Assessing Current Trends in Resident Hysterectomy Training

Objectives: Our survey assessed the current trends in hysterectomy experience in US obstetrics and gynecology (OG) residency programs and residents' and program directors' perceptions of robotic surgery's effect on surgical training. Methods: An online survey was e-mailed to program directors and graduating residents of 42 US OG programs. Results: A total of 21 program directors and 35 graduating residents responded. There was no significant difference between the number of hysterectomies residents and program directors thought should be performed. Only 38.1% of program directors and 27.8% of residents reported graduating residents as being "completely prepared" to perform a vaginal hysterectomy compared with 76.2% and 58.3% for abdominal, 28.6% and 22.2% for laparoscopic, and 0% and 2.8% for robotic hysterectomies. Only 12.1% of graduating residents and 17.7% of program directors reported residents sitting at the console "often" or "always" during robotic surgery. Only 34.3% of residents plan to perform robotic hysterectomy after graduation. Both residents (77.2%) and program directors (71.5%) reported that robotic surgery is having a negative impact on residents' training nationally. Conclusions: Graduating residents report adequate numbers of vaginal and abdominal hysterectomies. Both residents and program directors report that graduating residents are not prepared to perform all types of hysterectomies. Both residents and program directors express concern that robotic surgery is negatively impacting surgical training. Further efforts are needed to ensure that residents are graduating with surgical proficiency in these basic gynecologic procedures.