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The Role of Mentorship on the Career Choices for Obstetrics and Gynecology Residents
Abstracts / Journal of Minimally Invasive Gynecology 23 (2016) S1–S252 patient and operative factors among the antibiotic cohorts using multivariate logistic regression modeling, the risk of surgical site infection was significantly lower for patients receiving cefazolin plus metronidazole compared to those receiving cefazolin alone (OR 0.47, 95% CI 0.260.85). There was no difference in risk of surgical site infection between patients receiving cefazolin and those receiving second-generation cephalosporins (OR 1.03). Results were confirmed by propensity score matching analysis. Conclusion: Cefazolin plus metronidazole appears to reduce risk for surgical site infection after hysterectomy compared to cefazolin alone or second-generation cephalosporin alone. Implementation of this regimen has the potential to substantially decrease infectious morbidity associated with hysterectomy. 560 The Role of Mentorship on the Career Choices for Obstetrics and Gynecology Residents Po LK,1 Steele D,2 Kung R,1 Kroft J,1 Wong H,1 Liu G.1 1Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; 2Department of Obstetrics and Gynecology, St. Michael’s Hospital, Toronto, Ontario, Canada Study Objective: The benefits of mentoring in medicine include positive role models and impact on career selections. Mentees tend to practice in the same field as their mentors and had the same types of academic or non-academic practices. The process by which obstetrics and gynecology residents decide on sub-specialization is unknown. This study aims to determine a mentor’s impact on the career choices of current Ob/Gyn residents. Design: This cross-sectional study was conducted over 3 months. A 25-item questionnaire related to career choices and mentorship was distributed to current Ob/Gyn residents at the University of Toronto, Toronto, Canada. Chi-square was used to test the differences. Setting: N/A. Patients: N/A. Intervention: N/A. Measurements and Main Results: 31 of 62 residents responded to the survey (50% response rate). 74% of the respondents were female and 26% were male. Of the 71% of residents who entered residency with defined career plans, 81% did not feel their residency experience altered those plans. 68% of residents had decided on an academic or non-academic practice prior to residency and 89% of these residents had not changed
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Conclusion: Many obstetrics and gynecology trainees enter residency with a career plan and seek out mentors in the same field. Mentors can have a significant impact on career planning decisions and can influence a trainee’s decision to pursue subspecialization in obstetrics and gynecology. 561 Meta-Analysis and Systematic Review to Determine the Optimum Imaging Modality for the Detection of Deep Infiltrative Endometriosis in the Rectovaginal Septum Gerges B,1 Nadim B,1 Martins W,2 Condous G.1 1Acute Gynaecology, Early Pregnancy and Advanced Endosurgery, Nepean Hospital, Nepean Medical School, University of Sydney, Kingswood, NSW, Australia; 2 Medical School of Ribeirao Preto, Department of Obstetrics and Gynecology, University of Sao Paulo, Sao Paulo, Brazil Study Objective: To review the accuracy and determine the optimum imaging modality for the detection of deep infiltrative endometriosis (DIE) in the rectovaginal septum (RVS) in women with a clinical history of endometriosis. Design: A systematic review was conducted using MEDLINE, Embase, PubMed and Google Scholar to identify studies published between January 1990 and March 2016. Studies were considered eligible if they were prospective and used any imaging modality preoperatively to assess for the presence of DIE, specifically RVS DIE, which was then correlated with the laparoscopic gold standard. We restricted the eligibility to studies having at least 10 affected and 10 unaffected women. Setting: N/A. Patients: N/A. Intervention: N/A. Measurements and Main Results: The electronic searches retrieved 1034 records. After excluding the records that were clearly not eligible by reading title and abstracts, we completely evaluated 106 study groups for eligibility: 55 were excluded because they were related to studies that included less than 10 affected/unaffected women; and 12 were excluded due to potential redundant information with regards to the same population. We included 16 study groups in the analyses and the main results are reported on Table 1. Conclusion: The sensitivities of SVG and the MRI methods were very good, being better than TVS and much better than TRU. The sensitivity of all imaging methods was very good. As SVG is simpler, faster, and more readily available than MRI methods, we believe it should be the first line diagnostic tool for the women with suspected DIE in this region.
Table 1. Diagnostic test accuracy of imaging techniques in assessing DIE in the RVS. Method
Studies
N
Affected
Sens.
95%CI
Heterog.
Spec.
95%CI
Heterog.
