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Cai F, Santiago S, Southworth E, Stephenson-Famy A, Fay E, Wang EY, Burns RN. Taking the Express Lane: Student Attitudes Towards Tracking in Ob/Gyn Residency. Clin Obstet Gynecol 2024; 67:465-473. [PMID: 38934565 DOI: 10.1097/grf.0000000000000873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
We sought to determine the subspecialty interests of fourth-year medical students (MS4s) matched to Ob/Gyn and evaluate their attitudes towards residency tracking. Matched MS4s completed a survey regarding subspecialization, confidence in that choice, and desire for tracking. A total of 922 MS4s completed the survey. Of these, 474 (51.4%) desired subspecialty training, but were less confident in their choice compared with those desiring generalist careers (60.0/100 vs. 64.9/100, P =0.003). Those seeking subspecialty training were more likely to desire tracking (15.2% vs. 39.5%, P <0.001). In conclusion, 51% of MS4s desired subspecialty training over generalist careers. Almost 40% of these students are interested in tracking.
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Affiliation(s)
- Fei Cai
- Division of Perinatology, Oregon Health & Sciences University, Portland, Oregon
| | - Sarah Santiago
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan
| | - Elizabeth Southworth
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan
| | - Alyssa Stephenson-Famy
- Division of Maternal Fetal Medicine, University of Washington Medical Center, Seattle, Washington
| | - Emily Fay
- Division of Maternal Fetal Medicine, University of Washington Medical Center, Seattle, Washington
| | - Eileen Y Wang
- Division of Maternal Fetal Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ralph Nicholas Burns
- Division of Maternal Fetal Medicine, University of Texas Southwestern, Dallas, Texas
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Nutaitis AC, George EL, Mangira CJ, Wallace SL, Bowersox NA. Trends in Urogynecologic Surgery Among Obstetrics and Gynecology Residents From 2002 to 2022. UROGYNECOLOGY (PHILADELPHIA, PA.) 2024; 30:73-79. [PMID: 37428884 DOI: 10.1097/spv.0000000000001385] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
IMPORTANCE The number of American women with a pelvic floor disorder is projected to increase from 28.1 million in 2010 to 43.8 million in 2050. OBJECTIVES The objective of this study was to evaluate trends in the number of urogynecologic procedures performed by graduating obstetrics and gynecology residents and to compare variability in volume between residents in the 70th and 30th percentiles for logged cases. STUDY DESIGN National case log measures for residents who graduated between 2003 and 2022 were reviewed. Mean case numbers and variability in case numbers were analyzed over time. RESULTS Data were collected from a median of 1,216.5 residents (range, 1,090 to 1,427) annually. Mean number of vaginal hysterectomies logged per resident decreased by 46.4% from 2002/2003 to 2021/2022 ( P = 0.0007). Mean number of urogynecology procedures increased by 1,165.5% from 2002/2003 to 2007/2008 ( P = 0.0015). Mean number of incontinence and pelvic floor procedures (including cystoscopies) increased by 190.9% from 2002/2003 to 2011/2012 ( P = 0.0002). Mean number of incontinence and pelvic floor procedures (excluding cystoscopies) decreased by 39.7% from 2012/2013 to 2021/2022 ( P < 0.0001). Mean number of cystoscopies increased by 19.7% from 2012/2013 to 2021/2022 ( P < 0.0001). Ratios of cases logged by residents in the 70th percentile to those in the 30th percentile decreased for vaginal hysterectomies and cystoscopies ( P < 0.0001 and P = 0.0040, respectively). The ratio for incontinence and pelvic floor procedures (excluding cystoscopies) was 1.76 in 2012/2013 and 2.35 in 2021/2022 ( P = 0.2878). CONCLUSION Resident surgical training in urogynecology is decreasing nationally.
