Matthew T Siedhoff1, Mireille D Truong, Kelly N Wright. 1. Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Division of Minimally Invasive Gynecologic Surgery, Los Angeles, California, USA.
Abstract
PURPOSE OF REVIEW: This review aims to describe the influence of changes in obstetrics and gynecology on residency training and how tracking may help address emerging concerns around quality and safety in gynecologic surgery. RECENT FINDINGS: As has been shown in a variety of other surgical fields, recent evidence confirms that surgeries with higher volume gynecologists are associated with fewer complications, decreased cost, and an increase in use of minimally invasive surgery. Attending physicians and residents feel graduating obstetrics and gynecology (OB/GYN) trainees are unprepared to perform major surgery independently. Tracking has demonstrated tremendous success in general surgery, enriching trainee careers, allowing for increased operative and clinical experiences, enhancing autonomy, and improving mentorship, all while achieving equivalent or improved milestone achievement, case numbers, and board certification. A majority of medical students, residents, and OB/GYN residency program directors support tracking in OB/GYN. Currently, a single OB/GYN program provides tracking in the United States, with measurable success similar to that seen in general surgery. SUMMARY: Enhanced surgical volume results in better outcomes in gynecologic surgery, but current training models are insufficient to meet these volume demands. Tracking provides an attractive solution to create a more appropriate practicing model for physicians in women's health.
PURPOSE OF REVIEW: This review aims to describe the influence of changes in obstetrics and gynecology on residency training and how tracking may help address emerging concerns around quality and safety in gynecologic surgery. RECENT FINDINGS: As has been shown in a variety of other surgical fields, recent evidence confirms that surgeries with higher volume gynecologists are associated with fewer complications, decreased cost, and an increase in use of minimally invasive surgery. Attending physicians and residents feel graduating obstetrics and gynecology (OB/GYN) trainees are unprepared to perform major surgery independently. Tracking has demonstrated tremendous success in general surgery, enriching trainee careers, allowing for increased operative and clinical experiences, enhancing autonomy, and improving mentorship, all while achieving equivalent or improved milestone achievement, case numbers, and board certification. A majority of medical students, residents, and OB/GYN residency program directors support tracking in OB/GYN. Currently, a single OB/GYN program provides tracking in the United States, with measurable success similar to that seen in general surgery. SUMMARY: Enhanced surgical volume results in better outcomes in gynecologic surgery, but current training models are insufficient to meet these volume demands. Tracking provides an attractive solution to create a more appropriate practicing model for physicians in women's health.