Resident Physiciansʼ Comfort with Managing Irritable Bowel Syndrome at the Completion of Internal Medicine Residency

Abstract

Purpose: Irritable bowel syndrome (IBS) is a common gastrointestinal disorder. It is one of the top ten diagnoses seen in primary care practices and one of the top three diagnoses in gastroenterology practices. It is important that internal medicine resident physicians are comfortable managing IBS. This study evaluted internal medicine resident physicians' comfort level in managing IBS and evaluated the effectiveness of various learning modalities. Methods: An anonymous survey addressing core gastroenterology topics was distributed to all PGY-3 internal medicine resident physicians at an urban university medical center. Information was collected about the benefit of various teaching modalities during residency training and resident physicians' comfort level with gastroparesis management. The teaching modalities evaluated included attending rounds, autopsy conference, didactic rounds, direct patient care (inpatient and outpatient), grand rounds, individual reading, journal club, morning report and noon conference. Information was obtained on whether resident physicians participated in a gastroenterology elective. A database was developed. Statistical analysis was performed using Chi-square tables with statistical significance set at P < 0.05. Results: Twenty of 29 (69%) completed surveys were returned. Outpatient care and individual readings were reported as the two most beneficial teaching modalities. Formal teaching such as didactic rounds and grand rounds were not reported to be beneficial. There was a statistically significant difference (P= 0.0042) showing that the care of outpatients was a better instructional method for IBS management when compared to didactic rounds. Additionally, there was a statistically significant difference (P= 0.00057) showing care of outpatients to be a more effective method of teaching IBS management than grand rounds. 60% of resident physicians completing a gastroenterology elective felt that more emphasis should be placed on IBS management in the residency curriculum. Only 25% of residents reported comfort in managing IBS at the completion of training. Conclusion: Irritable bowel syndrome is a common gastrointestinal disorder. It is important that physicians can manage IBS effectively. Care of outpatients is an effective modality for resident physicians to learn IBS managment. However, the majority of resident physicians were uncomfortable in managing IBS upon completion of training. Exposing resident physicians to more outpatients with IBS and the development of educational initiatives should be considered to improve internal medicine resident physicians' comfort with IBS management and to enhance the internal medicine residency curriculum.