A national survey of obstetrics and gynecology resident perspectives on their preparedness to provide care for racially and socioeconomically diverse gynecologic oncology populations.

Abstract

9037 Background: Despite 83% female representation, Obstetrics and Gynecology (Ob/Gyn) lags behind other residencies in racial diversity, with 35.2% of trainees classified as Underrepresented in Medicine (URM). Fellowships are markedly less diverse, with Gynecologic Oncology representing 26.1% URM. While studies have examined Ob/Gyn residents’ self-perceived preparedness for surgical skills, little is known about their confidence in treating vulnerable patients with gynecologic malignancies. This survey assessed resident confidence in providing Gynecologic Oncology care to patient populations diverse in racial/ethnic background and insurance status, while accounting for residents’ own racial/ethnic backgrounds. Methods: An anonymous, novel Qualtrics survey was disseminated to current US Ob/Gyn residents, to elicit their self-reported preparedness to provide NCCN guideline-based care to diverse Gynecologic Oncology patient populations. Subjects were asked multiple-choice questions to record their own demographics followed by Likert scale questions which ranged from strongly disagree (1) to strongly agree (5) regarding their perceived readiness to care for patients diverse in insurance and racial background. Differences in responses between racial groups were analyzed using the Kruskal-Wallis Rank Sum test while differences in responses between ethnic groups were evaluated using the Wilcoxon Rank Sum test. Results: 207 residents complete the survey, mirroring sample sizes of national surveys of Ob/Gyn residents. There was no statistical difference in self-perceived preparedness between Hispanic and non-Hispanic Ob/Gyn residents regarding providing care for diverse racial minorities (mean Likert Non-Hispanic = 4.1 vs. Hispanic = 4.2; p = 0.222) or insurance types (mean Likert Non-Hispanic= 4.0 vs. Hispanic = 4.0; p=0.563). There was a significant difference in the number of Hispanic residents who felt that patients with Medicaid insurance experienced more difficulty obtaining non-operative gynecologic care compared to those with other insurance types (Hispanic = 3.7 vs. non-Hispanic = 3.2; p = 0.044). Further, there was a significant difference in the number of Hispanic residents who felt that patients with Medicaid insurance had to wait longer for outpatient appointments with a gynecologic oncologist (Hispanic = 3.6 vs. non-Hispanic = 3.0; p=0.016). Conclusions: All Ob/Gyn residents will encounter, screen for, and diagnose gynecologic malignancies, regardless of pursuit of Gynecologic Oncology fellowship. This study evaluated Ob/Gyn resident perceptions, finding that they feel overall prepared to provide Gynecologic Oncology care to socioeconomically diverse patient populations, though differences exist when residents are compared based on their backgrounds.