title: The Changing Scenario of Obstetrics and Gynecology Residency Training.
abstract: BACKGROUND
  Significant changes have been noted in aspects of obstetrics-gynecology (ob-gyn) training over the last decade, which is reflected in Accreditation Council for Graduate Medical Education (ACGME) operative case logs for graduating ob-gyn residents.
  
  
  OBJECTIVE
  We sought to understand the changing trends of ob-gyn residents' experience in obstetric procedures over the past 11 years.
  
  
  METHODS
  We analyzed national ACGME procedure logs for all obstetric procedures recorded by 12 728 ob-gyn residents who graduated between academic years 2002-2003 and 2012-2013.
  
  
  RESULTS
  The average number of cesarean sections per resident increased from 191.8 in 2002-2003 to 233.4 in 2012-2013 (17%; P < .001; 95% CI -47.769 to -35.431), the number of vaginal deliveries declined from 320.8 to 261 (18.6%; P < .001; 95% CI 38.842-56.35), the number of forceps deliveries declined from 23.8 to 8.4 (64.7%; P < .001; 95% CI 14.061-16.739), and the number of vacuum deliveries declined from 23.8 to 17.6 (26%; P < .001; 95% CI 5.043-7.357). Between 2002-2003 and 2007-2008, amniocentesis decreased from 18.5 to 11 (P < .001, 95% CI 6.298-8.702), and multifetal vaginal deliveries increased from 10.8 to 14 (P < .001, 95% CI -3.895 to -2.505). Both were not included in ACGME reporting after 2008.
  
  
  CONCLUSIONS
  Ob-gyn residents' training experience changed substantially over the past decade. ACGME obstetric logs demonstrated decreases in volume of vaginal, forceps, and vacuum deliveries, and increases in cesarean and multifetal deliveries. Change in experience may require use of innovative strategies to help improve residents' basic obstetric skills.
authors.forename: Natasha
authors.initials: N
authors.lastname: Gupta
authors.forename: Kristina
authors.initials: K
authors.lastname: Dragovic
authors.forename: Richard
authors.initials: R
authors.lastname: Trester
authors.forename: Josef
authors.initials: J
authors.lastname: Blankstein
mesh_terms: D000068:Accreditation / Q000592:standards; D002585:Cesarean Section / Q000639:trends; D002983:Clinical Competence; D004503:Education, Medical, Graduate; D005260:Female; D006176:Gynecology / Q000193:education* / Q000639:trends; D006801:Humans; D007396:Internship and Residency / Q000639:trends*; D013513:Obstetric Surgical Procedures / Q000706:statistics & numerical data / Q000639:trends*; D009774:Obstetrics / Q000193:education* / Q000639:trends; D011247:Pregnancy; D011272:Pregnancy, Multiple / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014481:United States