Why should you work with a high volume Gynecologic Surgeon?

If you need surgery, Its important to work with a good surgeon, That is a given, But when it comes to gynecologic surgery ,its even more important to look for an experienced surgeon. Board certification is not enough !

Its a common wisdome to choose an experienced surgeon if you need surgery,in the world of gynecologic surgery,training and exposure to gynecologic surgery is a hot topic in the surgical community,as there is a wide variation in that exposure,with the largest number of gynecologic surgeons (80% of them!) are classified as low volume surgeons with about one major surgery a month!

History of Gynecologic surgery:

Before 1930s,gynecologic surgeries were performed by general surgeons with experience and interest in pelvic surgery,in the later years,the field of obstetrics was merged with the field of obstetrics in residency training.

The Crisis In OBGYN residents training:

Residency training in gynecologic surgery faces many unique chllenges compared to other surgical branches:

The number of surgical cases is stagnant or going down,as other nonsurgical options become avilable.
The total time a resident spend in gynecologic surgery rotation is 18 months only for the whole residency,where they resident is expected to master differrent surgeries with differrent approaches!
OBGYN residents are also a primary care doctors who do annual exams,provide preventive care,prescribe vaccines,and expected to master prenatal care,obstetrics and its complications.
Most residencies are heavy in the number of deliveries but very low in gynecologic surgical cases,so they accept too many residents to cover the deliveries but the residents will have fewer gynecologic cases avilable for them.
The presence of fellows may negatively affect residents training as they are given the priority.
The use of the robotic surgery also negatively affected training,as attendings tend to give the residents less role in robotic surgeries.
Despite all the advances in knoweledge ,surgeries and surgical technologies,the duration of OBGYN residency is still the same 4 years.

OBGYN After Graduation:

After residency,surgical skills frequently deteriorate,because OBGYNs typically operate less frequently after graduation.
The average OBGYN dedicate 15% or less of their time to Gynecologic surgery,which translate into 1-2 days in the Operating room/month.

Comparison with other surgical specialities:

unlike other surgical specialities like orthopedics ,urology,..,most women have an a long existing relationship with their OBGYN,the doctor who perform their pap smear,prescribe their birth control or delivered their babies.
General surgeons dedicate most of the 5 years of training in the operating room.
Most surgeons operate daily or few times a week,but most gnecologist operate once a month.

Advantage to working with a high volume gynecologic surgeon:

More chance to have a minimally invasive surgical approach.
Less complications rate: while complications can occur with any surgeon,a significant number of of these complications are related to the experience of the surgeon.

What is a high volume Gynecologic Surgeon?

A Surgeon that is committed to structure its practice to be a high volume practice.

Currently ,this is achieved through one of two pathways:

Dedicated fellowship training.
Practice focused designation: For surgeons who are committed to gynecologic surgery,and structure their practice to be high volume through referral and specialization.