Comparison of a U.S. and Zambian Ob/Gyn Residency Training Programme

Maya M Hicks; Kenneth Chanda; Mulindi Mwanahamuntu; Monica B Jones; Anissa R Mattison; Krista S Pfaendler; Leeya F Pinder; Groesbeck P Parham; Michael L Hicks

doi:10.3332/ecancer.2022.1468

Comparison of a U.S. and Zambian Ob/Gyn Residency Training Programme

Ecancermedicalscience. 2022 Nov 7:16:1468. doi: 10.3332/ecancer.2022.1468. eCollection 2022.

Authors

Maya M Hicks^{1

2}, Kenneth Chanda³, Mulindi Mwanahamuntu³, Monica B Jones¹, Anissa R Mattison⁴, Krista S Pfaendler⁵, Leeya F Pinder^{6

7}, Groesbeck P Parham^{3

8

9}, Michael L Hicks^{3

8

10

11}

Affiliations

¹ Department of Obstetrics and Gynecology, Anne Arundel Medical Center, 2000 Medical Pkwy, Belcher Pavilion, Ste 309, Annapolis, MD 21401, USA.
² https://orcid.org/0000-0002-1993-3367.
³ Department of Obstetrics and Gynaecology, University Teaching Hospital - Women and Newborn Hospital, 10101 Nationalist Way, Lusaka, Zambia.
⁴ Trinity Health Academic Obstetrics and Gynecology, 44428 Woodward Ave Ste 104, Pontiac, MI 48341, USA.
⁵ Department of Obstetrics and Gynecology, West Virginia University School of Medicine, 64 Medical Center Drive, Morgantown, WV 26506, USA.
⁶ Department of Oncology, University of Washington, 1959 NE Pacific St, Seattle, WA 98195, USA.
⁷ https://orcid.org/0000-0002-8929-7810.
⁸ Department of Obstetrics & Gynecology, University of North Carolina at Chapel Hill, 101 Manning Dr., Chapel Hill, NC 27514, USA.
⁹ https://orcid.org/0000-0001-5922-5990.
¹⁰ St. Joseph Mercy Oakland, Michigan Cancer Center, 44405 Woodward Ave, Suite 202, Pontiac, MI 48341, USA.
¹¹ https://orcid.org/0000-0002-1819-155X.

Abstract

Introduction: The major objective of the study was to compare and contrast a U.S. and Zambian Ob/Gyn residency programme, using uniform metrics, as the basis for an initial exploration of perceived inequities in post-graduate medical education between low- and high-income countries.

Methods: Measurements of the following procedures were used to indicate whether minimum standards had been met by trainees in their respective postgraduate programmes: vaginal deliveries; C-sections; abdominal, vaginal and laparoscopic hysterectomies; other laparoscopic surgeries; cancer cases; abortions; obstetrical ultrasounds; cystoscopies; incontinence and pelvic floor surgeries. Evaluations were also made with respect to the presence or absence of an official ultrasound rotation, subspeciality and off-service rotations, protected didactic time and exclusive time on obstetrics and gynaecologic clinical services. Comparisons were made relative to these various categories and the average procedural numbers at each level of training to determine differences in trends and degree of exposure.

Results: Minimal procedural requirements were met by both the U.S. and Zambian programmes. For open surgical cases, the minimum standards were higher for the Zambian programme, whereas for procedures associated with the use of high-end technology, such as ultrasound and minimally invasive surgery, minimum standards were higher for the U.S. programme.

Conclusion: There were no significant differences in the Zambian and U.S. Ob/Gyn post-graduate training programmes, relative to their respective metrics. A more extensive analysis is required to determine the actual competency levels that are produced by the respective training systems.

Keywords: U.S. and African postgraduate training; comparisons of postgraduate medical education; inequities in postgraduate training; misperceptions in international research collaborations; post-graduate medical education; postgraduate training in Africa; postgraduate training in low- and middle-income countries (LMICs).