Trends in Psychiatric Education Among Obstetrics and Gynecology Residency Programs: A Program Director Survey [9C

Abstract

INTRODUCTION: One-third of women in the U.S. receive primary care exclusively from Obstetrician/Gynecologists. Recent literature reveals gaps in recognition of common psychiatric issues by Ob/Gyns. METHODS: Program directors of 239 Ob/Gyn residencies received a 17-item anonymous questionnaire to assess the status of psychiatric education. Analysis included descriptive statistics, Student’s t-tests, and logistic regression. RESULTS: 95 programs (40%) responded. 84% offered didactic instruction in psychiatric topics, of which 70% were taught by Ob/Gyn faculty. Few programs covered intimate partner violence (47%), non-obstetric depression (44%), anxiety (43%), medication management (31%), eating disorders (26%), human trafficking (20%), or PTSD (11%). 20% of programs offered an elective rotation. The most common barriers to psychiatric training were lack of sufficient integration between Ob/Gyn and psychiatry (46%), ACGME surgical requirements (42%), and lack of sufficiently knowledgeable instructors (38%). 81% of program directors did not agree that their residents are fully equipped to identify psychiatric needs in patients; however, only 22% agreed with the addition of an ACGME milestone for mental health. Community programs and those who identified lack of integration as a barrier were more likely to agree with adding a milestone (p=0.003). CONCLUSION: Significant gaps exist in psychiatric education of Ob/Gyn residents, and most program directors perceive that residents are not equipped to identify patient psychiatric needs. The most common barrier to providing additional training was a lack of integration between Ob/Gyn and psychiatry; future efforts should be directed towards this. However, the addition of a new milestone would likely meet considerable resistance.