Postgraduate medical education in obstetrics & gynecology in Switzerland in comparison to Germany and Austria, results of an international survey

Abstract

Background There is frequent academic exchange between Switzerland, Germany and Austria, facilitated by the common language. Also the postgraduate training curricula in obstetrics & gynecology show some similarities. We aimed to compare self-perceived level of ability, availability of simulation training and teaching and feedback culture among residents in obstetrics & gynecology in Switzerland, Germany, and Austria. The focus was on Switzerland, to gain better understanding of strengths and room for improvement. Methods In a cross sectional design, a web-based survey with 30 questions was distributed under obstetrics & gynecology residents in the three countries in August and September 2020. Primary outcome was the self-perception of skills in between-countries-comparison in mid-training trainees, i.e. omitting trainees in their first year as well as very advanced trainees and specialists. Secondary outcome was reported teaching, simulation training and feedback culture. German and Austrian responses were calculated together and compared with the Swiss replies. Results 422 participants took part in the survey, with 27.5% (n=116) from Switzerland, corresponding to a questionnaire response rate of around 19%. 48% of Swiss trainees were in training years 2-5. 57% of Swiss participants felt confident in obstetric procedures and 69% in gynecological procedures - compared to 52% and 68% in non-Swiss (p=0.005 and p=0.176). Swiss participants felt significantly more confident in performing gynecological than obstetric procedures (p=0.015). 63 % of Swiss participants had obstetric and 28% had gynecological simulation training compared to 37% and 17% in Germany and Austria, respectively (p<0.001 and p=0.007). 56% of Swiss participants reported “enough structured teaching”, 43% reported a “good teaching culture”, 47% of Swiss participants stated to receive regular feedback. Conclusions The majority of trainees in Switzerland feel confident in a range of procedures and interventions. Simulation training is relatively widespread, although especially surgical simulation training should be expanded. Clinical teaching and feedback culture should be strengthened. “Teach the teacher” courses should be encouraged to promote a sustainable feedback culture.