Urogynecology training and practice patterns after residency

Abstract

Objective: The perspective of recent graduates is important in assessing the adequacy of training and for improving clinical and surgical education. The objective of this study was to evaluate the urogynecology experience of recent Obstetrics and Gynecology residency graduates, to examine perceived and actual surgical load during and after residency, and to assess comfort level with diagnosing and treating urinary incontinence and pelvic organ prolapse.

Design: Questionnaire assessing satisfaction with urogynecology rotation, perceived surgical load in residency, estimates of surgical procedures in current practice, and comfort level with diagnosing and treating incontinence and prolapse.

Setting: University of Texas Southwestern Medical Center, Dallas, Texas.

Participants: Graduates from the University of Texas Southwestern Obstetrics and Gynecology residency program (1997-2006).

Results: Fifty-five percent (82/150) responded, with most being Caucasian, female, in private practice, and practicing in the Southern part of the United States. Forty-one of seventy-six (54%) rated their urogynecology experience as either acceptable, above average or superior. The most common procedures performed in residency were cystoscopy (mean, 11.3 ± 5.2 cases per resident) and anterior (mean, 8.9 ± 4.3 cases per resident) and posterior repair (mean, 11.1 ± 5.7 cases per resident). Increasing the surgical volume was reported as the single most important factor that would have enhanced their training. In practice, midurethral slings were the most commonly performed incontinence procedures. Few were performing other urogynecologic cases in practice, except for anterior-posterior colporrhaphy and cystoscopy. Sixty-six of 70 (94%) in practice were comfortable with diagnosing prolapse and incontinence. Seventy percent and 80% estimated that less than 1 quarter of their patient population had prolapse or incontinence, respectively.

Conclusions: Recent graduates from this program are comfortable making the diagnosis of prolapse and incontinence. The most commonly performed surgical procedures in residency and in practice include anterior and posterior colporrhaphy and cystoscopy.