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von Waldenfels G, Beck MH, Semmler J, Gerber A, Hennigs A, Vochem R, Blohmer JU, Schmalfeldt B, Pietzner K, Sehouli J. Training in obstetrics and gynecology between reality and vision: results of a JAGO-NOGGO survey in 601 physicians (NOGGO-Monitor-12 trial). Arch Gynecol Obstet 2024; 309:2771-2778. [PMID: 38625545 PMCID: PMC11147899 DOI: 10.1007/s00404-024-07508-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Accepted: 04/03/2024] [Indexed: 04/17/2024]
Abstract
PURPOSE The primary objective of this study was to establish a benchmark by collecting baseline data on surgical education in obstetrics and gynecology in Germany, including factual number of operations performed. MATERIALS AND METHODS A nationwide anonymous survey was conducted in Germany between January 2019 and July 2019 utilizing a specially designed questionnaire which addressed both residents and senior trainers. RESULTS A total of 601 participants completed the survey, comprising 305 trainees and 296 trainers. The trainees reported performing a median of 125 non-obstetric surgeries (IQR: 41-332) and 75 obstetric procedures (IQR: 27-168) independently. While most last-year residents managed to meet the targeted numbers for minor surgical procedures outlined in the logbook, they fell short of achieving the required numbers for major operations, such as hysterectomies or more complex laparoscopies. Although both trainees and trainers emphasized the significance of surgical training, the overall quality of the training was rated poorly, particularly by trainees. This was attributed to a high proportion of administrative tasks and a deficiency in teaching time within the operating theater. External fellowship and mentoring programs, as well as the implementation of regular, centralized reviews of residency training, were identified as potentially beneficial by both trainees and trainers. CONCLUSION The findings of this survey should serve as a wake-up call both within and outside of Germany, highlighting the importance of comprehensive and structured surgical training to enhance long-term patient care and increase satisfaction among obstetrics and gynecology trainees.
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Affiliation(s)
- Gabriel von Waldenfels
- Department of Gynecology, Breast Center, Campus Mitte, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Young Academy of Gynecologic Oncology (JAGO, ), Berlin, Germany
| | - Maximilian Heinz Beck
- Department of Gynecology, Breast Center, Campus Mitte, Charité-Universitätsmedizin Berlin, Berlin, Germany.
- Young Academy of Gynecologic Oncology (JAGO, ), Berlin, Germany.
- Department of Gynecology, Center for Oncological Surgery, Campus Virchow Klinikum, Charité-Universitätsmedizin Berlin, Berlin, Germany.
| | - Janina Semmler
- Young Academy of Gynecologic Oncology (JAGO, ), Berlin, Germany
- Department of Obstetrics, Campus Virchow Klinikum, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Annika Gerber
- Young Academy of Gynecologic Oncology (JAGO, ), Berlin, Germany
- Fertility Doctors Berlin, Berlin, Germany
| | - André Hennigs
- Young Academy of Gynecologic Oncology (JAGO, ), Berlin, Germany
- Department of Obstetrics and Gynecology, University Hospital Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany
| | - Ruth Vochem
- Young Academy of Gynecologic Oncology (JAGO, ), Berlin, Germany
- TFP Kinderwunsch Klagenfurt, Klagenfurt, Austria
| | - Jens-Uwe Blohmer
- Department of Gynecology, Breast Center, Campus Mitte, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Barbara Schmalfeldt
- Department of Gynecology and Gynecologic Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Society of Gynecology and Obstetrics (DGGG), Berlin, Germany
| | - Klaus Pietzner
- Young Academy of Gynecologic Oncology (JAGO, ), Berlin, Germany
- Department of Gynecology, Center for Oncological Surgery, Campus Virchow Klinikum, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Jalid Sehouli
- Young Academy of Gynecologic Oncology (JAGO, ), Berlin, Germany
- Department of Gynecology, Center for Oncological Surgery, Campus Virchow Klinikum, Charité-Universitätsmedizin Berlin, Berlin, Germany
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Neimann J, Knabl J, Puppe J, Bayer CM, Gass P, Gabriel L, Seelbach-Goebel B, Lermann J, Schott S. Duty Rosters and Workloads of Obstetricians in Germany: Results of a Germany-wide Survey. Geburtshilfe Frauenheilkd 2017; 77:894-903. [PMID: 28845054 DOI: 10.1055/s-0043-110863] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 05/05/2017] [Accepted: 05/09/2017] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND Compiling a daily hospital roster which complies with existing laws and tariff regulations and meets the requirements for ongoing professional training while also taking the legal regulations on the health of employees into account makes planning the duty roster a challenge. The aim of this study was to obtain a realistic picture of existing duty roster systems and of the current workloads of obstetricians in Germany. METHOD This online survey was sent to 2770 physicians training to become obstetricians or specializing in specific areas of obstetric care. The survey consisted of an anonymized 95-item questionnaire which collected data on different types of duty roster systems and the workload of obstetricians in Germany for the period from 17.02.2015 to 16.05.2015. RESULTS Out of a total of 2770 physicians who were contacted, 437 (16%) completed the questionnaire. Across all forms of care, the care provided outside normal working hours usually (75%) consisted of a combination of regular working times and on-call duty or even consisted entirely of standby duty. Level I perinatal centers were most likely 20% (n = 88) to have a shift system in place. Working a shift system was significantly more common in care facilities which had previously carried out a job analysis. The number of physicians in hospitals who are present during the night shift was higher in facilities with higher numbers of births and in facilities which offered higher levels of care. In addition to regularly working overtime and the fact that often not all the hours worked were recorded, it was notable that the systems used to compile duty rosters often did not comply with legal regulations or with collectively agreed working hours nor were they compatible with the staff planning requirements. OUTLOOK The results of this study show that the conditions of work, the working times, and the organization of working times in obstetric departments are in need of improvement. Recording the actual times worked together with an analysis of the activities performed during working times and while on standby would increase the level of transparency for employers and employees.
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Affiliation(s)
- Johannes Neimann
- Frauenklinik mit Brustzentrum, KRH Klinikum Siloah, Hannover, Germany
| | - Julia Knabl
- Klinikum der Universität München Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe Campus Innenstadt, München, Germany.,Department of Obstetrics, Klinik Hallerwiese, Nürnberg, Germany
| | - Julian Puppe
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Uniklinik Köln, Köln, Germany
| | | | - Paul Gass
- Frauenklinik, Universitätsklinikum Erlangen, Erlangen, Germany
| | - Lena Gabriel
- Klinik für Frauenheilkunde, Geburtshilfe und Reproduktionsmedizin, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany
| | - Birgit Seelbach-Goebel
- Krankenhaus der Barmherzigen Brüder - Klinik St. Hedwig, Lehrstuhl für Frauenheilkunde und Geburtshilfe der Universität Regensburg, Regensburg, Germany
| | | | - Sarah Schott
- Universitätsfrauenklinik, Universitätsklinikum Heidelberg, Heidelberg, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany.,Deutsches Krebsforschungszentrum, Heidelberg, Germany
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