Program Director Perceptions of Subspecialty Tracking in Obstetrics and Gynecology Residency

Background: Residency programs have experienced a trend toward decreased work hours and case volumes, negatively affecting the perception of graduating residents' competence. Subspecialty tracks have been proposed to help address these issues. Objective: We evaluated the perceptions of obstetrics and gynecology (ob-gyn) residency program directors (PDs) on subspecialty tracking during training. Methods: In 2017, a web-based, anonymous survey with Likert scale and open-ended items was e-mailed to US ob-gyn PDs. Results: Of 250 PDs surveyed, 169 (68%) responded. More than half (54%) reported tracking would positively affect training of future ob-gyn physicians; 80% agreed it would increase resident preparedness for fellowship. Nearly half (49%) indicated it should be available for interested residents. However, some respondents expressed concerns this would negatively affect resident training (38%) and could decrease the number of ob-gyn generalists (50%). Most (88%) believed that tracking, if implemented, should not be mandatory, and 84% agreed that a tracking curriculum should be accompanied by Accreditation Council for Graduate Medical Education (ACGME) and American Board of Obstetrics and Gynecology changes. Only 31% of PDs felt tracking could be successfully implemented in their programs. Barriers to implementation included too few residents to divide into tracks, challenging administrative logistics, and concerns about meeting ACGME case volume requirements. Conclusions: PDs have defined but diverse opinions on the implementation of tracking in ob-gyn. Slightly more than half of responding PDs reported tracking would positively affect the training of future ob-gyn physicians, and less than one-third indicated that their program could successfully implement tracking.