n the last decade, there has been mounting interest in and measures taken for increasing female representation within medicine. Given this attention, we review the current status of women in surgery along with detailed recommendations for rectifying gender disparities (Table 1).

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Background Improvement in outcomes after vaginal hysterectomy (VH) requires accurate identification of complications. We hypothesized that coded data, commonly used to determine morbidity, would miss more complications than chart review. Study Design Medical records of women who underwent VH from January 2004 through December 2005 were reviewed for cardiac or respiratory arrest, congestive heart failure, pulmonary edema, pulmonary embolism, urinary tract infection, ureteral obstruction, hemorrhage, and delirium. Complications were identified with use of coded data, in which diagnoses were classified with a modification of the Hospital Adaptation of the International Classification of Diseases. Results Records of 712 patients were reviewed. Of the 161 complications identified, 158 (158/161; 98.1%) were identified through chart review and 48 (48/161; 29.8%) through coded data. Codes captured all diagnoses of cardiac arrest, respiratory arrest, and pulmonary embolism but missed other complications. Conclusions Codes captured life-threatening complications, but other complications were underestimated or missed entirely. Reliance on coded data for outcome assessments can be misleading and should be combined with other methods to maximize validity.

Introduction and hypothesis Methods to increase surgical preparedness in urogynecology are lacking. Our objective was to evaluate the impact of a preoperative provider-initiated telehealth call on surgical preparedness. Methods This was a multicenter randomized controlled trial. Women undergoing surgery for pelvic organ prolapse and/or stress urinary incontinence were randomized to either a telehealth call 3 (± 2) days before surgery plus usual preoperative counseling versus usual preoperative counseling alone. Our primary outcome was surgical preparedness, as measured by the Preoperative Prepardeness Questionnaire. The Modified Surgical Pain Scale, Pelvic Floor Distress Inventory-20, Patient Global Impressions of Improvement, Patient Global Impressions of Severity, Satisfaction with Decision Scale, Decision Regret Scale, and Clavien-Dindo scores were obtained at 4-8 weeks postoperatively and comparisons were made between groups. Results Mean telehealth call time was 11.1 ± 4.11 min. Women who received a preoperative telehealth call (n = 63) were significantly more prepared for surgery than those who received usual preoperative counseling alone (n = 69); 82.5 vs 59.4%, p < 0.01). A preoperative telehealth call was associated with greater understanding of surgical alternatives (77.8 vs 59.4%, p = 0.03), complications (69.8 vs 47.8%, p = 0.01), hospital-based catheter care (54 vs 34.8%, p = 0.04) and patient perception that nurses and doctors had spent enough time preparing them for their upcoming surgery (84.1 vs 60.9%, p < 0.01). At 4-8 weeks, no differences in postoperative and patient reported outcomes were observed between groups (all p > 0.05). Conclusions A short preoperative telehealth call improves patient preparedness for urogynecological surgery.

Medical education underwent standardization at the turn of the 20th century and remained fairly consistent until recently. Incorporation of a patient-centered or case-based curriculum is believed to reinforce basic science concepts. One negative aspect is a reduction in hours spent with cadaveric dissection in the gross anatomy laboratory. For those entering a surgical career, limited anatomical exposure leaves knowledge deficits that must be corrected during further education during residency training. The benefit of providing formal anatomy education to residents and surgical fellows is described in the literature, specifically noting improvement in written test scores and surgical application.