The fellowship effect: how the establishment of a fellowship in female pelvic medicine and reconstructive surgery affected resident vaginal hysterectomy training

Danford, Jill M.; White, N.C.; New, Melinda; Fletcher, Sarah; Blume, Jeffrey D.; Ward, Renée M

doi:10.1016/j.ajog.2014.07.017

Cited by 7 publications

(2 citation statements)

References 9 publications

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“…One possibility is the potential impact of FPMRS fellowship on Ob/Gyn resident surgical training. However, some investigators report that resident involvement in cases remains constant, 20 whereas others report volume decreases after the initiation of FPMRS fellowship 21 . There are many opportunities to improve our understanding of the resident surgical experience through ACGME case log reporting.…”

Section: Discussionmentioning

confidence: 99%

Trends in Urogynecologic Surgery Among Obstetrics and Gynecology Residents From 2002 to 2022

Nutaitis¹,

George

Mangira

et al. 2023

UROGC

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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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Section: Discussionmentioning

confidence: 99%

Trends in Urogynecologic Surgery Among Obstetrics and Gynecology Residents From 2002 to 2022

Nutaitis¹,

George

Mangira

et al. 2023

UROGC

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“…Opportunities for further study and exploration of fellowship training include an examination of the perspectives of other stakeholders in medical education, as well as further analysis of the educational, administrative and organizational needs to host and develop these programs. Surveys and case log studies [ 4 , 34 , 35 ] provide conflicting reports on the effect of the presence of fellowship programs on residents’ procedural opportunities. The perspectives of residents in primary specialties and subspecialties as well as their program directors could be further examined and compared to the fellowship directors’ perspective on the benefits of fellowship on the academic environment.…”

Section: Discussionmentioning

confidence: 99%

Fellowship training: a qualitative study of scope and purpose across one department of medicine

2017

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BackgroundFellowship training follows certification in a primary specialty or subspecialty and focusses on distinct and advanced clinical and/or academic skills. This phase of medical education is growing in prevalence, but has been an “invisible phase of postgraduate training” lacking standards for education and accreditation, as well as funding. We aimed to explore fellowship programs and examine the reasons to host and participate in fellowship training, seeking to inform the future development of fellowship education.MethodsDuring the 2013–14 academic year, we conducted interviews and focus groups to examine the current status of fellowship training from the perspectives of division heads, fellowship directors and current fellows at the Department of Medicine, University of Ottawa, Canada. Descriptive statistics were used to depict the prevailing status of fellowship training. A process of data reduction, data analysis and conclusions/verifications was performed to analyse the quantitative data.ResultsWe interviewed 16 division heads (94%), 15 fellowship directors (63%) and 8 fellows (21%). We identified three distinct types of fellowships. Individualized fellowships focus on the career goals of the trainee and/or the recruitment goals of the division. Clinical fellowships focus on the attainment of clinical expertise over and above the competencies of residency. Research fellowships focus on research productivity. Participants identified a variety of reasons to offer fellowships: improve academic productivity; improve clinical productivity; share/develop enhanced clinical expertise; recruit future faculty members/attain an academic position; enhance the reputation of the division/department/trainee; and enhance the scholarly environment.ConclusionsFellowships serve a variety of purposes which benefit both individual trainees as well as the academic enterprise. Fellowships can be categorized within a distinct taxonomy: individualized; clinical; and research. Each type of fellowship may serve a variety of purposes, and each may need distinct support and resources. Further research is needed to catalogue the operational requirements for hosting and undertaking fellowship training, and establish recommendations for educational and administrative policy and processes in this new phase of postgraduate education.

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Female Pelvic Medicine and Reconstructive Surgery—What Does Certification Mean?

2018

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While subspecialty certification may improve training, identify experts, and ultimately lead to improved patient outcomes, certification might also be unnecessary for some physicians, weaken residency training, and limit the number of physicians who are deemed qualified to offer certain treatments. As pelvic floor disorders can considerably affect quality of life, and their prevalence is expected to increase with the aging population, high-quality FPMRS care is needed. In this article, we describe the history of FPMRS subspecialty certification as well as its potential advantages and disadvantages as suggested by literature. There are advantages and disadvantages of FPMRS subspecialty certification. Further research is needed to assess the effect of FPMRS subspecialty certification on patient outcomes.

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The fellowship effect: how the establishment of a fellowship in female pelvic medicine and reconstructive surgery affected resident vaginal hysterectomy training

Cited by 7 publications

References 9 publications

Trends in Urogynecologic Surgery Among Obstetrics and Gynecology Residents From 2002 to 2022

Trends in Urogynecologic Surgery Among Obstetrics and Gynecology Residents From 2002 to 2022

Fellowship training: a qualitative study of scope and purpose across one department of medicine

Female Pelvic Medicine and Reconstructive Surgery—What Does Certification Mean?

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