Female Pelvic Medicine Fellowships-The Urogynecologist's Perspective. (2009)

Attitudes and Perceptions Regarding Subspecialty Training in Female Pelvic Medicine and Reconstructive Surgery

Siddighi S, Barker M, Pancholy A, et al.

Int Urogynecol J 2008;19:1523–1526.1526 [PubMed].

The field of female pelvic medicine and reconstructive surgery (FPMRS) is a relatively new subspecialty in the fields of urology and obstetrics/gynecology (ob-gyn). Physicians who choose to specialize in this rapidly growing area of medicine develop an expertise in areas of gynecology, female urology, and colorectal surgery, and also study disorders of the pelvic floor and viscera.

Based on the current result of the National Resident Matching Program, fewer US senior medical students are specializing in ob-gyn. The most commonly cited reasons are issues with professional liability and the impact of long hours on quality of life.

The objective of the study was to evaluate perceptions regarding subspecialty training in FPMRS in the United States. A 57-item questionnaire was anonymously mailed to fellows and applicants to FPMRS fellowship. Seventy-four American fellowship interviewees and current fellows completed the entire questionnaire (56% response rate). Key factors associated with higher interest in FPMRS compared with general ob-gyn included competitiveness of the fellowship and new developments in the field. Key factors associated with higher interest in FPMRS compared with other subspecialties in ob-gyn were lower risk of malpractice and a higher sense of career satisfaction.

The majority of responders preferred academics over private practice or a mixture (55.4%, 17.6%, and 27%, respectively). The most important reasons for interest in FPMRS are quality time in the operating room and lower risk of malpractice. Additional attractive features include complexity of cases and the quantity of time spent in the operating room.

This study attempted to look at why FPMRS is so popular and attracting the best of the ob-gyn residents. This study showed that risk of malpractice, impact on personal time, and level of stress were believed to be low in FPMRS. Career satisfaction was found to be lower in ob-gyn than either general surgery or primary care. This study found that there is a higher sense of career satisfaction among fellows and faculty in FPMRS than in general ob-gyn.

FDA Public Health Notification: Serious Complications Associated With Transvaginal Placement of Surgical Mesh in Repair of Pelvic Organ Prolapse and Stress Urinary Incontinence

Schultz DG.

http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/PublicHealthNotifications/ucm061976.htm

Following is the text of a US Food and Drug Administration Public Health Notification that was issued on October 20, 2008.

This is to alert you to complications associated with transvaginal placement of surgical mesh to treat Pelvic Organ Prolapse (POP) and Stress Urinary Incontinence (SUI). Although rare, these complications can have serious consequences. Following is information regarding the adverse events that have been reported to the FDA and recommendations to reduce the risks.