A fellow-run clinic achieves similar patient outcomes as faculty clinics: A safe and feasible model for gynecologic oncology fellow education

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Abstract

Objectives: Fellow involvement in patient care is important for education, but effect on patient care is unclear. Our aim was to compare patient outcomes in gynecologic oncology attending clinics versus a fellow training clinic at a large academic medical center. Methods: A retrospective review of consecutive gynecologic oncology patients from six attending clinics and one faculty-supervised fellow clinic was used to analyze differences based on patient demographics, cancer characteristics, and practice patterns. Primary outcome was overall survival (OS); secondary outcomes included recurrence-free survival (RFS), postoperative complications and chemotherapy within the last 30 days of life. Survival analyses were performed using Kaplan-Meier curves with log-rank tests. Results: Of 159 patients, 76 received care in the attending clinic and 83 in the fellow clinic. Patients in the fellow clinic were younger, less likely to be Caucasian, and more overweight, but cancer site and proportion of advanced stage disease were similar. Both clinics had similar rates of moderate to severe adverse events related to surgery (15% vs. 8%, p =.76), chemotherapy (21% vs. 23%, p =.40), and radiation (14% vs. 17%, p =.73). There was no difference in median RFS in the fellow compared to attending clinic (38 vs. 47 months, p =.78). OS on both univariate (49 months–fellow clinic, 60 months–attending clinic vs. p =.40) and multivariate analysis [hazard ratio 1.3 (0.57, 2.75), P =.58] was not significantly different between groups. Conclusions: A fellow-run gynecologic oncology clinic designed to provide learning opportunities does not compromise patient outcomes and is a safe and feasible option for fellow education.

Original languageEnglish
Pages (from-to)209-213
Number of pages5
JournalGynecologic oncology
Volume159
Issue number1
DOIs
StatePublished - Oct 2020

Keywords

  • Administration
  • Ambulatory care
  • Fellow education
  • Health systems
  • Quality care

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