Understanding Minimally Invasive Gynecologic Surgery Training in Canada: A National Survey of Recent Graduates
CANSAGE ePoster Library. Papillon Smith J. 09/27/19; 275238; eP-105
Jessica Papillon Smith
Jessica Papillon Smith
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Abstract
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Objective: To characterize the fellowship training experiences in the eleven Canadian minimally invasive gynecologic surgery (MIGS) programs and to compare them to that of AAGL-accredited MIGS programs. Design: We conducted a cross-sectional, web-based survey study of the 2017-2018 graduates from Canadian MIGS programs. A 90-item pre-tested questionnaire was administered using SurveyMonkey and measured four key constructs: surgical exposure, research/academic endeavors, teaching/evaluation methods, and clinical responsibilities. Results: The response rate was 91% (20/22) and all 11 programs were represented. The minimum standards for 12/16 (75%) AAGL-required procedures were met by all programs. Programs were deficient in providing exposure to: office hysteroscopy (6/11), laparoscopic resection of deep endometriosis (3/11), laparoscopic myomectomy (2/11), laparoscopic adhesiolysis (1/11), and laparoscopic retroperitoneal dissection (1/11). Although all fellowships met the minimum volume of 110 minimally invasive hysterectomies, not all provided exposure to vaginal hysterectomy (3/11) and robotics (10/11). The academic activities of graduates was mixed: 14/20 had at least one manuscript published while 6/20 had none, and 12/20 concomitantly undertook a postgraduate degree. With regards to teaching, 10/20 reported having a structured curriculum, and 15/20 believed there would be benefit to standardizing training. The following were graduates’ career plans: academic center (14/20), community center (4/20) and undetermined (2/20). Conclusion: There are currently 11 well-established MIGS fellowship programs in Canada that differ in structure and focus, but that meet most requirements of AAGL-accredited programs. Given the variation identified in this survey, there may be an opportunity to standardize MIGS training nationwide and tailor it to a Canadian setting.
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