Gynecology Residency Programs Research Articles

Successful Implementation of the AIUM Standardized 4-Year Residency Ultrasound Curriculum in Obstetrics and Gynecology: Lessons Learned and Way Forward.

Significant disparities in sonographic education exist in Obstetrics and Gynecology programs in the United States. To address the lack of standardization in ultrasound teaching, the American Institute of Ultrasound in Medicine (AIUM) assembled a multi-society task force in 2018 that resulted in the publication of a Consensus Report outlining a standardized ultrasound curriculum and competency assessment. The primary objective of the study was to implement the AUIM standardized curriculum within an Obstetrics and Gynecology residency program at a tertiary medical center, and report on the early implementation experience. The secondary objective was to assess current national practices in ultrasound training in Obstetrics and Gynecology residency programs. Study design was an effectiveness-implementation hybrid study of a structured ultrasound educational program based on the 2018 AIUM Consensus Report. The theoretical portion of the curriculum consisted of 26 hours of didactic lectures distributed over 4 years. For the practical component, residents received instruction from faculty and sonographers and independently acquired the required images as part of their regular clinical work. Simulator app access was also provided for additional opportunities to practice and acquire images. Deidentified images for the required competencies were uploaded to a WhatsApp group for review. Theoretical knowledge was assessed with a series of multiple-choice exams. Practical skills were assessed through grading of images submitted through WhatsApp as well as direct observations of resident scans. At the completion of 4 years, the assessment of both theoretical knowledge and practical skills was carried out using the ISUOG Basic Training Examination. National patterns in the area of ultrasound education were assessed with a four-question electronic survey of Obstetrics and Gynecology program directors in the United States. Analysis of both portions of the study was primarily descriptive. Four Obstetrics and Gynecology residents completed the curriculum spanning postgraduate years 1 through 4. The number of competencies completed ranged from 7 to 19 out of 41. All of the residents passed the theoretical and practical components of the ISUOG Basic Training Examination. For the residency program director survey portion of the study, response rate was 20% (59 of 290). Among the respondents, 55.9% reported having a structured curriculum and 34.4% reported implementing the AIUM curriculum. The two most commonly cited obstacles to implementation of structured ultrasound teaching were uncertainty with how to start the process (49.2%) and lack of faculty engagement (49.2%). Implementation of the AIUM Curriculum within the framework of an Obstetrics and Gynecology residency program at a tertiary medical center is feasible. In our experimental group, completion of the curriculum resulted in passing of an internationally recognized validated assessment. Obstacles to implementation in our program included a wide range of engagement and participation among residents, and limited opportunities to obtain some of the required competencies. Identification of obstacles to implementation from the perspective of residency program directors is critical for developing targeted approaches to ensure widespread implementation. Successful standardized validated sonographic training of graduating Obstetrics and Gynecology residents is crucial for this operator-dependent modality that has tremendous implications on patient safety and clinical care.

Exposure to the reproductive endocrinology subspecialty among obstetrics and gynecology residency programs.

Prior studies found that Ob-gyn trainees believe they have inadequate experience in the REI subspecialty. We evaluated the amount of time devoted to REI within the 4-year rotation schedule of ACGME-accredited Ob-gyn residency programs. A list of current Ob-gyn residency programs, both with and without REI fellowships, was created using ACOG and ACGME databases. The programs' websites were reviewed, or the program coordinator was queried to determine the length and year of REI rotation, and the career or fellowships pursued by alumni. Wilcoxon rank sum test was utilized to assess differences in total REI rotation time between REI-affiliated and non-affiliated programs. Spearman's correlation was utilized to assess the association between total REI exposure and the percentage of alumni pursuing REI fellowships. Cumulative length of REI rotations throughout residency ranged from 0 to 20weeks. Mean cumulative rotation length was greater in non-REI than in REI-affiliated programs (7.4weeks vs. 6.1weeks, p = 0.007). However, REI-affiliated programs had greater exposure to REI rotations during the first 2years of residency (3.9weeks vs 3.1weeks, p = 0.042). Among all programs, 24% had the REI rotation in PGY-1, 61% in PGY-2, 50% in PGY-3, and 16% in PGY-4. The proportion of alumni matching in REI fellowship was significantly greater in REI-affiliated programs than non-REI affiliated programs (9.5% vs. 3.1%, p < 0.001). Compared to non-REI affiliated programs, Ob-gyn residencies affiliated with REI fellowships spend less time throughout residency training in REI rotations while sending a greater proportion of residents to REI fellowships.

