Assessment of obstetrics and gynecology training during residency: A global perspective

This study evaluates the global landscape of postgraduate obstetrics and gynecology (Ob/Gyn) training, focusing on curriculum content, dedicated training time, perceived competencies, and trainee satisfaction.

A cross-sectional online survey was conducted by the World Association of Trainees in Obstetrics and Gynecology (WATOG) between 2017 and 2019. A total of 1038 respondents from seven global regions, answered 46 questions addressing nine core Ob/Gyn subspecialty modules, including delivery room, maternal medicine, fetal medicine, general Ob/Gyn ultrasound, general gynecological surgery, urogynecology, onco-gynecology, assisted reproduction, and family planning. Primary outcome measures included Ob/Gyn subspecialty module inclusion in the training curriculum, self-reported time allocation to training modules, competency attainment, and satisfaction. Secondary analyses examined correlations between time allocation, perceived competency, and satisfaction and investigated regional differences using nonparametric statistical tests.

Delivery room training was universally included in training curriculums (≥94% across all regions) and garnered high satisfaction. Conversely, subspecialty modules, such as fetal medicine and assisted reproduction, were underrepresented in training curriculums in low- and middle-income regions. Correlation analyses revealed that increased training time had a weak but positive association with competency acquisition in several subspecialty modules (e.g., general gynecological surgery and onco-gynecology). However, satisfaction did not consistently correlate with training duration, suggesting that factors beyond time allocation-such as quality of instruction and supervision-might play a larger role. Notably, trainees in resource-limited settings reported more heterogeneous and often lower satisfaction scores, despite spending equal or greater total time on clinical activities.

Global Ob/Gyn curriculums share core elements, yet differ widely in time allocations and competencies achieved. The findings underscore a need for both international harmonization of minimum standards and context-specific adaptations to address local healthcare priorities and resource constraints. Competency-based frameworks that balance global benchmarks with regional realities could improve the training experience and outcomes for future Ob/Gyn specialists.