Residents' perspective of women's health curriculum in Internal Medicine and Med-Peds

Abstract

The purpose of our study was two-fold. First, to determine how relevant the women's health topics and skills listed in the FCIM (Federated Council for Internal Medicine (FCIM) Task Force on the Internal Medicine Residency) Curriculum to our graduates' practices. Second, to address the adequacy of our curriculum in meeting our graduates' learning needs. Postgraduate survey through American College of Physician associate members. This cross-sectional survey was conducted amongst the internal medicine and Med-Peds residents (N = 104) (Academic Internal Medicine Center [19], Med-Peds center [3]). A self-administered questionnaire was mailed to all residents. There were 4 items for need assessment, 6 items covering women health issues managed as outpatient, 6 items addressing skills and adequacy of our women's health curriculum to our graduated learning needs and 1 item for evaluations. Responses were recorded on a 5- point Likert scale. The study and the questionnaire were approved by the American College of Physician, Ohio section. The study was exempted from IRB review. More than 70% of the residents feel that they were not well prepared. The majority of items were considered inadequately taught as the mean adequacy of instruction scores were below 2.0 on the 5-point scale. In reference to our first research question regarding the relevance of the 65 FCIM items to our graduates' practices, approximately two thirds were considered relevant (see attached table with any FCIM item rated 4 or more). In our results, the highest adequacy of instruction was in obtaining a bone densitometry and assessing osteoporosis, managing urinary tract infection and vaginitis, and ordering a urine pregnancy test. The teaching and learning efforts in areas such as normal pelvic exam, obtaining and interpreting Pap smear, Mammogram indication and interpretation, Female sexual dysfunction, menopausal symptoms, and contraceptive management are needed to best prepare our graduates for practice. More than 90% of the residents agree that spending time in ambulatory rotations alone may not be sufficient to prepare residents to provide comprehensive care in this field. More than 98% residents agreed that further study of the effectiveness of a dedicated curriculum in women's health is needed. Use of this survey has allowed us to tailor and prioritize learning issues in women's health to meet the needs of our graduates.