UF Health OB-GYN residents obtain new minimally invasive surgical certification

Three chief residents in the University of Florida College of Medicine’s department of obstetrics and gynecology are among the first in the nation to receive a new certification in minimally invasive gynecologic surgery.

The residents — Brittany Heck, M.D.; Vasanti Jhaveri, M.D.; and Erika Wert, M.D. — passed the Essentials in Minimally Invasive Gynecologic Surgery, or EMIGS, exam last month after completing required training in June 2022.

EMIGS is a more precisely tailored online training and testing program that better fits the needs of the gynecologic specialty, said Nash S. Moawad, M.D., a professor in and chief of the department of obstetrics and gynecology’s division of minimally invasive gynecologic surgery.

Previously, UF Health OB-GYN residents sought Fundamentals of Laparoscopic Surgery, or FLS, training and certification. But FLS was designed for the general surgeon, he said.

“It’s a testament to the excellence of our residency programs that we are among the first in the United States to make the switch from FLS,” Moawad said. “It’s also a testament to the excellent didactic education and laparoscopic simulation training available to our residents and to the hard work, practice and dedication of our residents.”

Moawad noted the switch to EMIGS came under the leadership of Jessica S. Heft, M.D., an assistant professor in the department of obstetrics and gynecology and its residency program director.

“The shift to a gynecology-specific surgical skills exam has been talked about for many years, so it’s exciting to see that become a reality and even more exciting that UF Health is at the forefront of this innovation,” Heft said.

“Gynecologic surgery skills are not interchangeable with general surgery procedures or pathology,” she added. “Our trainees need to be evaluated in a way that represents our actual practice.”

The American Board of Obstetrics and Gynecology approved EMIGS in May 2022 to meet the standards for board eligibility, and it was made available by the American Association of Gynecologic Laparoscopists, or AAGL, in January. Over 700 residents from 106 residency programs have now made the switch to EMIGS.

“It clearly takes a lot of courage and commitment to be among the first few residents in the nation to take and pass the exam,” said Moawad.

EMIGS training includes three components. The didactic, or educational, component reviews different types of gynecologic minimally invasive surgeries, including laparoscopic, robotic and hysteroscopic. The program includes 80 narrated lectures spanning the gamut of evidence-based knowledge in minimally invasive gynecologic surgery, according to the AAGL.

The other components of EMIGS are the cognitive and the manual skills tests. The cognitive test is a multiple-choice exam scored to the standards set by the AAGL and EMIGS steering committee for OB-GYN residents.

The third component is a virtually proctored test in which residents demonstrate their surgical skill using a proprietary pelvis-shaped platform called a LaparoBowl. This requires the residents to demonstrate mastery of five essential laparoscopic tasks that are timed and recorded for scoring.

“This simulates the surgical environment of operating in the pelvic cavity rather than on a flat surface,” as is the case with other training methods, said Moawad, who serves as chair of the EMIGS steering committee for the AAGL.

The EMIGS program was designed and built with input from hundreds of gynecologic faculty members from institutions across the nation, he said.