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    Is surgical training in ob/gyn residency adequate?

    Dr Cohen reports receiving consulting fees from Olympus Surgical. Dr Hinchcliff has no conflicts of interest to report in respect to the content of this article.

     

    Much has changed since Howard Kelly established a gynecology residency at Johns Hopkins Hospital in the late 19th century. Though the time available for training is relatively fixed, the amount of information and number of skills that must be learned are increasing.

    Not only are residents expected to be competent in key aspects of obstetrics, primary care, and office gynecology, but they also must master a multitude of surgical techniques and be competent with evolving technology.

    When asked about the state of ob/gyn training in the Contemporary OB/GYN 2015 Labor Force Reader Survey, one respondent commented, “... we are training poorly prepared ob/gyns who are not capable of handling a variety of clinical problems, and who are not truly surgically independent and competent when they finish residency.”1

    This sentiment, although bleak, underscores an increasingly common concern about the adequacy of surgical training during residency.

    Sarah L. Cohen, MD, MPH
    Dr Cohen is an Assistant Professor in the Department of Obstetrics and Gynecology and Director of Research for the Division of Minimally ...
    Emily Hinchcliff, MD
    Dr Hinchcliff is a resident in the Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, Boston, Massachusetts.

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    • UBM User
      Surgical training is diluted because of the number of trainees that we train. This is essentially due to the fact that the trained people want 'some slaves' to do their mundane work and pretend to offer training to the larger number of trainees half-halfheartedly. Do we need this many obstetricians and gynecologists to do the job that can be done effectively and cheaply by midwives(European model) and family physicians who can perform all the screening visits? Instead we train a large number of fairly incompetent ObGyns who either have to do a MIS fellowship which is nothing but glorified gynecology rotations for 1 to 2 years or they disappear to be a 'glorified midwife' doing deliveries or a poorly skilled family physicians. You can make this better by taking good quality, motivated and highly competitive trainees who should work hard next to the staff and learn the trade well and come out equipped to deal with common ObGyn problems well. Equally don't reduce the number of years of training as one will have to put in the time to be competent to have seen all the variety of patients that they will encounter in their practice

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