Objective: To determine the role and significance of anatomy in the practice of obstetrics and gynaecology (O&G) and the relationship between the importance of anatomy and the acquisition of anatomical knowledge. Design: Explorative qualitative study. Setting: Belgium and the Netherlands. Population: Twelve gynaecologists and gynaecology trainees. Methods: Semi-structured Interviews including questions on the importance of anatomy in the practice of O&G. Main Outcome: Themes to understand the role of anatomy. Results: The role of anatomy in the practice of O&G lies in three areas: 1. daily activities 2. for the feeling of self-efficacy; 3. to gain a respected name as a doctor. Motivation plays a central role to which extent anatomy knowledge is actually obtained and seems to come quite late during postgraduate training or even while being already a gynaecologist. Stimulating factors for obtaining knowledge are responsibility, patient problems, new techniques and supervisors who pay attention to anatomy. Barriers are found in the feeling of insecurity and the lack of a reference. Conclusions: Although anatomical knowledge plays an important role in gynaecology practice, this importance is frequently not recognized until late in postgraduate training. This may have a negative impact on patient safety, as this late realisation can negatively affect knowledge acquisition. Trainees require reasons for action early in their curricula. Change in trainee motivations and innovations in teaching methods may optimise the process of knowledge acquisition. The overarching goal should be to educate doctors to work safely and with a high degree of self-efficacy.

Objective: To determine the anatomy knowledge in postgraduate obstetrics and gynaecology trainees. Our hypothesis was that trainees possess a good knowledge of anatomy and, on average, would correctly answer at least 80% of questions on core anatomy knowledge. Design: A 10-year longitudinal study. Setting: This study included the results from annual progress tests over 10 years (2010–2019) that were completed by Dutch obstetrics and gynaecology postgraduates. Population: Dutch trainees in the field of obstetrics and gynaecology. Methods: Anatomy questions included in a yearly progress test were assessed for their relevance. Relevance was determined according to a previous Delphi study, which identified 86 structures that are essential for the safe and competent practice of general gynaecologists. Scores on relevant anatomy questions were calculated. Main Outcome Measures: The mean percentage correct answers. Results: Of all 1637 questions of the yearly progress test, 54 were anatomy-related questions (3.3%). Of these 54 questions, 38 (70%) were considered as relevant questions. The mean 10-year correct response rate on relevant questions was 64.5%. Conclusions: The anatomy knowledge of obstetrics and gynaecology trainees is insufficient. Our results highlight the need to test and improve anatomy knowledge during postgraduate obstetrics and gynaecology training. Funding: None. Keywords: anatomy knowledge, progress testing, obstetrics and gynaecology, postgraduate training

Objective: international validation of the Dutch Delphi consensus study about which anatomical structures that should be taught to ensure safe and competent practice among general gynaecologists. Design: Validation study. Setting: Academic, non-academic teaching and non-academic, non-teaching hospitals worldwide. Population: Gynaecologists and trainees in gynaecology. Methods: The relevance of 123 items included in the Dutch Delphi study was scored on a Likert scale between 1 (not relevant) and 5 (highly relevant). Consensus was defined when  70% of the panellist scored the item as relevant or very relevant and the average rating was  4. Main Outcome Measures: Clinically relevant anatomical structures. Results: A total of 192 gynaecologists and trainees from seven countries (Belgium, Germany, Norway, Oceania, Sweden, United Kingdom and United States) completed the questionnaire. Of the 123 structures, 72 (58.5%) were internationally relevant. When the 72 relevant structures from the international Delphi study were compared with the 86 relevant structures from the Dutch Delphi study, 70 (81.4%) structures matched. Conclusions: This study identified 70 anatomical structures that should be taught for safe and competent practice of general gynaecologists based on national and international validation. The results of our study identify the learning needs (i.e., the content) for an international anatomy curriculum. The development of the curriculum (i.e., the form) can be determined by each country and used to standardize and guide postgraduate training in gynaecology. This is an important step in the era of international teaching and training.