Importance of abortion training to United States Obstetrics and Gynecology residency applicants in 2023

ObjectiveNearly half of obstetrics and gynecology (OB/GYN) residency programs in the United States lost access to local training in abortion care following the 2022 Dobbs v Jackson Supreme Court decision. We aimed to determine whether OB/GYN residency candidates who desire abortion training apply to programs in states where abortion is restricted/banned. Study DesignIn 2023, we conducted an anonymous electronic survey of residency interviewees at three large academic OB/GYN programs about the importance of various program characteristics in their selection process. We chose to represent both very restrictive and protective environments for abortion care. We stratified respondents by importance of abortion training in applying to programs (essential or very important [high preference group] versus moderately, slightly, or not important [low preference group]). ResultsWe analyzed 175 completed surveys (response rate 56%). Of 175 respondents, most (n=115, 66%) stated that access to abortion training was essential (33%) or very important (33%) when applying to programs. Both high preference group (82%) and low preference group respondents (98%) applied in states where abortion is banned or restricted. Respondents applied in banned/restricted states due to geography, concern about applying to too few programs, and expectation that the program would provide out-of-state training nonetheless. ConclusionThe majority of survey respondents who reported that access to abortion training during residency is essential or very important applied to programs where abortion training is not locally available. Most of these applicants expected programs in restricted states to provide training regardless. ImplicationsResidency programs should be aware of the importance of abortion training to applicants, as well as abortion training expectations, and work to develop opportunities and strengthen training networks in abortion care to meet candidates’ needs and ensure adequate learning opportunities exist for all.

Assessment of Second Victim Trauma Resources for Obstetrics and Gynecology Residents [ID 2683424

INTRODUCTION: Second victim trauma (SVT) encompasses psychological, cognitive, or physical symptoms experienced by health care providers after adverse events. Obstetrics and gynecology trainees may be more vulnerable to SVT given their exposure to adverse events and lack of experience. Our objective was to assess the background knowledge of SVT among obstetrics and gynecology residency program directors (PDs) and the curricula and resources available to support obstetrics and gynecology trainees. METHODS: An 18-question survey was developed and disseminated to all 295 obstetrics and gynecology PDs. The survey assessed baseline knowledge of SVT, psychological resources available, knowledge regarding the SVT validated screening tool, and personal experiences. Descriptive and statistical analysis was performed using STATA, Version 12. RESULTS: A total of 99 PDs completed the survey (34% response rate). 92% of PDs had heard of SVT, and 82% felt they could identify its signs/symptoms. 41% of programs had SVT in the curricula. 28% of programs exist in hospitals with an SVT program, and 60% have trained clinician peer supports. Program directors who have an SVT curriculum were twice as likely to be familiar with validated survey tools for SVT (P=.004), and 2.7 times more likely to identify warning signs that a resident may need additional support (P&lt;.001). 86% of PDs would like additional education on SVT. CONCLUSION: The majority of obstetrics and gynecology residency PDs are aware of SVT and have an idea of how to identify this in their residents. The rates of embedded resources vary across the country. Additional education and curriculum development focused on SVT may benefit obstetrics and gynecology PDs and trainees.

Correlation Between Residency Program Characteristics and American Board of Obstetrics and Gynecology Certifying Examination Passage Rates [ID 2683567

INTRODUCTION: The correlation between obstetrics and gynecology residency program size and type with certifying examination passage rates is not previously reported. Our objective was to evaluate the relationship between residency program size and type with American Board of Obstetrics and Gynecology (ABOG) certifying examination (CE) pass rates. METHODS: This is a cross-sectional study of ABOG specialty CE passage rates from 2020 to 2022. The CE passage rates were obtained from the ABOG website and stratified by program size (small 3–4, medium 5–7, large &gt;8 residents per class) and type (community-based; community-based, university-affiliated; and university-based). Military-based programs were excluded, as were programs of unknown size. Passage rates were compared among groups using chi-squared test. RESULTS: During the study period, 3,766 candidates sat for the CE. Small programs accounted for 730 candidates (19.4%), 1,805 (47.9%) candidates from medium programs, and 1,231 candidates (32.7%) from large programs. Passage rates were higher among medium and large programs versus small programs (small [604/730; 82.7%], medium [1,656/1,805, 91.7%], and large [1,149/1,231; 93.3%]; P&lt;.001). Passage rates among community-based candidates (299/347; 86.2% pass rate) and community-based university-affiliated candidates (962/1,100; 87.5% pass rate) were lower versus university-based candidates (2,148/2,319; 92.6% pass rate; P&lt;.0001). CONCLUSION: During the study period, university-based programs and medium or large programs had higher CE passage rates. There are a number of limiting factors to the interpretation of the results such as academic differences upon entry to residency, resources available at each program, and amount of dedicated study time. A causal effect of program size and type cannot be assumed.

