Recent Ob/Gyn Residency Graduates' Experience With Hysterectomy

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Abstract

Local Mentor:

Carol Major, MD

APGO Advisor:

Jody Steinauer, MD

OBJECTIVE:

To estimate the average hysterectomy volume performed by Obstetrician-Gynecologists in their first five years following residency graduation

METHODS:

This is a retrospective cohort study of recent residency graduates. Provider-identified, patient-deidentified case mix data from 2004-2014 were obtained from the Massachusetts Center for Health Information Analysis statewide database. Data were crosslinked to demographics, year of residency graduation, and fellowship training. Data were narrowed to simple hysterectomies by Ob/Gyn specialists within five years of graduation. Mean hysterectomy numbers performed in each of the first five full calendar years following residency were determined by descriptive statistics and stratified by modality. A veteran cohort of physicians completing residency training 20 or more years earlier but younger than 65 served as a comparison group.

RESULTS:

Case mix data revealed 89,026 hysterectomies performed by 1,909 physicians from January 1, 2004 to December 31, 2013. Of these 1,359 were simple hysterectomies performed by 85 recent residency graduates practicing as Ob/Gyn specialists. For this cohort, the mean number of hysterectomies performed annually was 4.7, 4.6, 4.7, 4.3, and 4.1 in each of the first five full calendar years respectively following training. Recent graduates most commonly chose the abdominal route (41.6%), with laparoscopic (32.4%), laparoscopically assisted vaginal (11.1%) and vaginal (14.7%) chosen less commonly. Hysterectomy volume did not change significantly over the first five years. Procedures performed in 2014, and comparison to the veteran cohort will be included in the final analysis (see poster presentation).

CONCLUSION:

Recent graduates perform an average of 4 hysterectomies annually, most often abdominally.

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