Surveying surgical skills: perceptions of ob/gyn residency program directors, chief residents and recent graduates

Prior studies suggest OBGYN residency graduates may be underprepared to perform gynecologic surgery at graduation. OBGYN residents typically receive a 18-24 months of surgical training, but it is unclear how much time is actually spent operating or how this translates to surgical competence. This study aimed to survey chief (PGY4) residents, program directors, and recent graduates on their perceptions of surgical experience. We surveyed PGY4 OBGYN residents, program directors (PDs), and recently graduated generalists via an anonymous, electronic survey distributed to ACGME programs’ listed contact by email. Recipients were asked to forward surveys to the respective groups. All US programs without formal tracking were included. Responses were collected in RedCAP. Descriptive statistics were reported. Results were analyzed in STATA, using χ2 for categorical variables and Student t test for continuous variables. All results yielding P< 0.5 were considered statistically significant. A total of 26 PDs (12%), 41 PGY4 residents and 24 recently graduated generalists responded. 88% of Residents and 79% of recent graduates identified as female. 46% of resident respondents planned to pursue a generalist practice. They were predominantly from the south (37%) and in university based programs (80%). Program Directors were predominantly generalist OBGYNs (76%). Recent graduates reported the bulk of their postgraduate time was in clinic (55%), with less time dedicated to labor and delivery (21%), and gynecologic surgery (10%). PDs and PGY4s reported residents spent a mean of 19 and 20 months on OB rotations and 21 and 19 months on Gyn OR rotations, respectively (p=0.59, 0.80). Both groups also reported similar means of 20 and 21 hours per week spent operating in the Gyn OR respectively (p=0.81). ACGME minimum numbers for OB procedures were achieved significantly earlier than Gyn procedures according to both PDs (p<0.01) and PGY4s (p<0.01). Confidence level independently performing cesarean delivery was significantly higher than performing TLH according to both recent grads and PGY4s (p<0.01). Both groups also felt significantly more confident performing both TAH (p<0.01) and TLH (p<0.01) compared to TVH. PGY4s and recent grads agreed residency training would benefit from less L&D (p