Longitudinal Study of the Impact of Urogynecology Fellows on Resident Education
Drs. Geoffrey Cundiff, Victoria Hands, Jessica Bienstock

Johns Hopkins Medical Center

Baltimore, Maryland

Objective:   To assess residents’ perceptions of the impact of a new fellowship in Urogynecology and Reconstructive Pelvic Surgery on their educational experience over time.

Materials and Methods: All 28 obstetrics and gynecology residents were asked to complete a visual analog questionnaire that assessed how they felt urogynecology fellows impacted their education in 6 areas: general gynecology (Gyn), gynecologic surgery (Gyn Surg), laparoscopic surgery (Laparoscopy), urogynecology (Urogyn), urogynecologic surgery (Urogyn Surg) and overall educational experience (Education). They were also asked to grade the quality of their education in urogynecology during the previous year.  The questions were grouped into broad categories including urinary incontinence, lower urinary tract symptoms, voiding dysfunction, pelvic organ prolapse, fecal incontinence, and defecatory dysfunction.  The initial questionnaire was given within one month of the beginning a new 3-year fellowship in Urogynecology and Reconstructive Pelvic Surgery, and then on a yearly basis for 3 years.  Statistics are descriptive. 

Results: The mean response rate was 32%. In the initial questionnaire the fellows were perceived as detracting from the educational experience (mean scores < 50 mm). Thereafter there was a positive increase in the perceived impact of fellows in all educational categories that was sustained at two and three years. (Figure 1) Residents also reported higher self-assessments of the quality of their education in urogynecology in all categories each year after the initiation of the fellowship, although the scores declined the third year.  During this time period the number of surgeries for urinary incontinence and pelvic organ prolapse reported by residents on their S forms increased (178 versus 274 cases). 

Conclusions: While at the outset residents anticipated the addition of a fellowship in urogynecology to have a negative impact on their educational experience, they consistently reported a positive impact after the fellowship was instituted.