Implementation of a robotic surgery curriculum in an obstetrics and gynecology residency program

Implementation of a robotic surgery curriculum in an obstetrics and gynecology residency program

Rapid Root Cause Analysis: Improving OBGYN Resident Exposure to Quality Improvement and Patient Safety Curricula.

Introduction Each year, millions of patients in the United States experience harm as a result of the healthcare they receive. One mechanism used by health systems to learn how and why errors occur is root cause analysis (RCA). RCA teams develop action plans to create and implement systemic changes in healthcare delivery in order to prevent future harm. The American Council on Graduate Medical Education (ACGME) recognizes the importance of analyzing adverse events, and it requires that all residents participate in real or simulated patient safety activities, such as RCAs.Often, institutional RCAs necessitate the assimilation of participants on short notice and demand considerable time investment, limiting the feasible participation of graduate medical education (GME) trainees. This presents a gap between ACGME expectations and the reality of resident involvement in patient safety activities. We present the first iteration of a quality improvement project encompassing a three-hour resident physician training course with simulated RCA-experiential learning. The purpose of this project was to produce a condensed, educational RCA experience that adequately trains allGME learners to serve as informed healthcare safety advocates while also satisfying ACGME requirements. Methods The course ("rapid RCA") was conducted during protected weekly academic training. All residents of the San Antonio Uniformed Services Health Education Consortium (SAUSHEC) Obstetrics and Gynecology (OBGYN) residency program who had not previously participated in a real or simulated RCA were required to take the "rapid RCA." Pre- and post-course surveys were completed anonymously to assess baseline knowledge, new knowledge gained from the course, and attitudes toward the course and its importance to resident training. Results Fourteen OBGYN residents attended the "rapid RCA," indicating that 64% (14 out of 22) of the program had no previous experience or opportunity to participate in a real or simulated RCA. Participation in the course demonstrated a significant gain of new knowledge with an increase from 0/14 to 10/14 (71%) residents correctly answering all pre- and post-course questions, respectively (p < 0.001). Additionally, on a Likert scale from 1 to 5, with 5 indicating "expert level," residents indicated they felt more comfortable on patient safety topics after taking the course (mean pre-course score 1.85 to post-course score 3.64,p < 0.001). All participants indicated they would prefer to take the "rapid RCA" as opposed to the only available local alternative option for a simulated RCA, currently offered as a full-day intensive course. Conclusion A meaningful increase in patient safety knowledge and attitudes toward topics covered in an RCA was demonstrated through the implementation of a "rapid RCA" in OBGYN residents. We plan to incorporate this into our annual curriculum to satisfy ACMGE requirements. This format could be adapted for other specialties as applicable.

Obstetrics and gynecology applicant perceptions of residency program culture with virtual interviews: a qualitative analysis of social media posts

BackgroundIn the United States, Obstetrics and Gynecology residency interviews are instrumental in assessing the compatibility between medical student applicants and residency programs during the match process. Applicant perceptions of Obstetrics and Gynecology residency culture are a key component in determining how they rank residency programs. In 2020, residency interviews transitioned to a virtual format, and little is known about how applicants evaluated program culture during this first round of universal virtual interviews. Medical students in the United States commonly use Reddit, a popular social media platform, to discuss residency programs and share interview experiences. We explored Obstetrics and Gynecology applicants’ considerations regarding residency program culture during the first universal virtual interview season in 2020–2021 by analyzing posts on a Google spreadsheet accessed through Reddit.MethodsIn 2022, we imported 731 posts from the “2020-21 OB GYN Residency Applicant Spreadsheet” Google spreadsheet posted to the 2020–2021 Residency Interview Spreadsheet megathread on the r/medicalschool subreddit to NVivo 12(QSR International, Burlington, MA), a qualitative analysis software program. Three investigators used qualitative inductive techniques to code and identify themes.ResultsApplicants used visual, verbal and behavioral cues during virtual Obstetrics and Gynecology residency interviews to understand three components of the workplace culture: prioritization of diversity, equity and inclusion, social environment, and resident workload.ConclusionsObstetrics and Gynecology residency programs convey information about their culture during virtual interviews through the behavior, appearances and responses of residents and interviewers to applicant questions. To ensure they accurately represent their culture to applicants, programs should consider educating residents and faculty around the implications of interview-day conduct.

