Are OB/GYN Residents Getting Enough Surgical Training?Posted October 20, 2016 by Stacy Bolzenius
Undergoing surgical training in OB/GYN residency is an important part of preparing for a career in this area of medicine. However, there has been a growing concern over whether the amount of training residents are receiving these days is enough. Gynecology residents have a certain amount of training time for surgery just as they had in the past, but there are now more developments in surgical procedures, techniques and technology to learn and master.
Statistics on Surgical Training
Studies on preparedness among gynecology and obstetrics residents for fellowships have indicated that training does not seem to be adequate. According to a study published in Obstetrics & Gynecology, 20 percent of first-year residents in fellowship training had the ability to perform vaginal hysterectomies independently, while 34 percent had the ability to perform basic hysteroscopic procedures independently. Results for postoperative care and patient management were considerably higher, though, with 71 percent of residents being rated as adequate in all subspecialties.
Limited Training Hours
One of the possible reasons behind decreases in preparedness among OB/GYN residents is a limit of 80 work hours per week. This dates back a mandate enacted in 2003 by the Accreditation Council for Graduate Medical Education. This limit was put in place to reduce resident fatigue, which was believed to have been linked to the death of a patient. In practice, however, the effects of this limitation have been controversial. Those who have more than one surgical subspecialty have claimed that the 80-hour limit might actually be doing more harm than good among residents. Research on these effects has shown that these limitations have improved the wellness of residents to some extent, but they have also been linked to poorer performance on exams in certain specialties. The results of this research also showed that the outcome among patients did not improve in general.
Reasons for Decreased Preparedness
There are a few different factors that might be contributing to a lower degree of preparedness in gynecology residents. These include cases becoming more complex while also declining in number overall. In other words, residents are expected to handle more complicated cases, but the smaller number of these cases does not provide them with enough practice. The use of minimally invasive procedures rather than more traditional procedures could account for the lower number of complex cases.
Ways to Handle the Preparedness Problem
Solutions to the problem of preparedness in surgical training include encouraging residents to pursue subspecialties and requiring additional time for training in terms of years. Some residency programs might also benefit from working with local physicians and other hospitals to increase the number of cases that residents have access to.
To keep up with the latest information on OB/GYN surgery and other women’s health issues, we encourage you to explore our webinars and audio courses at Perinatal Resources, Inc.