OJOG  Vol.3 No.4 A , June 2013
Surgical and non-surgical education practices in female pelvic medicine and reconstructive surgery fellowships within the United States
ABSTRACT

Data are scarce regarding surgical and non-surgical education in accredited Female Pelvic Medicine and Reconstructive Surgery (FPMRS) fellowships in theUnited States. We compared surgical and non-surgical and education among training programs and expected surgical comfort level with pelvic reconstructive procedures from the perspective of the fellow and program director. An online survey was distributed to program directors and fellows from the 39 accredited FPMRS fellowships at the time (2010). Domains evaluated in the survey were academic education requirements; surgical approaches to prolapse and to incontinence; other surgical procedures; and research and publication expectations. In total, forty fellows from 21 programs and directors from 27 programs. The most common surgical procedures performed for apical, anterior, and posterior prolapse were uterosacral ligament suspension, native tissue anterior colporrhaphy, and posterior colporrhaphy, respectively. Differences in perceived surgical comfort level were seen for coccygeus suspension, graftreinforced posterior colporrhaphy, rectus fascial sling, urethral bulking agent, cystoscopic ureteral stent placement and bowel repair. A greater proportion of program directors reported that fellows would be comfortable performing these procedures upon graduation than the proportion reported by the fellows themselves. Differences exist in FPMRS training nationwide, however, responding fellows appeared to be trained in multiple approaches to prolapse repair. Differences were seen in surgical comfort level as perceived by fellows and program directors.


Cite this paper
Occhino, J. , Myer, E. , Singh, R. and Gebhart, J. (2013) Surgical and non-surgical education practices in female pelvic medicine and reconstructive surgery fellowships within the United States. Open Journal of Obstetrics and Gynecology, 3, 20-27. doi: 10.4236/ojog.2013.34A004.
References
[1]   Goff, B.A. (2008) Changing the paradigm in surgical education. Obstetrics & Gynecology, 112, 328-332. doi:10.1097/AOG.0b013e3181802163

[2]   Karram, M.M. (2008) The future of surgical training in the field of urogynecology and female pelvic floor surgery. International Urogynecology Journal and Pelvic Floor Dysfunction, 19, 1591. doi:10.1007/s00192-008-0746-0

[3]   Julian, T.M. and Rogers, R.M. (2006) Changing the way we train gynecologic surgeons. Obstetrics & Gynecology Clinics of North America, 33, 237-246. doi:10.1016/j.ogc.2006.01.005

[4]   Walter, A.J. (2006) Surgical education for the twentyfirst century: Beyond the apprentice model. Obstetrics & Gynecology Clinics of North America, 33, 233-236. doi:10.1016/j.ogc.2006.01.003

[5]   Beard, J.D., Marriott, J., Purdie, H. and Crossley, J. (2011) Assessing the surgical skills of trainees in the operating theatre: A prospective observational study of the methodology. Health Technology Assessment, 15, 1-162.

[6]   Schreuder, H.W., Oei, G., Maas, M., Borleffs, J.C. and Schijven, M.P. (2011) Implementation of simulation in surgical practice: Minimally invasive surgery has taken the lead: The Dutch experience. Medical Teacher, 33, 105-115. doi:10.3109/0142159X.2011.550967

[7]   Schimpf, M.O., Feldman, D.M., O’Sullivan, D.M. and LaSala, C.A. (2007) Resident education and training in urogynecology and pelvic reconstructive surgery: A survey. International Urogynecology Journal and Pelvic Floor Dysfunction, 18, 613-617. doi:10.1007/s00192-006-0203-x

[8]   Sultana, C.J., Kenton, K., Ricci, E. and Rogers, R.G. (2007) The state of residency training in female pelvic medicine and reconstructive surgery. International Urogynecology Journal and Pelvic Floor Dysfunction, 18, 1347-1350. doi:10.1007/s00192-007-0329-5

[9]   Kenton, K., Sultana, C., Rogers, R.G., Lowenstein, T. and Fenner, D. (2008) How well are we training residents in female pelvic medicine and reconstructive surgery? American Journal of Obstetrics & Gynecology, 198, 567. e1-e4.

[10]   Drutz, H.P. (2010) IUGA guidelines for training in female pelvic medicine and reconstructive pelvic surgery (FPM-RPS): Updated guidelines 2010. International Urogynecology Journal, 21, 1445-1453.

[11]   The American Board of Obstetrics and Gynecology, Inc. and The American Board of Urology, Inc. (2011) General and special requirements for graduate medical education in the subspecialty of female pelvic medicine and reconstructive surgery. http://www.med.uc.edu/obgyn/ Libraries/Documents/ GSR-FPM_4-11_Internet_Ver sion.sflb.ashx

[12]   Lee, P.S., Bland, A., Valea, F.A., Havrilesky, L.J., Berchuck, A. and Secord, A.A. (2009) Robotic-assisted laparoscopic gynecologic procedures in a fellowship training program. Journal of the Society of Laparoendoscopic Surgeons, 13, 467-472. doi:10.4293/108680809X12589998403921

[13]   Geller, E.J., Schuler, K.M. and Boggess, J.F. (2011) Robotic surgical training program in gynecology: How to train residents and fellows. Journal of Minimally Invasive Gynecology, 18, 224-229. doi:10.1016/j.jmig.2010.11.003

[14]   Heisler, C.A. (2011) Importance of adequate gross anatomy education: The impact of a structured pelvic anatomy course during gynecology fellowship. Anatomical Sciences Education, 4, 302-304. doi:10.1002/ase.235

[15]   Blaivas, J.G. and Appell, R.A. (2000) Female pelvic medicine and reconstructive surgery fellowships. Neurourology and Urodynamics, 19, 635-636. doi:10.1002/1520-6777(2000)19:6<635::AID-NAU1>3.0.CO;2-4

 
 
Top