Case Log Trends of Graduating Obstetrics and Gynecology Residents Between 2018 and 2024

TL;DR

This study shows that U.S. OB/GYN residents from 2018 to 2024 had fewer surgeries like abdominal hysterectomies and operative vaginal deliveries, but more laparoscopic hysterectomies.

Contribution

The study identifies significant longitudinal trends in resident surgical exposure and raises concerns about surgical competency assessment.

Findings

Abdominal hysterectomy and operative vaginal delivery case volumes declined significantly between 2018 and 2024.

Laparoscopic hysterectomy experience increased steadily over the study period.

Declines in core procedures suggest a need to reevaluate surgical competency assessments for residents.

Abstract

Resident case logs demonstrate changes in case volume, including operative deliveries and hysterectomies; trends highlight a potential need to rethink surgical competency assessment.

The aim of this study was to evaluate logged operative experience of obstetrics and gynecology residents in the United States between 2018 and 2024.

This was a retrospective analysis of publicly available Accreditation Council for Graduate Medical Education case log summary statistics of graduating obstetrics and gynecology residents. National mean case volumes per resident were summarized. Changes in operative experience between 2018 and 2024 classes were described with absolute and percent differences. Longitudinal trends across academic years were evaluated with Spearman rank correlation. To assess distributional changes in hysterectomies and operative vaginal deliveries, selected national percentiles (10th, 50th, and 90th) were additionally evaluated.

Across multiple procedures, mean operative experience declined between 2018 and 2024, with the largest relative decreases observed in abdominal hysterectomy (−35.3%) and operative vaginal deliveries (−15.4%). Strong monotonic downward trends were observed over time for these procedures. In contrast, laparoscopic hysterectomy experience increased steadily across academic years. Percentile-based analyses showed parallel shifts at the 10th, 50th, and 90th percentiles for several procedures.

Operative experience between 2018 and 2024 changed among graduating obstetrics and gynecology residents, with declining exposure in several core procedures and increased experience noted with laparoscopic hysterectomy. These findings highlight the importance of ongoing evaluation of training exposure in the context of national discussions regarding resident surgical readiness at the end of training.

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