Needs Assessment of a Minimally Invasive Gynecologic Surgery (MIGS) Curriculum: Perspectives of Recent OB/GYN Graduates​

Abstract

Introduction Current Accreditation Council for Graduate Medical Education (ACGME) guidelines for endoscopy and laparoscopy training are vague, and previous research indicates a significant proportion of graduating obstetrics and gynecology (OB/GYN) residents feel inadequately trained in minimally invasive gynecologic surgery (MIGS).

Study Objective The study evaluates the experience of recent Indiana University School of Medicine (IUSM) OB/GYN residency graduates and assess the need for an enhanced MIGS curriculum.

Methods This study surveyed 51 IUSM OB/GYN residency and fellowship graduates (2018-2022) using Likert-type items to assess satisfaction with the curriculum, confidence in robotic and laparoscopic skills, frequency of skills simulation, confidence performing various hysterectomy methods as lead surgeon, and current MIGS utilization in practice. Bivariate analysis, Pearson correlation, and thematic analysis of open-ended responses were performed.

Results Twenty-eight graduates (55%) responded. While 80% expressed satisfaction with the overall quality of MIGS training, only 70% felt adequately prepared to perform laparoscopic hysterectomy and 28% felt prepared for robotic surgery post-graduation. A strong positive correlation (r=.63, p < .0001) existed between training in robotic operating room (OR) team dynamics and perceived preparedness for independent robotic surgery. Most trainees (74%) expressed interest in robotic certification if readily available. Key themes from open-ended responses included the importance of early robotics exposure and protected time for MIGS simulations.

Conclusions These findings reveal that graduates under the current IUSM curriculum do not feel adequately prepared for laparoscopic and, especially, robotic surgery. The significant disparity between laparoscopic and robotic skill comfort highlights the need for a robust, standardized MIGS curriculum. We hypothesize this needs assessment and overlapping resident and fellow curriculum will provide the framework for an optimal MIGS curriculum, better equipping OB/GYN graduates for evolving gynecologic surgery