Resident Education Curriculum in Pediatric and Adolescent Gynecology: The Short Curriculum 4.0

Exposure to pediatric and adolescent gynecology (PAG) varies across residency programs in obstetrics and gynecology, family medicine, and pediatrics, as well as both adolescent medicine and PAG fellowship programs. Nevertheless, these programs are responsible for training residents and fellows and providing opportunities to fulfill PAG learning objectives. To that end, the North American Society for Pediatric and Adolescent Gynecology has taken a leadership role in PAG trainee education by creating and maintaining this Short Curriculum. The curriculum outlines specific learning objectives central to PAG education and lists high-yield, concise resources for learners. This updated curriculum replaces the previous 2021 publication with a new focus toward accessible online content and updated resources.

Trauma-Informed Care Training in U.S. and Canadian Ob/Gyn Residencies.

This is a cross-sectional study investigating the prevalence and nature of trauma-informed care (TIC) training in obstetrics and gynecology residency programs. In our sample, 20% of programs had annual TIC training, 53% had less than annual training, and 27% had no training at all. Only 25.3% of respondents were satisfied with their current training in interpersonal trauma and TIC. A lack of facilitators to conduct such training was the primary barrier to implementing TIC. Significant opportunity exists to improve TIC education for Ob/Gyn trainees.

Religious and cultural diversity support across US based obstetrics and gynecology residency program

Religious and cultural diversity support across US based obstetrics and gynecology residency program

Social media trends in obstetrics and gynecology residency programs on Instagram and X (Twitter).

During the COVID pandemic, residency program's social media presence increased to aid in residency recruitment by attempting to increase engagement and readily available information for applicants across specialties. However, little information exists on what characteristics and content on obstetrics and gynecology (OBGYN) residency program accounts attract more followers or engagement. To identify social media trends in OBGYN residencies and determine which aspects of programs influence the number of followers and interaction with content posted. We performed a retrospective review of ACGME accredited OBGYN programs and determined their presence on Instagram and X in the fall of 2021. Content from the thirty programs with the most followers was analyzed independently by two authors. Multivariate analysis and a linear mixed model were used to characterize and evaluate content on Instagram and X. Most programs utilized Instagram (88.5%, N = 262/296) and were managed solely by residents (84.4%, N = 108/128). Number of followers on Instagram positively correlated with features such as program size, Instagram profile duration, and Doximity rankings (p < 0.0x01). Programs on X had more followers if their profile had a longer duration, followed more individuals, or were ranked higher on Doximity. The most posted Instagram content was biographical and social in nature. Instagram posts with the highest engagement were awards and/or the Match. Understanding what social media content attracts more followers and increases engagement is crucial as it likely impacts OBGYN resident recruitment. Professional groups should establish guidelines for social media use in recruitment for the protection of both residents and applicants.

Program Signaling in Obstetrics and Gynecology Residency Applications.

The objectives of this study were to evaluate how obstetrics and gynecology residency program directors used applicant signaling and to understand how two tiers of signals influenced interviews, ranking, and matching into programs. A multimethod, deductive-sequential design was employed using a national survey of residency program directors and a convenience sampling of programs to study how obstetrics and gynecology program directors used program signals in the 2022-2023 residency-application cycle. A total of 80.5% (236/293) of program directors receiving the survey provided information about signaling, and 20 programs provided application outcome data for applicants who signaled them. The majority of program directors (86.9%) opted into signaling, 43.4% used signals as part of their initial screening, and 33.1% used it as a tiebreaker after reviewing applications, with 45.4% feeling it improved their ability to conduct a holistic review and 41.5% inviting applicants they may not have invited previously. Among programs providing applicant data, the influence of signals on the chances of an applicant being interviewed varied, but an overall strong positive effect of signaling was observed across the sample. The mean rank was 42 for gold signals, 45 for silver, and 38 for no signal (F(3)=5.97, P <.001). Signaling was widely used by programs and was an effective tool to allow applicants to communicate real interest in a program. Signaling was associated with an increased likelihood of an applicant's being interviewed but did not influence an applicant's position on the rank list.

