Training Pathways for Minimally Invasive Gynecologic Surgery: An Analysis of Residencies and Matched FMIGS Trainees

Area of Science:

• Surgical Education
• Gynecologic Surgery Training
• Graduate Medical Education

Background:

• Minimally Invasive Gynecologic Surgery (MIGS) is a subspecialty within obstetrics and gynecology (OBGYN).
• Understanding the training landscape for OBGYN residents pursuing a Fellowship in MIGS (FMIGS) is crucial for surgical education.
• The pathway to FMIGS fellowship and the role of residency program structure require further investigation.

Purpose of the Study:

• To assess the training environment within OBGYN residency programs concerning Minimally Invasive Gynecologic Surgery (MIGS).
• To analyze the educational pathway for residents aiming to secure a Fellowship in MIGS (FMIGS).
• To determine the proportion of OBGYN residency programs with affiliated MIGS fellowships or divisions.

Main Methods:

• An observational, cross-sectional study was conducted using data from the Accreditation Council for Graduate Medical Education (ACGME).
• Data included OBGYN residency programs and accredited gynecologic fellowships from 2022 to 2026.
• Fellowship match lists from the AAGL were used to identify FMIGS fellows and analyze residency-to-fellowship transitions.

Main Results:

• Out of 298 OBGYN residency programs, 15% had an affiliated FMIGS fellowship, and 9% had a MIGS division without a fellowship.
• From 2022 to 2026, 227 residents matched into FMIGS fellowships; 53% came from residencies with FMIGS programs.
• Overall, 35% of residency programs had at least one resident match into FMIGS during the study period, showing variability.

Conclusions:

• Residency programs featuring co-located FMIGS fellowships or MIGS divisions are associated with improved fellowship match success.
• The presence of dedicated MIGS infrastructure within OBGYN residency programs appears to positively influence resident progression into fellowship training.
• Further analysis of program-specific factors may elucidate optimal training models for MIGS surgeons.