of Georgia prior to completing a residency in obstetrics and gynecology at Atlanta Medical Center. He subsequently completed a fellowship in Maternal Fetal Medicine at The George Washington University School of Medicine. He practiced for 17 years in a hospital based setting while also serving as a Regional Perinatal Director for the State of Georgia. Currently, Dr Boddy is an Associate Clinical Professor at Stanford University School of Medicine and the Medical Director of the Stanford Children's Healthcare Perinatal Diagnostic Center in Salinas, California. His interests include prenatal diagnosis, improving quality of care and patient safety. Jane ChuehJane ChuehDr Jane Chueh received her Bachelor Degrees in Biology and Humanities at Stanford University. She attended medical school at University of California San Diego, completed her residency at University of Washington and her fellowships in Maternal Fetal Medicine and Clinical Genetics at University of California San Francisco. She has worked in both academic and hospital-based practices in the Northern California Bay Area. Currently she is a Clinical Professor at Stanford Medical School, serving as the Director of Prenatal Diagnosis and Therapy at Stanford Children's Health. She enjoys practicing prenatal diagnosis and high risk obstetrics, collaborating in research projects related to ultrasound and simulation teaching, and mentoring Stanford undergraduates and medical students.

Effect of high-fidelity shoulder dystocia simulation on emergency obstetric skills and crew resource management skills among residents

ObjectiveTo determine the effect of a simulation training program for residents in obstetrics and gynecology in terms of technical and nontechnical skills for the management of shoulder dystocia. MethodsA prospective study was performed at a center in Italy in April–May 2015. Thirty-two obstetrics and gynecology residents were divided into two groups. Residents in the control group were immediately exposed to an emergency shoulder dystocia scenario, whereas those in the simulation group completed a 2-hour training session with the simulator before being exposed to the scenario. After 8weeks, the residents were again exposed to the shoulder dystocia scenario and reassessed. Participants were scored on their demonstration of technical and nontechnical skills. ResultsIn the first set of scenarios, the mean score was higher in the simulation group than the control group in terms of both technical skills (P=0.008) and nontechnical skills (P<0.001). This difference was retained after 8weeks. ConclusionHigh-fidelity simulation programs could be used for the training of residents in obstetrics and gynecology to diagnose and manage obstetric emergencies such as shoulder dystocia.

Prevalence and predictors of burnout among obstetrics and gynecology residents in Canada

The aim of this study is to evaluate the prevalence of burnout syndrome among obstetrics and gynecology residents, as well as the relationship between several demographic and work-related characteristics and the prevalence of burnout. We surveyed 143 residents in obstetrics and gynecology programs across eight provinces in Canada using an electronic survey questionnaire and the Maslach Burnout Inventory Human services survey. The prevalence of high emotional exhaustion was 12.6 % higher among younger than older residents and 12.4 % higher among female compared to male residents. The prevalence of high depersonalization was13.0 % higher among male versus female residents. The prevalence of high emotional exhaustion among residents who reported sufficient supervision during the night shift was significantly lower than among those who reported insufficient supervision (95 % CI −49.7, −8.6). Additionally, we found that adequate access to food during the night shift was associated with a lower prevalence of any burnout (95 % CI −31.8, −0.2). Similar associations were observed for high emotional exhaustion and high depersonalization. We also found a 22.1 % (95 % CI −60.0, 15.7) lower prevalence of emotional exhaustion among residents who work 60 h/week or less. Our results suggest decreased levels of burnout in resident physicians who reported sufficient staff supervision, adequate access to food during the night shift, and fewer working hours. Future studies should be directed to examine the effectiveness of different strategies to improve the residency training in obstetrics and gynecology.

Editorial introductions

Editorial introductions

Integrating Anatomical Education into a Residency Curriculum of a Surgical Specialty