A Framework for Diversifying Obstetrics and Gynecology Training Programs.

There is an urgent need to diversify the physician workforce in obstetrics and gynecology to serve a diverse patient population and mitigate disparities in care. There is a paucity of data on how to improve recruitment of individuals from underrepresented minoritized groups to the field of obstetrics and gynecology. This article outlines important steps for sharing the department's commitment to diversity, equity, and inclusion; addresses ways to attract a diverse applicant pool; and reviews the importance of and need to perform a holistic review of applicants. This commentary also shares some approaches to support faculty and trainees that may lead to sustained increases in diversity. Using this framework, the authors successfully increased the diversity of their obstetrics and gynecology residency program.

Ethics education among obstetrics and gynecologists in Saudi Arabia: a cross-sectional study

There are a lot of efforts to promote ethics education and training at an undergraduate and postgraduate level around the world, including in Saudi Arabia. However, there is still a lack of structured ethics education curricula in obstetrics and gynecology residency programs in Saudi Arabia. In the current scenario, where new ethical dilemmas are emerging, an ethics education that only focuses on teaching the ethical principles does not enhance the competence to deal with the ethical challenges in daily practice. This study evaluates the lack of ethics education and training in obstetrics and gynecology residency programs in Saudi Arabia. A cross-sectional survey of working obstetricians and gynecologists in Saudi Arabia was conducted among all working levels of doctors (the residents, registrars, consultants, and program directors) from various hospitals of Saudi Arabia. 391 practitioners responded to the survey, representing a response rate of 39.1%, including 257 (66.4%) females and 130 (33.6%) males. 74 (23.0%) received formal education (medical school = 35%; residency programs = 11.8%; sub-specialty programs = 4.3%; postgraduate programs = 7.4%), 85 (26.4%) received informal education (online training = 12.8%; conferences = 18.9%; courses and workshops = 13.3%; self-learning = 31.7% and daily practices = 20.7%), and 78 (19.95%) received no ethics education. Almost all the respondents had a positive attitude towards ethical principles, but a least percent were competent to deal with the ethical challenges. The bottom line of this survey is the imperativeness of reinforcement of formal ethics education in obstetrics and gynecology postgraduate programs in Saudi Arabia.

Competitiveness of Obstetrics and Gynecology Residency Programs and Applicants.

Competitiveness of Obstetrics and Gynecology Residency Programs and Applicants.

Transparency around abortion training on obstetrics and gynecology residency program websites

ObjectivesThe availability of family planning and abortion training in residency is a concern for applicants, particularly following the overturning of Roe v Wade. We aimed to characterize public information on abortion training in obstetrics and gynecology residency programs in states with and without abortion bans. Study designWe abstracted residency program data using a publicly available database of obstetrics and gynecology residency programs. We performed a systematic internet search of each program’s website to identify information on abortion training. We defined states with abortion bans as those with total or near-total bans as of November 2022. Using Stata SE 16, we used Student t tests and Fisher exact tests to characterize differences between programs with public abortion training information and those without. ResultsOf 293 obstetrics and gynecology residency programs, 197 (67.2%) included online information regarding abortion training. Of 64 programs in states with abortion bans, 34 (53%) had public information regarding abortion training, compared to 163 (71%) of the 229 programs in states with legal abortion. Programs with publicly available abortion training information were more likely to be academic (49.8% vs 26%, p < 0.001) and have a higher percentage of female residents (86.6% vs 82.9%, p = 0.003). Programs in states with legal abortion were more likely to use words like “abortion” (36.2% vs 17.7%, p = 0.05). ConclusionsOnly two-thirds of obstetrics and gynecology residency programs publicize abortion training information. Almost half of all programs in states with abortion bans do not share this information, revealing a need for improved transparency to better inform residency applicant decision-making. ImplicationsDuring the 2022–2023 academic cycle, one-third of obstetrics and gynecology residency programs did not include information about family planning or abortion training online. In states with abortion bans, this number increased to almost one-half. These findings serve as a call to action for programs to clarify their commitment to abortion training.

