Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center.
Urogynecology (Phila). 2023 Jul 1;29(7):597-600. doi: 10.1097/SPV.0000000000001326. Epub 2022 Dec 27.
Comprehensive surgical training is an essential component of obstetrics and gynecology residency, yet subspecialty experience may be declining.
The objective of this study was to describe trends in reported obstetrics and gynecology resident experience in female pelvic medicine and reconstructive surgery (FPMRS).
This study was a retrospective analysis of national case log reports from the Accreditation Council for Graduate Medical Education (ACGME) for obstetrics and gynecology residents.
From 2013 through 2019, ACGME collected data from a median of 241 programs (range, 239-242) with a median of 1,259 residents (range, 1,213-1,286) reporting annually. There was a 26% decrease in resident-reported experience with incontinence and pelvic floor procedures from 74 ± 38 in 2013 to 55 ± 34 in 2019 ( P < 0.001). Cystoscopy increased by 19% from 43 ± 25 in 2013 to 51 ± 29 in 2019 ( P < 0.001). From 2014 to 2019, vaginal hysterectomy cases decreased by 12% ( P < 0.001).
There was a significant decrease in resident-reported FPMRS surgical experience from 2013 to 2019, while cystoscopy numbers increased. After laparoscopic and vaginal hysterectomies were unbundled in 2013, resident vaginal hysterectomy cases decreased from 2014 to 2019. Given that the ACGME Incontinence and Pelvic Floor designation comprises a wide range of procedures, future investigation is needed to elucidate the gaps in FPMRS-specific surgical training during residency and its implication in comprehensive resident surgical training.
综合外科培训是妇产科住院医师培训的重要组成部分，但亚专业经验可能正在下降。
本研究旨在描述妇产科住院医师在女性盆底医学和重建外科（FPMRS）方面报告的经验趋势。
这是一项对妇产科住院医师的研究生医学教育认证委员会（ACGME）国家病例报告的回顾性分析。
从 2013 年到 2019 年，ACGME 从中位数为 241 个项目（范围为 239-242）中收集数据，中位数为 1259 名（范围为 1213-1286）居民每年报告。与 2013 年的 74±38 相比，居民报告的尿失禁和盆底手术经验减少了 26%，至 2019 年的 55±34（P<0.001）。膀胱镜检查增加了 19%，从 2013 年的 43±25 增加到 2019 年的 51±29（P<0.001）。从 2014 年到 2019 年，阴道子宫切除术的病例减少了 12%（P<0.001）。
从 2013 年到 2019 年，居民报告的 FPMRS 手术经验显著减少，而膀胱镜检查的数量增加。2013 年腹腔镜和阴道子宫切除术被拆分后，从 2014 年到 2019 年，居民阴道子宫切除术的病例减少。鉴于 ACGME 尿失禁和盆底指定包含了广泛的手术，未来的研究需要阐明住院医师期间 FPMRS 特定手术培训的差距及其对综合住院医师手术培训的影响。