Anatomy is a cornerstone of modern medical education yet there is a continuing trend toward decreasing the time devoted to cadaveric dissection during medical school. Has the decrease in its use negatively impacted student's anatomical foundation? This is an especially relevant question for postgraduate education in surgical specialties, where an understanding of the pertinent anatomy is vital.Medical students entering residency training in obstetrics and gynecology often do not have an adequate understanding of pelvic anatomy. In fact, the recent growth in professional development courses employing cadaveric dissections is a testament to practicing gynaecologists recognition of inadequate teaching of pelvic anatomy. Designing a program to address this knowledge deficit is a worthwhile aim, especially if it includes elements that will maximize the utility of anatomical knowledge in surgical practice. Learners need a three‐dimensional understanding of pelvic anatomy that is transferable to pelvic surgery. Such a program should have clinical correlations, and develop production sets that are foundational to gynaecologic procedures. Lastly, repetition is essential to knowledge retention.A multimodality approach to teaching surgical anatomy is the most practical means to achieve these pedagogical goals. Clay modeling is a three‐dimensional technique that serves as an adjunct to lectures to refresh anatomy knowledge in residents entering an Obstetrics and Gynaecology program. The objective of the clay‐modeling session is to allow residents to conceptualize and build the anatomic structures of the pelvis in 3 dimensions using pre‐cut clay structures and a bony pelvis. While the lectures and supplementary teaching methods, are useful to build on the foundation provided by the clay‐modeling lab, the value of cadaveric dissection cannot be overstated. For Gynaecology, both vaginal and laparoscopic cadaver labs should be included, and can be achieved in sequence on the same cadaver. Repetition is the key to sustaining long‐term learning. Perhaps the best way to achieve this is by creating a clinical learning environment that highlights the importance of anatomical considerations and creates opportunities for cognitive reinforcement. Ultimately, the most important approach is to define it as a core competency required for advancement, and to develop discriminating means to test for it. As postgraduate accreditation bodies increasingly adopt competency‐based curricula, the need for valid methods of assessing anatomical competency becomes more pressing.

Preparedness of Ob/Gyn residents for fellowship training in gynecologic oncology

Residency training in obstetrics and gynecology is being challenged by increasingly stringent regulations and decreased operative experience. We sought to determine the perception of preparedness of incoming gynecologic oncology fellows for advanced surgical training in gynecologic oncology. An online survey was sent to gynecologic oncologists involved in fellowship training in the United States. They were asked to evaluate their most recent incoming clinical fellows in the domains of professionalism, level of independence/graduated responsibility, psychomotor ability, clinical evaluation and management, and academia and scholarship using a standard Likert-style scale. The response rate among attending physicians was 40% (n=105/260) and 61% (n=28/46) for program directors. Of those who participated, 49% reported that their incoming fellows could not independently perform a hysterectomy, 59% reported that they could not independently perform 30min of a major procedure, 40% reported that they could not control bleeding, 40% reported that they could not recognize anatomy and tissue planes, and 58% reported that they could not dissect tissue planes. Fellows lacked an understanding of pathophysiology, treatment recommendations, and the ability to identify and treat critically ill patients. In the academic domain, respondents agreed that fellows were deficient in the areas of protocol design (54%), statistical analysis (54%), and manuscript writing (65%). These results suggest that general Ob/Gyn residency is ineffective in preparing fellows for advanced training in gynecologic oncology and should prompt a revision of the goals and objectives of resident education to correct these deficiencies.

Obstetrics and Gynecology Ultrasound and Evidence-based Medicine in Medical Education

ABSTRACT Evidence-based medicine (EBM) is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. Despite improvement in knowledge, technology, effective medical therapies and ample practice guidelines, the practice of medicine in all specialties including obstetrics and gynecology (OB/GYN) continues to lag behind along with alarming rate of medical errors. Similarly, ultrasonography is rapidly expanding in the practice of medicine across many specialties but standardized requirements and ultrasound curricula for residency training in obstetrics and gynecology are still lacking. EBM is a required component of the curriculum of medical education at all levels but still does not have a firm foothold in the practice of medicine in the United States and other countries because of barriers. There are many proposed changes to improve the efficacy of current teaching of EBM and ultrasound including an early introduction in preclinical curriculum and integration of a longitudinal EBM-ultrasound training in the continuum of medical education. We present a case of postmenopausal bleeding (PMB) which was managed according to the traditional way, and review of EBM literature to contrast differences in clinical decision of two clinical approaches. How to cite this article Aragon L, Ho H. Obstetrics and Gynecology Ultrasound and Evidence-based Medicine in Medical Education. Donald School J Ultrasound Obstet Gynecol 2014;8(1):77-82.

Editorial introductions

Editorial introductions

Looking to the Future of Obstetrics and Gynaecology Training in Canada: A Resident's Perspective

Looking to the Future of Obstetrics and Gynaecology Training in Canada: A Resident's Perspective