title: Assessing Resident Surgical Volume Before and After Initiation of a Female Pelvic Medicine and Reconstructive Surgery Fellowship.
abstract: OBJECTIVE
  The effect of fellowship programs on resident training for gynecologic surgery volume has not been clearly defined. The purpose of our study is to assess resident surgical volume for laparoscopic and vaginal hysterectomy before and after initiation of a female pelvic medicine and reconstructive surgery (FPMRS) fellowship.
  
  
  METHODS
  A retrospective review of Accreditation Council for Graduate Medical Education Resident Case Logs of obstetrics and gynecology residents who graduated in the 3 years before and after initiation of a FPMRS fellowship was performed. Mean values of vaginal and laparoscopic hysterectomies were compared using two-tailed t-tests with statistical significance set at p < 0.05.
  
  
  METHODS
  Obstetrics and gynecology resident case logs at the Ronald Reagan University of California Los Angeles (UCLA) Medical Center were assessed. The UCLA Medical Center, located in Los Angeles, CA, is a tertiary referral center with a graduating class of 7 obstetrics and gynecology residents yearly.
  
  
  METHODS
  Obstetrics and gynecology residents who graduated from residency 3 years before and after imitation of a FPMRS fellowship were included. In the 3 years before the start of the fellowship, 20 residents graduated, whereas 21 residents graduated after the start of the fellowship.
  
  
  RESULTS
  Residents who graduated in the 3 years after the start of the FPMRS fellowship, finished with 4.6 less vaginal hysterectomies compared with residents who graduated before the fellowship (p = 0.022). Residents who graduated in the 3 years after the start of the FPMRS fellowship finished with 3.2 more laparoscopic hysterectomies compared with residents who graduated before the fellowship although this was not significant (p = 0.25).
  
  
  CONCLUSIONS
  Resident surgical volume was significantly decreased for vaginal hysterectomy after the initiation of a FPMRS fellowship, whereas laparoscopic hysterectomy volume was not significantly changed. Longer follow-up and a national assessment are necessary to determine the broader effect of fellowship training on resident surgical experience.
authors.affiliation: Department of Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, Los Angeles, California. Electronic address: ZaidQChaudhry@gmail.com.
authors.forename: Zaid
authors.initials: Z
authors.lastname: Chaudhry
authors.affiliation: Department of Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, Los Angeles, California; Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, California.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Tarnay
mesh_terms: D000046:Academic Medical Centers; D000068:Accreditation; D000328:Adult; D002140:California; D002983:Clinical Competence; D004503:Education, Medical, Graduate / Q000458:organization & administration; D005257:Fellowships and Scholarships / Q000458:organization & administration*; D005260:Female; D006176:Gynecology / Q000193:education; D006801:Humans; D007044:Hysterectomy / Q000193:education* / Q000379:methods*; D015907:Hysteroscopy / Q000193:education / Q000379:methods; D008297:Male; D009774:Obstetrics / Q000193:education; D019651:Plastic Surgery Procedures / Q000193:education* / Q000379:methods; D012189:Retrospective Studies; D016526:Workload
keywords: Medical Knowledge; Patient Care; Systems-Based Practice; laparoscopic hysterectomy; resident surgical experience; surgical training; vaginal hysterectomy