OBGYN Residents Research Articles

Assessing emergency room leadership of ObGyn residents in a public university teaching hospital of Sindh, Pakistan: a cross-sectional survey

BackgroundLeadership is a critical competency for medical professionals, yet it is often neglected in medical training. For ObGyn residents, leadership training is particularly crucial as it significantly impacts both maternal and newborn outcomes, as well as the operational efficiency of healthcare teams. The main objective of this study was to assess the perceptions of obstetrics and gynecology residents who served as group leaders in the emergency team at the Department of Gynecology, Ward 3, Dr. Ruth K.M. Pfau Civil Hospital Karachi.MethodsA Cross-sectional survey was conducted with purposively sampled 28 year-4 residents who worked as group leaders during last 3 years (from 2018 to 2020) of their residency program at the emergency team in the department of Gynecology Ward 3 Dr Ruth KM Pfau Civil Hospital Karachi. The perceptions on leadership were assessed on 25 items scale sent through a questionnaire on email. Grading of responses was done using a 4-point ordinal scale where 1 meant little importance and 4 was regarded as having great importance. Data was summarized with relevant descriptive statistics and was analyzed on SPSS version 22.ResultsThe mean age of residents was 30.36. The mean leadership scores of the group of residents were calculated to be 77.50 (SD ± 9.57) while 14(50%) residents showed good and 14 (50%) showed excellent leadership skills based on cumulative scores. Of the 25 traits examined in this study, the highest reported trait was humility 3.82 (± 0.39) followed by empowerment 3.68 (± 0.77) and effective communication 3.68 (± 0.77). While responding about learning experiences, 89.3% of participants felt that the experience enhanced their decision-making skills and boosted their confidence in dealing with emergencies.ConclusionOur study highlights the critical importance of leadership development in the training of ObGyn residents, particularly in high-pressure emergency settings. The findings reveal that residents value leadership traits such as humility, empowerment, and effective communication, which are essential for building teamwork and ensuring optimal patient outcomes and patient satisfaction.

Improving OBGYN resident CREOG scores

Background: OBGYN residents take an annual in-service training exam from the Council on Resident Education in Obstetrics and Gynecology (CREOG). The CREOG exam is used within the residency program to identify areas of improvement in education and to help residents prepare for passing the written boards. Introduction: This study’s aim was to improve knowledge and preparation for the CREOG exam through an improved didactic schedule and more focused test preparation strategy. This included incorporating a question bank and CREOG preparation throughout the year. Methods: The average standardized scores per resident class year for Corewell Health East- Dearborn were reviewed from 2019 to 2024. Study Design: The didactic schedule emphasized areas of weakness identified in the prior year, a question bank gamified, and CREOG preparation was initiated at the beginning of the academic year. Residents were also given a personal analysis with areas of improvement from prior years and a faculty liaison. Results: From 2019 to 2024, scores of each class year increased. In the PGY1 class year, the score increased from 54% in 2019 to 60% in 2024. In the PGY2 class year, the score increased from 57% in 2019 to 69% in 2024. In the PGY3 class year, the score increased from 55% in 2019 to 70% in 2024. In the PGY4 class year, the score increased from 58% in 2019 to 71% in 2024. The overall score has increased from 56% in 2019 to 67% in 2024. Discussion: Over six years, our residency didactic schedule and learning environment was revamped by our residents and faculty which resulted in improved scores in the CREOG exam. Conclusion: The improvement in CREOG scores will continue to guide future changes in our didactic schedule.

Correction To: Pilot Study: Developing Curriculum to Prepare Fourth-Year Medical Students Applying for OBGYN Residency Within the Defense Health Agency

Correction To: Pilot Study: Developing Curriculum to Prepare Fourth-Year Medical Students Applying for OBGYN Residency Within the Defense Health Agency

Accuracy of OBGYN Resident Physician Clinical Estimation of Fetal Weight in Term Pregnancies Before and After a Teaching Curriculum

