Gynecology residents' preparedness to perform standard gynecological procedures autonomously: A national survey among French residents and faculty

Objective: This study aimed to explore the perceptions of French residents and academic teachers regarding residents' autonomy during training and their preparedness to perform standard gynecological procedures. Methods: A national survey of French obstetrics and gynecology residents and their academic teachers was conducted using an online questionnaire distributed in 2023, which gathered opinions on the level of autonomy granted in the operating room for performing standard gynecological procedures and perceptions of preparedness upon graduation. The survey also examined perceptions on the impact of factors that improve surgical autonomy. Results: The response rate was 43% (510/1197) for residents and 31% (42/137) for academic teachers. The opinions of residents and academic teachers regarding residents' surgical preparedness by graduation were similar, except for vaginal hysterectomy (30% vs. 57%, P < 0.001). Residents were thought prepared to perform hysteroscopy and adnexal surgery by laparoscopy by >90% of respondents. Regarding hysterectomy, opinions varied depending on the approach: the only approach for which more than two-thirds of residents (67%) were thought to be prepared by gradation was laparoscopy. Regarding factors promoting surgical autonomy, 99% of residents and 97% of teachers considered case volume and coaching quality essential. Only 37% of residents and 55% of teachers deemed the introduction of summative assessment relevant. Conclusion: French residents and academic teachers reported adequate preparedness for hysteroscopy and adnexal surgery. There were concerns regarding preparedness for more complex surgeries, particularly laparotomic and vaginal hysterectomy. These findings underscore the need for revisions in training methods and residency objectives.