MRI MRI CE MRI with Gel SVG TRU TVS
4 2 1 1 1 6
293 209 58 54 346 486
95 63 16 36 84 173
76% 79% 94% 81% 18% 47%
67-86% 70-89% 72-99% 65-90 5-48% 22-71%
Low High N/A N/A N/A Very high
93% 95% 90% 100% 95% 96%
87-100% 92-99% 78-96% 82-100% 88-98% 92-99%
High Moderate N/A N/A N/A High
MRI = Magnetic resonance imaging, CE = Contrast enhanced, SVG = Sonovaginography, TRU = Transrectal ultrasound, TVS = Transvaginal ultrasound; Heterog. = Heterogeneity.
their plans during residency. 61% of respondents had a mentor and 58% had identified their mentor during residency. Male residents were more likely to seek out same gender mentors compared to female residents (83% vs. 69%, p=.033). 70% of respondents felt that their mentor was important or very important in their career planning decisions. 53% had the same field and 55% had the same practice type as their mentor. 86% of respondents felt that a formal career-planning program would be helpful.
562 Does Visuospatial Aptitude Predict Surgical Performance in Ob/Gyn Residents? Hinchcliff E,1 Cox M,1 Breitkopf D,2 Kumar A,2 Green I,2 Cohen S.1 1 Brigham and Women’s Hospital, Boston, Massachusetts; 2Mayo Clinic, Rochester, Minnesota
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Conclusion: Many obstetrics and gynecology trainees enter residency with a career plan and seek out mentors in the same field. Mentors can have a significant impact on career planning decisions and can influence a trainee’s decision to pursue subspecialization in obstetrics and gynecology. 561 Meta-Analysis and Systematic Review to Determine the Optimum Imaging Modality for the Detection of Deep Infiltrative Endometriosis in the Rectovaginal Septum Gerges B,1 Nadim B,1 Martins W,2 Condous G.1 1Acute Gynaecology, Early Pregnancy and Advanced Endosurgery, Nepean Hospital, Nepean Medical School, University of Sydney, Kingswood, NSW, Australia; 2 Medical School of Ribeirao Preto, Department of Obstetrics and Gynecology, University of Sao Paulo, Sao Paulo, Brazil Study Objective: To review the accuracy and determine the optimum imaging modality for the detection of deep infiltrative endometriosis (DIE) in the rectovaginal septum (RVS) in women with a clinical history of endometriosis. Design: A systematic review was conducted using MEDLINE, Embase, PubMed and Google Scholar to identify studies published between January 1990 and March 2016. Studies were considered eligible if they were prospective and used any imaging modality preoperatively to assess for the presence of DIE, specifically RVS DIE, which was then correlated with the laparoscopic gold standard. We restricted the eligibility to studies having at least 10 affected and 10 unaffected women. Setting: N/A. Patients: N/A. Intervention: N/A. Measurements and Main Results: The electronic searches retrieved 1034 records. After excluding the records that were clearly not eligible by reading title and abstracts, we completely evaluated 106 study groups for eligibility: 55 were excluded because they were related to studies that included less than 10 affected/unaffected women; and 12 were excluded due to potential redundant information with regards to the same population. We included 16 study groups in the analyses and the main results are reported on Table 1. Conclusion: The sensitivities of SVG and the MRI methods were very good, being better than TVS and much better than TRU. The sensitivity of all imaging methods was very good. As SVG is simpler, faster, and more readily available than MRI methods, we believe it should be the first line diagnostic tool for the women with suspected DIE in this region.
Table 1. Diagnostic test accuracy of imaging techniques in assessing DIE in the RVS. Method
Studies
N
Affected
Sens.
95%CI
Heterog.
Spec.
95%CI
Heterog.
MRI MRI CE MRI with Gel SVG TRU TVS
4 2 1 1 1 6
293 209 58 54 346 486
95 63 16 36 84 173
76% 79% 94% 81% 18% 47%
67-86% 70-89% 72-99% 65-90 5-48% 22-71%
Low High N/A N/A N/A Very high
93% 95% 90% 100% 95% 96%
87-100% 92-99% 78-96% 82-100% 88-98% 92-99%
High Moderate N/A N/A N/A High
MRI = Magnetic resonance imaging, CE = Contrast enhanced, SVG = Sonovaginography, TRU = Transrectal ultrasound, TVS = Transvaginal ultrasound; Heterog. = Heterogeneity.
their plans during residency. 61% of respondents had a mentor and 58% had identified their mentor during residency. Male residents were more likely to seek out same gender mentors compared to female residents (83% vs. 69%, p=.033). 70% of respondents felt that their mentor was important or very important in their career planning decisions. 53% had the same field and 55% had the same practice type as their mentor. 86% of respondents felt that a formal career-planning program would be helpful.
562 Does Visuospatial Aptitude Predict Surgical Performance in Ob/Gyn Residents? Hinchcliff E,1 Cox M,1 Breitkopf D,2 Kumar A,2 Green I,2 Cohen S.1 1 Brigham and Women’s Hospital, Boston, Massachusetts; 2Mayo Clinic, Rochester, Minnesota