Gynecology Resident Experience with Office Hysteroscopy Training

Abstract

Background: Hysteroscopy is the gold standard for evaluating intrauterine pathology. The majority of physicians currently perform hysteroscopy in the operating room. Lack of training has been cited as a barrier to performing office hysteroscopy; however, resident training in office hysteroscopy has not yet been evaluated.

Methods: A prospective cross-sectional survey was performed. A validated 17 question survey tool was sent to 297 program directors of Accreditation Council for Graduate Medical Education accredited obstetrics and gynecology residency programs for distribution to their residents. The survey utilized a Likert scale to assess resident interest in learning office hysteroscopy, satisfaction in training, and perceived self-efficacy to perform office hysteroscopy independently upon graduation.

Results: Two hundred and ninety-three obstetrics and gynecology residents responded. Of the respondents, 26.3% reported receiving training in office hysteroscopy. There was no statistically significant difference in training among postgraduate years or program regions. A greater proportion of male residents received training when compared to female residents (42.9% vs. 24.2%, p = 0.019). Ninety-four percent of residents reported interest in learning office hysteroscopy. Satisfaction with hysteroscopy training in the operating room versus the office was 91.1% vs. 11.3% respectively. Of the fourth-year residents, 17.4% felt they could perform office hysteroscopy independently upon graduation and 14.5% reported feeling comfortable performing the procedure.

Conclusions: Residency training in office hysteroscopy is lacking and residents are unprepared to perform the procedure after graduation. Enhanced residency training in office hysteroscopy would likely improve resident comfort and ability to perform office hysteroscopy in practice.

Keywords: Curriculum; Education; Office Hysteroscopy; Residency.

Figure 1.

A) Map of geographic locations of sampled residents’ residency programs. B) Map of accredited obstetrics and gynecology residency programs that were contacted to participate in the study.

Figure 2.

Comparison of residents interested and not interested in learning office hysteroscopy. A subgroup analysis of residents not interested in office hysteroscopy illustrates their post-residency practice plans.

Figure 3.

Evaluation of resident satisfaction with office hysteroscopy training, operating room hysteroscopy training, and other gynecological surgery training. satisfaction assessed on a five-point likert scale.