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Affiliation(s)
| | | | | | - Shannon L Wallace
- Division of Urogynecology and Pelvic Floor Disorders, Women's Health Institute, Cleveland Clinic, Cleveland, OH
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Shah HH, Fishbane S, Ross DW, Jhaveri KD, Sachdeva M. Subspecialty Focus Tracks During Nephrology Fellowship Training. Am J Kidney Dis 2023; 82:639-643. [PMID: 37516298 DOI: 10.1053/j.ajkd.2023.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 05/01/2023] [Accepted: 05/05/2023] [Indexed: 07/31/2023]
Affiliation(s)
- Hitesh H Shah
- Division of Kidney Diseases and Hypertension, Department of Medicine, North Shore University Hospital and Long Island Jewish Medical Center, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, New York
| | - Steven Fishbane
- Division of Kidney Diseases and Hypertension, Department of Medicine, North Shore University Hospital and Long Island Jewish Medical Center, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, New York.
| | - Daniel W Ross
- Division of Kidney Diseases and Hypertension, Department of Medicine, North Shore University Hospital and Long Island Jewish Medical Center, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, New York
| | - Kenar D Jhaveri
- Division of Kidney Diseases and Hypertension, Department of Medicine, North Shore University Hospital and Long Island Jewish Medical Center, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, New York
| | - Mala Sachdeva
- Division of Kidney Diseases and Hypertension, Department of Medicine, North Shore University Hospital and Long Island Jewish Medical Center, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, New York
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Blank SV, Huh WK, Bell M, Dilley S, Hardesty M, Hoskins ER, Lachance J, Musa F, Prendergast E, Rimel BJ, Shahin M, Valea F. Doubling down on the future of gynecologic oncology: The SGO future of the profession summit report. Gynecol Oncol 2023; 171:76-82. [PMID: 36827841 DOI: 10.1016/j.ygyno.2023.02.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/07/2023] [Accepted: 02/10/2023] [Indexed: 02/25/2023]
Abstract
The original vision of the field of gynecologic oncology was to establish a multidisciplinary approach to the management of patients with gynecologic cancers. Fifty years later, scientific advances have markedly changed the overall practice of gynecologic oncology, but the profession continues to struggle to define its value-financial and otherwise. These issues were examined in full at the Society of Gynecologic Oncology (SGO) Future of the Profession Summit and the purpose of this document is to summarize the discussion, share the group's perceived strengths, weaknesses, opportunities, and threats (SWOT) for gynecologic oncologists, further educate members and others within the patient care team about the unique role of gynecologic oncologists, and plan future steps in the short- and long- term to preserve the subspecialty's critical mission of providing comprehensive, longitudinal care for people with gynecologic cancers.
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Affiliation(s)
- Stephanie V Blank
- Icahn School of Medicine at Mount Sinai, New York, NY, United States of America.
| | - Warner K Huh
- University of Alabama Birmingham, Birmingham, AL, United States of America
| | - Maria Bell
- MBA Sanford Women's Health, Sioux Falls, SD, United States of America
| | - Sarah Dilley
- Emory Healthcare, Atlanta, GA, United States of America
| | - Melissa Hardesty
- Alaska Women's Cancer Care, Anchorage, AK, United States of America
| | - Ebony R Hoskins
- Medstar Washington Hospital Center, Washington, D.C, United States of America
| | - Jason Lachance
- Maine Medical Partners, Scarborough, ME, United States of America
| | - Fernanda Musa
- Swedish Cancer Institute, Seattle, WA, United States of America
| | | | - B J Rimel
- Cedars-Sinai Medical Center, Los Angeles, CA, United States of America
| | - Mark Shahin
- Abington Hospital, Jefferson Health, Willow Grove, PA, United States of America
| | - Fidel Valea
- Northwell Health, Zucker School of Medicine, New Hyde Park, NY, United States of America
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Talbott JMV, Wasson MN. Sex and Racial/Ethnic Diversity in Accredited Obstetrics and Gynecology Specialty and Subspecialty Training in the United States. JOURNAL OF SURGICAL EDUCATION 2022; 79:818-827. [PMID: 35033485 DOI: 10.1016/j.jsurg.2021.12.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/29/2021] [Accepted: 12/12/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To compare trends in racial and gender diversity in Obstetrics and Gynecology (OBGYN) residency and fellowship programs from beginning of program accreditation in 2012 to the most recently published report for 2018. DESIGN Data was abstracted in August 2020 from publicly available reports on the Accreditation Council for Graduate Medical Education (ACGME) website. Reports from 2012 to 2018 were compared with Chi-square tests and the Cochran-Armitage trend test assessed trends over time. PARTICIPANTS U.S. medical residents and fellows, with a focus on those in accredited OBGYN fellowship programs (Female Pelvic Medicine and Reconstructive Surgery (FPMRS), Gynecologic Oncology (GYNONC), Maternal Fetal Medicine (MFM), and Reproductive Endocrinology and Infertility (REI)). RESULTS From 2012 to 2018 men in all residency programs increased 0.88% (from 53.92% male to 54.80%, p < 0.0001). Across all years there were less men in OBGYN (16.89%) compared to all residency programs (54.39%, p < 0.0001). All OBGYN fellowships combined had more men proportionately than OBGYN residencies (24.14% vs. 16.89%, p < 0.0001). MFM had the most men (26.7%) then GYNONC (25.18%), FPMRS (21.36%), and REI (20.09%) (p = 0.024). There were no statistically significant trends in sex or race over time. From 2012 to 2018 residents overall were 42.96% white. OBGYN residents overall were 54.20% white. GYNONC had the highest percentage of white trainees (73.45%), followed by MFM (67.8%), REI (65.62%), then FPMRS (60%) (p = 0.0003). CONCLUSIONS According to ACGME core competencies, residents are expected to demonstrate sensitivity and responsiveness to diverse patient populations (professionalism) and advocate for improvements to systems-based practice. These results may suggest systemic issues in the recruitment of women and people of color into competitive sub-specialty programs. Such deficiencies in representation can impact patient care. Future research is needed to assess trends over time as data become available and to evaluate specific barriers to applications and selection of minority applicants.
