Surgical training in gynecologic oncology: Past, present, future
Mitchel S Hoffman1, Dennis S Chi2, Daniel L Clarke-Pearson3
1Department of Oncologic Sciences, University of South Florida Morsani College of Medcine, H. Lee Moffitt Cancer Center, 12902 Magnolia Drive: GYN Program, Tampa, FL 33612, United States of America.
Gynecologic Oncology
|May 28, 2020
Summary
Gynecologic oncology surgical training is evolving due to reduced cancer surgeries and new therapies. Training programs must adapt to ensure future surgeons maintain comprehensive surgical skills.
Area of Science:
- Gynecologic Oncology
- Surgical Education
- Cancer Treatment Modalities
Background:
- Review of surgical care in gynecologic oncology training, examining past, present, and future trends.
- Analysis of factors influencing surgical scope and training duration.
- Exploration of the impact of evolving cancer therapies on surgical practice.
Observation:
- Decreased incidence of cervical cancer and advancements in radiation therapy have reduced radical hysterectomies and exenterations.
- Neoadjuvant chemotherapy and sentinel lymph node mapping are minimizing the extent of cytoreductive surgery and lymphadenectomies.
- Expansion of targeted therapies and personalized medicine are limiting surgical training time and scope.
Findings:
- Gynecologic oncologists' surgical scope may become limited, necessitating collaboration with other surgical disciplines.
- Current training enhancements include off-service rotations, simulation, advanced courses, and extended durations.
- Fellows must maximize exposure to available clinical materials to address potential training deficiencies.
Implications:
- Subspecialty training programs need to re-evaluate the scope of surgical training and practice.
- Consideration of alternative training structures, such as an additional elective research year, may be beneficial.
- Ensuring comprehensive surgical competency in gynecologic oncology requires proactive adaptation of training curricula.
