The Current State of AAGL-Fellowship in Minimally Invasive Gynecologic Surgery: Surgical Volume and Case Types

Area of Science:

• Minimally Invasive Gynecologic Surgery (FMIGS)
• Surgical Education
• Fellowship Training

Background:

• Fellowships in Minimally Invasive Gynecologic Surgery (FMIGS) are crucial for advanced training.
• Assessing the current state of these programs is vital for quality improvement.

Purpose of the Study:

• To describe the current state of AAGL-FMIGS fellowship programs.
• To assess case volume, case types, and differences among programs.
• To evaluate the impact of Program Director (PD) training on fellow surgical experience.

Main Methods:

• Retrospective cohort study of AAGL-FMIGS fellows in the U.S. (2020-2024).
• Analysis of case logs to determine surgical volume and procedure types.
• Comparison of outcomes based on whether Program Directors were FMIGS-trained or not.

Main Results:

• 130 fellows completed fellowships; median 2-year total cases: 510.
• Most common procedures: hysterectomy (210), peritoneal procedures (125), endometriosis (89).
• Fellows with FMIGS-trained PDs had higher total case volume (537 vs. 464), myomectomies (71 vs. 44), and endometriosis surgeries (108 vs. 58).

Conclusions:

• AAGL-FMIGS programs demonstrate robust surgical volume.
• Program Director training significantly impacts fellow surgical volume and case mix.
• FMIGS-trained PDs are associated with greater fellow experience in total cases, myomectomies, and endometriosis procedures.