The impact of procedural activities on musculoskeletal pain experienced by pregnant surgeons.

BACKGROUND: Two-thirds of surgeons report work-related musculoskeletal disorders (WRMD). There is limited data on WRMD symptoms experienced by pregnant surgeons. METHODS: We distributed an electronic survey via personal contacts to attending and trainee surgeons across six academic institutions to assess the impact of procedural activities and surgical ergonomics (SE) on WRMD symptoms during pregnancy. RESULTS: Fifty-three respondents were currently or had been pregnant while clinically active, representing 93 total pregnancies. 94.7% reported that symptoms were exacerbated by workplace activities during pregnancy and 13.2% took unplanned time off work as a result. Beyond 24 weeks of pregnancy, 89.2% of respondents continued to operate/perform procedures, 81.7% worked \u3e24-h shifts and 69.9% performed repetitive lifting \u3e50 pounds. No respondents were aware of any institutional pregnancy-specific SE policies. CONCLUSIONS: Procedural activities can exacerbate pain symptoms for the pregnant surgeon. SE best practices during pregnancy warrant further attention

PD02-04 TOP-HEAVY TRAINING: TRENDS IN UROLOGY RESIDENT EXPOSURE TO MAJOR SURGERY

INTRODUCTION AND OBJECTIVE:The landscape of urologic training has shifted dramatically with the emergence of robotic surgery. Increased utilization of robotic surgery may alter the level of trainin..

Longitudinal Changes in the Operative Experience for Junior Urology Residents

To evaluate longitudinal trends in surgical case volume among junior urology residents. There is growing perception that urology residents are not prepared for independent practice, which may be linked to decreased exposure to major cases early in residency.Retrospective review of deidentified case logs from urology residency graduates from 12 academic medical centers in the United States from 2010-2017. The primary outcome was the change in major case volume for first-year urology (URO1) residents (after surgery internship), measured using negative binomial regression.A total of 391,399 total cases were logged by 244 residency graduates. Residents performed a median of 509 major cases, 487 minor cases, and 503 endoscopic cases. From 2010 to 2017, the median number of major cases performed by URO1 residents decreased from 64 to 49 (annual incidence rate ratio 0.90, p<0.001). This trend was limited to oncology cases, with no change in reconstructive or pediatric cases. The number of major cases decreased more for URO1 residents than for residents at other levels (p-values for interaction <0.05). The median number of endoscopic cases performed by URO1 residents increased from 85 to 194 (annual incidence rate ratio 1.09, p<0.001), which was also disproportionate to other levels of residency (p-values for interaction <0.05).There has been a shift in case distribution among URO1 residents, with progressively less exposure to major cases and an increased focus on endoscopic surgery. Further investigation is needed to determine if this trend has implications on the surgical proficiency of residency graduates

Gender-Based Disparity Exists in the Surgical Experience of Female and Male Urology Residents

To determine if a discrepancy exists in the number and type of cases logged between female and male urology residents. ACGME case log data from thirteen urology residency programs was collected from 2007 to 2020. The number and type of cases for each resident were recorded and correlated with resident gender and year of graduation. The median, and 25th and 75th percentiles number of cases were calculated by gender, and then compared between female and male residents using Wilcoxon rank sum test. A total of 473 residents were included in the study, 100 (21%) were female. Female residents completed significantly fewer cases, 2174, compared to male residents, 2273 (p = 0.038). Analysis by case type revealed male residents completed significantly more general urology (526 versus 571, p = 0.011) and oncology cases (261 versus 280, p = 0.026). Additionally, female residents had a 1.3 fold increased odds of logging a case in the assistant role than male residents (95% confidence interval: 1.27 - 1.34, p < 0.001). Gender-based disparity exists within the urology training of female and male residents. Male residents logged nearly 100 more cases than female residents over four years, with significant differences in certain case subtypes and resident roles. The ACGME works to provide an equal training environment for all residents. Addressing this finding within individual training programs is critical