Analysis of Urogynecology Exposure in OBGYN Residency

Objectives: This study aimed to investigate the association between early and frequent exposure to Urogynecology during residency and characteristics of Obstetrics and Gynecology residency programs, such as program setting, size, average hours worked per week, and affiliation with a Urogynecology fellowship program.

Methods: Data from 298 Obstetrics and Gynecology residency programs were collected from the Fellowship and Residency Electronic Interactive Database Access System (FREIDA). The earliest possible Urogynecology rotation and number of mandatory rotations were obtained from each program's website. Military residencies and residencies without a schedule on their website were excluded. “Early” Urogynecology exposure was defined as first exposure during PGY-1 or 2. Descriptive analyses were conducted to find the mean and standard deviation for continuous variables, and frequencies and percentages for categorical variables. The data were analyzed using chi-squared tests for categorical variables, Spearman correlation coefficient for continuous variables, and Wilcoxon and t-tests to compare categorical and continuous variables, to identify any associations between program characteristics and Urogynecology exposure.

Results: Out of 256 programs analyzed, 88.28% offered a Urogynecology rotation, and 24.61% were affiliated with a Urogynecology fellowship program. Only 4.52% of programs offered a Urogynecology rotation as early as PGY-1, while 44.34% offered it for the first time in PGY-2, 40.27% in PGY-3, and 10.86% did not have a Urogynecology rotation until PGY-4. No significant association was found between program setting (University-based vs. Community-based, university-affiliated) and earliest Urogynecology exposure. However, programs affiliated with a fellowship program were associated with increased early Urogynecology exposure (64.29% vs. 35.71%, p-value=0.0076). Larger programs were also associated with increased early exposure (5.99 vs. 5.23, p-value=0.0162). Community-based, university-affiliated programs required more Urogynecology rotations than University-based programs (1.66 vs. 1.40, p-value= 0.0435). Additionally, a negative correlation was found between average hours worked per week during PGY-1 and the number of required Urogynecology rotations (Spearman correlation coefficient= -0.16124, p-value=0.0113). No association was found between being affiliated with a fellowship program and number of required Urogynecology rotations.

Conclusions: This study provides valuable insights into the state of Urogynecology exposure during Obstetrics and Gynecology residency and highlights the potential impact of program characteristics on early and frequent exposure to the field. The results indicate being affiliated with a Urogynecology fellowship is associated with earlier Urogynecology exposure during residency. Additionally, community-based, university-affiliated programs require more Urogynecology rotations on average than university-based programs. However, it is important to note that these findings do not necessarily encompass the totality of Urogynecology exposure during residency training at these programs. Other factors not accounted for in this study, such as individual program leadership, resident interest, and available resources, may also influence Urogynecology exposure. We hope these findings can guide students applying to Obstetrics and Gynecology residency programs.