Surgical Proficiency of Obstetrics and Gynaecologic Residents in Nigeria

The aim of residency training is to produce competent and professional experts in their areas of specialty. Surgical proficiency is required to be able to offer patients a genuine choice of treatment options and safety of procedures performed. We assessed self-reported level of proficiency for common major gynaecological surgeries among trainee gynaecologists.

Pretested self- administered questionnaires were distributed to senior residents at the West African College of Surgeon's revision course in Obstetrics and Gynaecology.

They were 42 respondents from 15 institutions in Nigeria; 66.7%were males. The mean number of years in residency was 5±1 years.The most commonly performed surgeries were salpingectomy, ovarian cystectomy, myomectomy where approximately 60%, 30% and 33% of residents had performed 10 or more of these surgeries respectively. The least performed surgeries were vaginal hysterectomy, fistula repair and laparoscopic surgeries because each of these surgeries had never been performed more than 60% of residents. These commonly performed surgeries were associated with self-reported average or more proficiency. Reported challenges to attaining surgical proficiency were trainer incapability (92.5%), theatre/hospital logistics (75%), inadequate cases (65%) and trainer unavailability (55%).

Our findings suggest that majority of the senior residents of Obstetrics and Gynaecology assisted and performed insufficient number of gynaecological surgeries to attain proficiency in these procedures. A formal training curriculum needs to be utilized in the training of surgical residents.