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Affiliation(s)
| | - Megan N Wasson
- Department of Medical and Surgical Gynecology, Mayo Clinic, Phoenix, Arizona
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Lauer JK, Advincula AP. The Future of the Gynecologic Surgeon: Rationale for and Steps toward Subspecialization of Complex Gynecologic Surgery. J Minim Invasive Gynecol 2020; 28:726-729. [PMID: 33387690 DOI: 10.1016/j.jmig.2020.12.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 12/23/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Jacob K Lauer
- Division of Gynecologic Specialty Surgery, Department of Obstetrics and Gynecology, Columbia University, New York, New York.
| | - Arnold P Advincula
- Division of Gynecologic Specialty Surgery, Department of Obstetrics and Gynecology, Columbia University, New York, New York
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Ready for the robot? A cross-sectional survey of OB/GYN fellowship directors' experience and expectations of their incoming fellow's robotic surgical skills. J Robot Surg 2020; 15:723-729. [PMID: 33141409 DOI: 10.1007/s11701-020-01160-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 10/14/2020] [Indexed: 10/23/2022]
Abstract
To describe OB/GYN fellowship directors' (FDs) observations, expectations, and preferences of incoming fellow's robotic surgery preparedness. Cross-sectional study. OB/GYN FDs in gynecologic oncology, minimally invasive gynecologic surgery, female pelvic medicine and reconstructive surgery, and reproductive endocrinology and infertility in the United States. 60 FDs answered the questionnaire. Participants completed an online questionnaire about their preferences and expectations of robotic surgery experience for incoming fellows. FDs observed that many incoming first-year fellows had a baseline understanding of robotic technology (60%) and robotic bedside assist experience (53%). However, few could perform more advanced robotic tasks; with FDs indicating fellows could infrequently robotically suture (18%), or perform the entire hysterectomy (15%). FDs reported higher composite observation than expectation scores (34.3 versus 22.2, p < 0.0001), and higher preference than expectation scores (34.0 versus 22.2, p < 0.0001). The composite expectation score of high-volume divisions was greater than of low-volume divisions (23.7 versus 14.0, p = 0.04). Among the domains identified, FDs most strongly preferred their fellows be able to bedside assist, have a basic understanding of robotic technology, and have basic robotic operative skills. While incoming fellows have more robotic skill than their FDs expect, few are deemed competent to independently operate the robot. Higher volume robotic surgery divisions have higher expectations of the robotic skills of their incoming fellows compared to low-volume divisions; however, FDs neither expected nor preferred their incoming fellows to be fully competent in all aspects of robotic surgery.
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Hysterectomy Route and Numbers Reported by Graduating Residents in Obstetrics and Gynecology Training Programs. Obstet Gynecol 2020; 135:1230. [DOI: 10.1097/aog.0000000000003859] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Reed VR, Emery J, Farrell RM, Jelovsek JE. Tracking—A Flexible Obstetrics and Gynecology Residency Curriculum. Obstet Gynecol 2019; 134 Suppl 1:29S-33S. [DOI: 10.1097/aog.0000000000003464] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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