Abortion training in U.S. obstetrics and gynecology residency programs in a post-Dobbs era

ObjectivesThe Accreditation Council for Graduate Medical Education requires all obstetrics and gynecology residents have access to abortion training. The impact of Dobbs on training remains unknown. We aimed to describe residency programs affected by abortion bans and those lacking abortion training despite permissive state policies. We considered demographic data to understand the impacts on residents under-represented in medicine. Study designWe used residency databases and websites to abstract data. We identified programs offering routine abortion training as either those with Ryan Programs or those with website or email acknowledgment of training. We defined states with abortion bans as those with either complete or 6-week bans as of December 2022. We used χ2 and Student’s t tests in descriptive analyses and performed a logistic regression to adjust for demographic and program-specific variables. ResultsOf 286 residency programs included, 140 (49%) offered routine abortion training prior to Dobbs. As of December 2022, 19 of these (14%) had lost the ability to provide routine in-state abortion training. Of 223 residency programs in states with legal abortion, 102 (46%) programs lacked routine abortion training. These sites were more likely to be community or community-university programs, with graduates more likely to practice as generalists. Resident race/ethnicity did not differ between residents in states with legal abortion vs abortion bans. ConclusionsNearly half of obstetrics and gynecology residency programs in states with legal abortion do not appear to provide routine abortion training. Further work is needed to understand this paucity of training and maximize access in legislatively permissible environments. ImplicationsFollowing Dobbs, 14% of residency programs lost in-state abortion training. Notably, in states with legal abortion, 46% of programs lack routine abortion training despite permissive legislation. This presents a window of opportunity for expansion of abortion training, particularly at community and community-university hybrid residency sites.

Needs assessment of menopause education in United States obstetrics and gynecology residency training programs.

This study aimed to assess the variance in menopause education, educational resources, and the needs of obstetrics and gynecology (ObGyn) residency programs by conducting a national survey of program directors (PDs). In 2022, an institutional review board-approved Web-based Qualtrics survey was designed and distributed electronically to 145 US ObGyn residency PDs. The survey consists of 15 questions. The main outcomes are reported using descriptive statistics. The survey was completed by 99 of 145 PDs (68.3%). Almost all participants (92.9%) strongly agreed that residents nationwide should have access to a standardized menopause curriculum that could be utilized in their programs. Only 31.3% reported having a menopause curriculum in their residency program. Of the programs with a menopause curriculum, 96.8% reported using lectures, 77.4% reported assigned readings, and 74.2% had either dedicated menopause clinics or other clinics with a high volume of menopausal patients. Of all programs surveyed, only 29.3% reported that trainees had dedicated time assigned to a menopause clinic. A total of 83 of 99 PDs agreed or strongly agreed that their programs needed more menopause educational resources, and most (89.7%) stated they were likely or very likely to use self-paced menopause modules that include performance feedback if available. Data from the needs assessment questionnaire revealed that menopause education and resources vary across residency programs, with the majority lacking a dedicated menopause curriculum. Most PDs expressed a desire for more educational resources and standardized training materials, and preferred to access an online national menopause curriculum.

Resident perception of obstetrics and gynecology residency breast disease curriculum: a national study

As part of the education objectives in obstetrics and gynecology residency programs, the Council on Resident Education in Obstetrics and Gynecology includes benign breast disease and breast cancer screening, diagnosis, and management. However, obstetrics and gynecology residency curricula vary highly in their focus on this subject. The comfort level of the average obstetrics and gynecology resident in the United States in managing breast disease is unknown. This study aimed to examine the perspective of obstetrics and gynecology residents in the United States on their education and training in breast disease. An 18-question survey was distributed to all Accreditation Council for Graduate Medical Education program coordinators to distribute to their residents collect demographic information, training environment, and perspective on breast disease education. All statistical analysis was performed using SPSS (version 2.0; IBM Corporation, Armonk, NY). The survey was distributed to 241 programs, and a response was received from 28 programs (a program response rate of 12.0%). Based on the programs' response, there was a total of 582 eligible residents, and the survey was completed by 180 residents (a response rate of 31.0%). Of all responses, 121 residents (67.2%) did not have a dedicated breast disease rotation or clinical time. Most residents were uncomfortable with their education, training, and ability to manage benign breast disease (mean of 4.14 on a scale of 1-10). Most residents desired additional dedicated time to breast education during their obstetrics and gynecology training. The only variable associated with an improved resident comfort level for the management of breast disease was dedicated clinical time (relative risk [RR], 2.0; 95% confidence interval [CI], 0.04-1.45; P=.04). Obstetrics and gynecology residency programs should consider adding dedicated clinical time to breast disease to increase their residents' comfort with breast disease management.