Race and Gender in the Obstetrics and Gynecology Clerkship: A Mixed Methods Assessment

Abstract

OBJECTIVE: To assess perceptions of the obstetrics and gynecology (OBGYN) clerkship and to observe if either race or gender informs selection of specialty. METHODS: A prospective cross-sectional study was performed among third and fourth year medical students from February-June 2018. Respondents completed an anonymous and confidential online survey examining their perceptions of the field, the clinical clerkship itself and the potential influence of race and gender during the clerkship. Qualitative responses were coded in an iterative process to evaluate for specific themes. Categorical variables were analyzed using the χ2 test. A p-value of less than 0.05 was considered statistically significant. RESULTS: 123 out of 229 (53.7%) medical students responded to the survey. Students were more likely to consider OBGYN as a career choice upon completion of the clerkship compared to before (44.9% vs 31.7%, p=0.03). Eleven percent (11%) of respondents reported race personally affecting their clerkship experience whereas 66% identified gender to be a personal influencer on clerkship experience. Male and under-represented minority (URM) students delineated more negative clinical interactions along with fewer meaningful educational experiences on the clerkship due to a perceived lack of cultural inclusivity. The lack of both racial and gender diversity of faculty, residents and ancillary staff was perceived as fostering an environment of discomfort due to displays of both unconscious and conscious bias. CONCLUSION: Male and URM medical students have disparate experiences on the OBGYN clerkship as compared those who are female or white, with the racial/gender composition of the clinical environment being contributory.