Characteristics of OBGYN Residencies Associated with Successful Match into Urogynecology

Title: Characteristics of OBGYN Residencies Associated with Successful Match into Urogynecology

Objective: Urogynecology is often underrepresented in OBGYN residency curriculum even though the lifetime risk of needing Urogynecologic surgery of 12.6% is expected to rise with the aging United States population. The lack of Urogynecology exposure early in residency is counterproductive to the timing of the relatively early NRMP match for this subspecialty. The objective of our study was to determine the characteristics of OBGYN residency programs associated with successful Urogynecology match applicants.

Methods: This is an observational cross-sectional study utilizing publicly available data from 56 ACGME accredited Urogynecology (OBGYN) fellowships websites, OBGYN residency websites and FREIDA database over the approximate years of 2019 to 2022. Fellowship websites were analyzed for their listed fellows, one program associated with United States military was excluded. 4 programs did not provide information about their fellows. The remaining 51 Urogynecology fellowships' websites were evaluated for the OBGYN residencies their fellows trained in.

An assessment was performed for associative factors of OBGYN residency programs for Urogynecology fellowship matching success. The analyzed factors included presence of a home Urogynecology fellowship, number of Urogynecology faculty, and exposure to Urogynecology prior to 3rd year of residency. This information was obtained from residency websites and, if available, the Urogynecology department website.

Linear regression was used to investigate the relationship between number of successful matches and the number of Urogynecology faculty. Mann -Whitney U and Kruskal-Wallis tests were used to investigate the associations between presence of home Urogynecology fellowship and residency exposure to Urogynecology prior to or after 3rd year with successful matching, respectively.

Results: 144 matched residents were identified in the 2019 to 2022 cohort. 20.8% (n=30) were male and 13.2 % (n=19) of this cohort matched at their home Urogynecology fellowship. On average, matched fellows moved about 600 miles from their home programs to their fellowship program. The Albert Einstein College of Medicine, NYU Grossman School of Medicine, UPMC Medical Education Program and University of Cincinnati Medical Center/College of Medicine had the highest number of matched residents, 4 residents from each program over the years analyzed. A greater number of Urogynecology faculty had a strong association with number of successful matches (p= 0.001). This was still statistically significant when looking at absolute percentage of fellows produced out of graduating class (p=0.004). The presence of a home Urogynecology program had a strong association with number successful matches (p=0.02). This was not statistically significant when looking at absolute percentage of fellows produced out of graduating class (p=0.887), this may be in part due to larger programs more often having their own fellowship. Exposure to Urogynecology rotation prior to 3rd year compared to during or after third year was also associated with a greater number of successful matches (p=0.025). However when looking at absolute percentage of matched residents, this factor was no longer statistically significant (p=0.412).

Conclusion:
Adequately engaging and preparing OBGYN residents interested in pursuing Urogynecology should be a priority for OBGYN residencies; early Urogynecology rotations are perhaps one way to offer this to residents. With the rising need for providers to care for women with pelvic floor disorders, encouragement into the field of Urogynecology will be essential to providing specialty care to the aging United States population.