Hysteroscopic surgery: Perspectives on skills training.

STUDY OBJECTIVE: To assess the current exposure to hysteroscopy in gynecologic residency and daily practice in The Netherlands.

DESIGN: Survey (Canadian Task Force Classification III).

SUBJECT: Postgraduate year 5 and 6 residents in Obstetrics and Gynecology and gynecologists who finished residency within 1998-2003 in The Netherlands.

INTERVENTION: Residents and gynecologists received a survey regarding performance of hysteroscopy, self-perceived competency, and factors influencing hysteroscopic training.

MEASUREMENTS AND MAIN RESULTS: Responses were received from 88% of the senior residents and 83% of the gynecologists. All respondents were interested in performing hysteroscopic surgery and performed the procedures taught during residency training. All respondents were interested in performing 1 or more advanced procedures. Depending on type of procedure, fewer respondents (0%-52%) were performing these procedures. Limitation of advanced hysteroscopic skills at the end of residency was found to be due to the lack of having been primary surgeon. It was felt that the preferred level of hysteroscopic surgery after residency could be reached best by hiring an advanced endoscopic gynecologist (49%).

CONCLUSION: Implementation of basic, but not advanced, hysteroscopic procedures taught during residency in The Netherlands has been successful to date. Residents and gynecologists are also interested in performing advanced hysteroscopic surgery. However, only a minority of the respondents perform these procedures in their current practice. Residents attain proficiency in advanced hysteroscopic surgery if they have the opportunity to perform these procedures. To improve the exposure to residents and the integration into daily practice, it is of great importance that the skills among the surgical educators improve.