Descriptive cross-sectional survey.

SOGOC members, October 2011-January 2012.

Target populations defined a priori: G1 residents at FMSB Yaoundé I (N = 58 known), G2 faculty attendings (N = 12 known), G3 non-faculty civil-servant attendings involved in training (denominator unknown estimated ~30), G4 private non-teaching consultants (denominator unknown).

SOGOC member.

Non-member.

Sampling exhaustive for G1/G2, convenience for G3/G4. Participant flow: invited 58 + 12 + unknown; responded 32, 5, 9, 1. Response rate known denominators 37/70 = 52.9%; residents alone 55.2%. No formal sample size calculation as exploratory, aimed for maximum participation.

Developed from validated French surveys adapted. Domains: Demographics, training organization (number of rotations, external rotations, sectorization), satisfaction (binary), factors influencing quality (Like: never/sometimes/most often/always), educational resources (frequency), assessment.

Content validity reviewed by 3 senior OBGYN educators.

Residents+2 consultants not in the final sample for clarity and duration mean 6.2 min. Internal consistency Cronbach alpha of 0.78 for satisfaction/quality items. No test-retest. Questionnaire attached as Supplementary File 1. Missing data: item-specific denominators reported (e.g., 33/37 indicates 10 missing).

Email via a dedicated address, then in-person by investigators to increase participation. Anonymous, no incentive, no sponsorship.

Excel 2003 entry, SAS 9.2. Descriptive: n (%), with 95% CI Wilson. Comparison: Fisher exact test chosen due to small expected counts < 5; groups combined as residents (G1) vs attendings (G2 + G3 + G4) for main comparisons to increase power. Exact p-values reported. No adjustment for multiple comparisons (exploratory, noted as limitation). No multivariable analysis feasible due to n = 47.

Ethical approval University of Buea ref: 2023/0158/UB/AcA/TTSD/TSS/AA and FMSB Administrative Authorization SOGOC/2011/12. Voluntary, informed consent, anonymous. No patient data.

Response bias acknowledged; email vs in-person may influence. Self-report bias. Selection bias due to unknown denominators for G3/G4 [1][2].

Total 47 responses. G1 32/58 (55.2%), G2 5/12 (41.7%), G3 9, G4 1 (Table 1).

Table 1. Participant characteristics and participation.

The majority of the participants were Residents (G1) representing 55.2% (95% CI 41.5 - 68.3).

Only two surgical rotations (visceral surgery and urology) plus gynecology are mandatory for DES at FMSB. 84.4% (27/32) residents considered 2 - 3 rotations sufficient vs 93.3% (14/15) attendings reported having completed > 2 rotations during their own training. Resident-attending relationship: good 42.6% (20/47), pleasant 14.9% (7/47), stressful/confusing 27.7% (13/47), missing 14.9% (7/47) (Table 2).

Table 2. Organization of surgical training.

84% of Residents think 2 - 3 rotations are sufficient, 93.3% attendings completed more than 2 rotations, 71.9% intend external rotation, 80.0% attendings think external rotation improves skills vs 53.1% residents and 59.6% support sectorization.

External Rotations: Among residents without external placement, 71.9% (23/32) intended external rotation, and 53.1% (17/32) perceived it would improve skills. Attendings 80.0% (12/15) agreed external placements improve skills (Table 2).

Sectorization: 59.6% (28/47) supported sectorization, 6.4% (3/47) undecided, 34.0% (16/47) opposed (Table 2).

Satisfaction: 31.3% (10/32; 95%CI 16.1 - 50.0) residents satisfied with current surgical training vs 80.0% (12/15; 95%CI 51.9 - 95.7) attendings satisfied when recalling their own residency training, p = 0.003 (Figure 1).

Figure 1. Satisfaction with 95% confidence intervals. Perceived educational resources and assessment: comparison residents (G1) vs attending physicians (G2 + G3 + G4). Satisfaction with surgical training during residency. Residents currently in training reported significantly lower satisfaction (10/32, 31.3%) compared with attending physicians recalling satisfaction during their own residency (12/15, 80.0%), Fisher exact test p = 0.003. Data are based on self-reported perceptions. Error bars represent 95% confidence intervals (Wilson).

Based on respondent perceptions (n = 47): attending experience -most often 57.4% (27/47), mentorship culture- most often 53.2% (25/47), operative workload- most often 48.9% (23/47). Resident seniority-more often 46.8% (22/47) vs consultant seniority- most often 57.4% (27/47). High number of residents: most often negative only 12.8% (6/47).

Educational Resources (Table 3)

Theoretical: Anatomical knowledge from preclinical years satisfied 10.6% (5/47), partially satisfied 53.2% (25/47). Only 6.3% (2/32) of residents were fully satisfied.

Reported never receiving theoretical surgical courses: 62.2% (28/45); 21/32 residents (65.6%) vs 4/10 faculty (40.0%), p = 0.042.

Reported no access to computer-based resources: 73.0% (27/37); 24/32 residents (75.0%) vs 3/5 faculty (60.0%), p = 0.037.

Table 3. Access to training resources and educational tools. (a) Residents (G1, n = 32) vs teaching consultants (G2, n = 5) vs total (n = 37)—Fisher exact test, 95% CI wilson; (b) Detailed breakdown of simulation/training resources of Table 3.

Interpretation: There was a substantial lack of exposure to simulation-based training: 89.2% had no exposure to laparoscopic pelvic trainers, 97.3% had no anatomy laboratory exposure, and 86.5% had no animal-model exposure. Statistically significant differences between groups were observed for computer-based resources (p = 0.037), library surgical references (p = 0.014), and surgical theory courses (p = 0.042).

Library access: once per semester 14.9% (7/47), once per month 10.6% (5/47), once per week 14.9% (7/47), never 57.4% (27/47) with 2 missing, difference p = 0.014 (Table 3).

Practical Training (n = 37 respondents): Reported never having pelvic trainer sessions 89.2% (33/37), no dissection lab 97.3% (36/37), no animal model 86.5% (32/37). Note percentages reflect reported access/perceptions, not absolute institutional absence (Table 3).

No theoretical assessment 64.4% (29/45), no weighted practical assessment 85.1% (40/47). Assessment when present subjective attending judgment. 97.9% (46/47) desired objective assessment (Table 3).

First national survey in Cameroon, inclusion of residents and attendings, STROBE-compliant, pretested questionnaire Cronbach 0.78.

1) Outdated data 2011-2012 acknowledged but baseline value and persistence constraints; 2) Small sample n = 47 especially only 1 private practitioner limiting generalizability beyond FMSB Yaoundé; 3) Unknown denominators for G3/G4 precluding response rate; 4) Self-reported perceptions not operative volumes; 5) No multivariable analysis due to power; multiple comparisons without correction; 6) Numerical inconsistencies corrected to 76% (22/29); 7) Recall bias; 8) Selection bias.