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CC BY-NC-ND 4.0 · AJP Rep 2020; 10(03): e319-e323
DOI: 10.1055/s-0040-1715168
Case Report

Debunking the Myth: Do Maternal-Fetal Medicine Fellows Negatively Impact Resident Obstetrical Skills?

Authors

  • Sarah K. Dotters-Katz

    1   Department of Obstetrics and Gynecology, Duke University, Durham, North Carolina

  • Matthew Grace

    2   Department of Obstetrics and Gynecology, Vanderbilt University, Nashville, Tennessee

  • R Phillips Heine

    3   Department of Obstetrics and Gynecology, Wake Forest University, Winston-Salem, North Carolina

  • Katie Propst

    4   Department of Obstetrics and Gynecology, Obstetrics/Gynecology and Women's Health Institute, Cleveland Clinic, Cleveland, Ohio

Funding None.
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Abstract

Objective Residency applicants often express concern that fellows negatively impact surgical opportunities, especially with less common procedures. We sought to describe the impact of maternal-fetal medicine (MFM) fellows on resident surgical opportunities.

Study Design Anonymous 27-question e-survey sent to obstetrics and gynecology (OBGYN) residents in the United States and Puerto Rico in March 2018. Questions included experience as primary surgeon, for fourth year residents only, comfort performing procedures postresidency, and demographics. Residents from programs with MFM fellows (pMFM) were compared with those without (nMFM). Descriptive statistics used as appropriate. Regression was performed, controlling for significant variables.

Results A total of 417 residents completed the survey; 275 (66%) from nMFM and 142 (33%) from pMFM. PMFM residents were more likely to have >7 residents/year, be from an academic residency, and less likely to be planning to practice obstetrics postresidency (all, p < 0.01). Plan to pursue MFM fellowship did not differ. NMFM residents were more likely to have been primary surgeon on a vacuum assisted delivery (77 vs. 63%, p < 0.01). No difference in primary surgeon experience was seen for forceps delivery, breech deliveries, third- or fourth-degree repairs, cerclage, or cesarean hysterectomy. With regard to comfort performing procedures postresidency, vacuum-assisted vaginal delivery (VAVD) was more likely among nMFM trainees, no other differences seen. In regression models, no differences in likelihood of comfort performing procedures postresidency for any procedures based on the presence of MFM fellows were seen. Among pMFM residents, 94% stated fellows positively impacted their learning.

Conclusion MFM fellows do not appear to impact residents' perceived competency in obstetric procedures and the majority of trainees report that fellows positively impact their education.

Keywords

MFM fellow - fellowship - medical education - complex obstetrics - resident education

Prior Presentation

This research was presented as a poster presentation at the 2019 ACOG national meeting in Nashville, TN.




Publication History

Received: 05 February 2020

Accepted: 24 April 2020

Article published online:
23 September 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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