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The state of resident education in urogynecology and pelvic floor disorders

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Abstract

To determine the state of resident education in the areas of pelvic floor dysfunction and urogynecology a survey was sent to program directors (or their designees) of United States residency training programs. A six-page 14-question survey was sent to 274 approved residency programs. The response rate was 46.4%. Program directors were queried on educational objectives and materials, diagnostic and therapeutic techniques and evaluation of resident performance. To confirm results, the responses were checked against data published in the APGO/CIBA Directory of Residencies in Obstetrics and Gynecology. Eighty per cent of programs used the objectives established by the American Uro-Gynecologic Society or the Council on Resident Education in Obstetrics and Gynecology. Resident lectures or textbooks were the most frequent sources of educational information used. The annual CREOG in-training exam was the most frequently utilized evaluation process. Ninety-three per cent of residents obtained hands-on experience with urodynamics and all residents were exposed to retropubic techniques for the surgical treatment of incontinence. Resident education in non-surgical techniques to treat urinary incontinence, however, was lacking in approximately 50% of programs. The survey suggests that the basic foundation may be in place to provide residents with adequate exposure to diagnostic and therapeutic measures for dealing with pelvic floor disorders and urogynecology. There are, however, many aspects which need attention in our educational objectives for resident education. A broader focus on the non-surgical management of incontinence needs to be encouraged.

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Editorial Comment: As underscored by the authors, a great deal of continued emphasis will need to be focused on the standardized educational experience in the area of urogynecology/pelvic floor disorders, particularly as the lifespan of the female population increases. Despite the recent swell of interest in educating residents as well as practicing gynecologists in this area, it is disconcerting to learn from this study that eight of the 126 responding programs had no evaluation process of resident knowledge/performance in place. This paper highlights that, while the majority of programs offer urodynamics and lower urinary tract endoscopy, other diagnostic (e.g. ultrasonography) and therapeutic (e.g. biofeedback, behavior modification) modalities need to be expanded further. In addition, the training of residents in more sophisticated anti-incontinence and corrective genitourinary prolapse surgery needs to be more consistent between the residency programs. As the speciality of obstetrics and gynecology now pronounces itself as one of the primary care specialties, it is paramount that intensive efforts be made to standardize as much as possible the educational experience of residents.

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Rosenzweig, B.A., Even, A.H. & Scotti, R.J. The state of resident education in urogynecology and pelvic floor disorders. Int Urogynecol J 6, 18–21 (1995). https://doi.org/10.1007/BF01961843

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  • DOI: https://doi.org/10.1007/BF01961843

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