Obstetrics and gynecology residents’ preparedness to perform essential obstetric procedures autonomously: A national survey among French residents and teachers

Abstract

Objective

To assess the self-evaluation of French residents and the opinion of academic teachers regarding the autonomy granted during residents’ training and the level of preparation achieved at the end of the residency to perform essential obstetric procedures.

Methods

A national survey of French obstetrics and gynecology residents and their academic teachers was conducted using an online questionnaire distributed in 2023, which gathered the self-evaluation by residents and opinion of academic teachers on the level of autonomy for essential obstetric procedures and perceptions of preparedness upon graduation. The survey also examined perceptions on the impact of factors that improve autonomy.

Results

510 of the 1197 (43%) residents and 49 of the 137 academic teachers (36%) completed the questionnaire. Both residents and academic teachers were confident that residents would be prepared at the end of residency to perform most essential obstetric procedures, including vacuum and forceps or spatula assisted vaginal delivery. However, regarding advanced obstetric surgery in case of severe postpartum hemorrhage (PPH), only 36% of 6th-year residents reported feeling capable of performing a uterine artery ligation in case of an emergency, and 11% in performing a hemostatic hysterectomy. Main factors that were perceived as important for improving autonomy were the number of cases and the quality of coaching.

Conclusion

French residents reported a gradual increase in autonomy throughout their residency for the majority of essential obstetric procedures, with the exception of surgical management of severe PPH. Teachers shared a similar opinion. Simulation and the quality of supervision appear to be promising pathways for enhancing their autonomy.