Residents' perspectives on surgical training and the resident-fellow relationship: comparing residency programs with and without gynecological oncology fellowships

The effect of a gynecological oncology fellow on obstetrics and gynecology resident education and training is uncertain. The objective is to assess the effect of gynecological oncology fellows on the surgical training of residents in obstetrics and gynecology. Fourth year residents in obstetrics and gynecology in the United States were identified and stratified as to the presence or absence of an oncology fellowship program. Demographics, surgical volume, procedures performed, and self-assessment of surgical proficiency were collected. Responses were compared between residency programs with and without fellowships. Responses were received from 40% of programs. Residents at programs without a fellowship more frequently operated with attendings than did residents at programs with fellows, 91% vs 77%, P = 0.016, and more frequently were responsible for complicated cases, 39% vs 22%, P < 0.0001. Over 90% of residents in both groups reported surgical training as positive and valuable; both groups reported a similar perceived lack of proficiency in radical hysterectomy and lymphadenectomy. Attitudes toward the fellows were generally positive; however, competition for cancer cases was reported by over 66% of residents from programs with fellows. While fellows are often thought of as a detracting factor to residency training, they do not appear to affect the perception of the quality of resident surgical training.