Case log trends of urogynecology and reconstructive pelvic surgery fellows: A comparison of urology‐ and gynecology‐based fellowship programs

Abstract

AbstractAimsUrogynecology and Reconstructive Pelvic Surgery (URPS) fellowship can be pursued after completion of either a urology (URO) or obstetrics and gynecology (GYN) residency. Our aim is to determine differences in graduating fellow cohort (GFC) case logs between URO‐ and GYN‐based URPS programs.MethodsAccreditation Council for Graduate Medical Education case logs for URPS GFCs in both GYN‐ and URO‐based programs were analyzed for the 2019–2023 academic years (AY). Unpaired t‐tests with Welch's correction were used to compare annual mean logged cases between URO‐ versus GYN‐based GFCs for select surgical categories and the top 11 most logged index cases.ResultsGYN‐based GFCs logged more cases for all pelvic organ prolapse (POP) categories including surgery on apical POP, anterior wall POP, and posterior wall POP (all p < 0.01), while URO‐based GFCs logged more cases for surgery on the urinary system (p = 0.03). For the top 11 logged procedures, URO‐based GFCs logged more sacral neuromodulation cases (p = 0.02), whereas GYN‐based GFCs logged more slings, vaginal hysterectomies, minimally‐invasive hysterectomies, vaginal apical POP, vaginal posterior POP, vaginal anterior POP, and minimally‐invasive apical POP cases (all p < 0.01). There was no difference between URO‐ and GYN‐based GFCs for complex urodynamics, cystoscopy with botox injection, or periurethral injection cases.ConclusionsURO‐based URPS fellows tend to graduate with more surgery on the urinary system and sacral neuromodulation cases, while GYN‐based fellows perform more slings, hysterectomies, and POP surgery. These findings may help fellowships better understand potential differences in training among graduates from URO‐ and GYN‐based programs and encourage collaboration to lessen these discrepancies.