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Routine neonatal circumcision: opportunities for improving residency training.
Brian Le1, Vidit Sharma, Dae Kim
1Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA. b-le@northwestern.edu
Journal of Pediatric Urology
|June 22, 2012
Summary
Both obstetrics-gynecology (ob-gyn) and urology residents report inadequate formal training in neonatal circumcision. Urology residents demonstrated better knowledge of contraindications, while ob-gyn residents reported higher comfort performing the procedure.
Area of Science:
- Medical Education
- Surgical Training
- Neonatal Care
Background:
- Neonatal circumcision is commonly performed by primary care physicians, with urologists often managing complications.
- Previous studies identified a need for improved formal training in neonatal circumcision for obstetrics-gynecology (ob-gyn) residents.
- This study extends the needs assessment to urology residents.
Purpose of the Study:
- To assess the comfort, education, and proficiency of ob-gyn and urology residents in neonatal circumcision.
- To identify gaps in formal training for neonatal circumcision among residents.
- To compare the skills and comfort levels between ob-gyn and urology residents regarding neonatal circumcision.
Main Methods:
- An online survey was administered to ob-gyn and urology residents from November 2008 to November 2009.
- The survey assessed resident comfort, education, and proficiency in pre-operative evaluation and performance of neonatal circumcisions.
- Response rates were 74% for ob-gyn residents and 65% for urology residents.
Main Results:
- A majority of ob-gyn residents (62%) and a third of urology residents (33%) intended to perform neonatal circumcisions.
- Both groups reported minimal formal training. Ob-gyn residents expressed greater comfort performing circumcisions (mean 5.9 vs. 4.3), while urology residents showed higher comfort in pre-operative evaluation (mean 5.1 vs. 3.9).
- Urology residents correctly identified contraindications more often than ob-gyn residents (63% vs. 42%).
Conclusions:
- Formalized training in neonatal circumcision is insufficient for both ob-gyn and urology residents at the studied institution.
- While ob-gyn residents are more comfortable performing the procedure, urology residents exhibit better understanding of contraindications.
- There is a clear need for enhanced curriculum development and formalized training programs for neonatal circumcision in residency programs.
