Influence of Residency Training on Operative Vaginal Delivery in Independent Practice.

Objective: To determine if residency training in the use of forceps and vacuums in vaginal deliveries is associated with their use in postgraduate practice.

Study design: We surveyed all Ob/Gyn residency graduates of 4 academic programs from 2004-2012. The average number of vacuums and forceps performed per graduating resident was linked to respondents, who were then grouped by self-report as using forceps alone, vacuums alone, or both in practice. Multivariable logistic regression determined predictors of use of forceps and vacuums in practice

Results: The response rate was 61.2% (n=200). Those practicing obstetrics (n=171) were classified as forceps only (24%), vacuums only (22%), or both (54%). Use of forceps in practice was greater for those who graduated within the last 5 years (OR 7.55, 95% CI 2.37-24.07), felt inadequately trained in vacuums (OR 4.58, 95% CI 1.23-17.00), cared for a patient population <50% privately insured (OR 4.08, 95% CI 1.58-10.52), and performed more forceps in residency (OR 1.69, 95% CI 1.31-2.18 per 5 forceps performed on average). The only significant predictor of vacuum use was the number of vacuum deliveries performed in residency (OR 3.71, 95% CI 2.28-6.01 per 5 vacuums performed on average).

Conclusion: Independent practice pattern for operative vaginal delivery reflects residency training for both vacuums and forceps.