title: Preparedness of Obstetrics and Gynecology Residents for Fellowship Training.
abstract: OBJECTIVE
  To evaluate the perceptions of fellowship program directors of incoming clinical fellows for subspecialty training.
  
  
  METHODS
  A validated survey by the American College of Surgeons was modified and distributed to all fellowship program directors in four subspecialties within obstetrics and gynecology: female pelvic medicine and reconstructive surgery, gynecologic oncology, maternal-fetal medicine, and reproductive endocrinology-infertility. The 59-item survey explored five domains concerning preparedness for fellowship: professionalism, independent practice, psychomotor ability, clinical evaluation, and academic scholarship. A Likert scale with five responses was used and tailored to each subspecialty. Standard statistical methods were used to compare responses between subspecialties and to analyze data within each subspecialty individually.
  
  
  RESULTS
  One hundred thirty directors completed the survey, for a response rate of 60%. In the domain of professionalism, more than 88% of participants stated that incoming fellows had appropriate interactions with faculty and staff. Scores in this domain were lower for gynecologic oncology respondents (P=.046). Responses concerning independent practice of surgical procedures (hysterectomy, pelvic reconstruction, and minimally invasive) were overwhelmingly negative. Only 20% of first-year fellows were able to independently perform a vaginal hysterectomy, 46% an abdominal hysterectomy, and 34% basic hysteroscopic procedures. Appropriate postoperative care (63%) and management of the critically ill patient (71%) were rated adequate for all subspecialties.
  
  
  CONCLUSIONS
  Graduating residents may be underprepared for advanced subspecialty training, necessitating an evaluation of the current structure of resident and fellow curriculum.
  
  
  METHODS
  III.
authors.affiliation: Department of Obstetrics and Gynecology, Divisions of Gynecologic Oncology, Family Planning, Reproductive Endocrinology and Infertility, and Female Pelvic Medicine and Reconstructive Surgery, University of Colorado School of Medicine, Aurora, and the Colorado Center for Reproductive Medicine, Lonetree, Colorado; the Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Washington University in St. Louis School of Medicine, St. Louis, Missouri; the Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Duke University School of Medicine, Durham, North Carolina; and the Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Saketh R
authors.initials: SR
authors.lastname: Guntupalli
authors.forename: David W
authors.initials: DW
authors.lastname: Doo
authors.forename: Michael
authors.initials: M
authors.lastname: Guy
authors.forename: Jeanelle
authors.initials: J
authors.lastname: Sheeder
authors.forename: Kenan
authors.initials: K
authors.lastname: Omurtag
authors.forename: Laxmi
authors.initials: L
authors.lastname: Kondapalli
authors.forename: Fidel
authors.initials: F
authors.lastname: Valea
authors.forename: Lorie
authors.initials: L
authors.lastname: Harper
authors.forename: Tyler M
authors.initials: TM
authors.lastname: Muffly
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D004503:Education, Medical, Graduate / Q000458:organization & administration*; D005257:Fellowships and Scholarships / Q000458:organization & administration*; D005260:Female; D006176:Gynecology / Q000193:education; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration*; D008297:Male; D020380:Needs Assessment; D009774:Obstetrics / Q000193:education; D015397:Program Evaluation; D014481:United States