Purpose: Accurate prediction of fetal birth weight can improve antepartum and intrapartum shared decision-making with patients. Therefore, this study primarily sought to determine if OBGYN residents are more accurate at clinically estimating fetal weight via Leopold maneuvers following a teaching curriculum including a hands-on simulation model. Secondary aims were to determine if accuracy changes depending on training level, maternal or fetal characteristics. Methods: A paired t-test was used to evaluate the primary aim of the teaching curriculum’s effect on accuracy of correct fetal weight estimation. Nineteen residents served as their own controls to assess differences in accuracy by performing 10-12 estimates prior to and after the teaching curriculum. The curriculum consisted of a short verbal workshop with images of how to perform Leopold maneuvers, along with five models that were created to represent a gravid uterus with a fetus measured in the 5th, 25th, 50th, 75th, 95th percentiles. Residents were also tested on models with unknown weights to confirm accuracy prior to completing the teaching curriculum. The inclusion criteria during the fetal weight estimates pre- and post-curriculum was as follows: mother had to deliver during hospital admission; gestational age was between 37 weeks and 41 weeks; singleton pregnancy; mother had not undergone rupture of membranes; mother was English speaking. Accuracy was defined as estimated fetal weight within 10% of actual birth weight. Generalized Logistic Mixed Models were used to assess accuracy when adjusting for PGY level, maternal and fetal characteristics. Maternal characteristics including age, BMI, race, pregestational diabetes, gestational diabetes, polyhydramnios, and oligohydramnios were abstracted from maternal medical charts via retrospective chart review. Infant characteristics including fetal macrosomia, fetal growth restriction, and gestational age were also recorded. Analyses were conducted using SAS 9.4; all p-values were two-sided and p-values <0.05 were deemed statistically significant. Results: Nineteen OBGYN residents performed a total of 443 Leopold maneuvers to estimate fetal weight. Overall, resident estimation accuracy within 10% of actual birth weight improved from 65.5% to 67.4% (p=0.49) after the teaching curriculum. Senior residents showed a greater improvement after the teaching curriculum than junior residents, however it was not statistically significant. This could be due to the low sample size. Increasing gestational age was associated with higher odds of accurate estimation of fetal weight (OR 1.34, p=0.0295). There were no other differences in accuracy based on other maternal or fetal factors. Conclusion: The teaching of Leopold maneuvers is often not formalized in residency programs. This study did not show the expected improvement in accuracy of fetal weight estimation. Considerations that may impact clinical estimations include improving the simulation model, revising the teaching curriculum, and/or doing the teaching curriculum more frequently. Incorporating this hands-on simulation annually within the residency program educational curriculum to standardize the learning experience may be beneficial.

Attitudes and Likelihood of Outpatient Cervical Ripening via Single Balloon Foley Catheter Among OB/GYN Providers, Nurse Practitioners, and Obstetric Labor & Delivery Nurses

Introduction/Objectives: In certain parts of the United States and other developed nations, cervical ripening using the Foley catheter has already been introduced into the outpatient setting. An approved protocol exists at Loyola University Medical Center (LUMC), however usage is nonexistent. The primary aim of this study was to determine the current level of knowledge and familiarity regarding outpatient cervical ripening among OBGYN physicians and labor and advanced practice nurses at LUMC. The secondary aim of the study was to elucidate willingness to offer outpatient cervical ripening and potential reasons for support and hesitancy of this practice. Methods: We created an 8-question anonymous survey to elucidate the current level of knowledge regarding outpatient cervical ripening and potential reasons that a provider may have in support of and against outpatient cervical ripening. The survey was distributed among General OBGYN attendings, fellows, residents, labor and delivery (LD) and advanced practice (APN) nurses at LUMC. Descriptive statistics and Fisher’s exact test was performed on categorical data. An ordinal logistic regression model was used to compare the odds of being more likely to offer outpatient cervical ripening between attendings and resident physicians and the odds of being familiar with outpatient cervical ripening. Results: 45 obstetric care providers completed the survey (comprising 20 OB/GYN residents, 10 General OB/GYN attendings, 13 LD, and 2 APN nurses). The response rate was 72%. 73% of all respondents had some degree of familiarity with outpatient cervical ripening, while 84% were familiar with the current body of research on this practice. Overall, the willingness to offer outpatient cervical ripening was 55% for the group, with only 11% unwilling. There was no difference in the willingness to offer outpatient cervical ripening between attendings and resident physicians (OR = 1.25, 95% CI: 0.32 – 4.88; p = .75) (Table 1). Major factors that drove willingness to offer were decreased induction to delivery time (77%) and patient convenience (85%). Major factors that drove unwillingness to offer OP cervical ripening were lack of fetal monitoring (66%), increased communication from patients (66%), and additional utilization of clinic resources/time for protocol implementation (66%). Resident physicians were significantly more likely to report familiarity with the current research on outpatient cervical ripening than nurses (OR=5.04; 95% CI: 1.24-20.45; p=.02) and attending physicians (OR=4.13; 95% CI: 1.05-17.78; p=.04). There was no difference in familiarity with research behind the practice between physicians and nurses respondents (p=.85). There was no association between those who reported the level of familiarity with the concept of outpatient cervical ripening and their willingness to offer (OR = 1.52, 95% CI: 0.40 – 5.78; p = .54) (Table 2). Conclusions: Moving preinduction cervical ripening to an outpatient setting is equally efficacious and safe when compared to inpatient cervical ripening. However, despite having an existing protocol for cervical ripening using a Foley Balloon, this practice is not currently utilized at LUMC. Our survey suggests that though physicians and nurses are familiar with the concept and the research behind the practice, there are limiting factors for use. Further education regarding outpatient cervical ripening are essential for increasing practice adoption.

Disparities Across the CREOG Districts: Annual Variations of Wellness and Inclusivity Efforts in Obstetrics & Gynecology Residency Websites

Over the past few years, CREOG has emphasized improving resident well-being, decreasing physician burnout, and supporting efforts toward inclusivity. This focus has also been shared by various medical specialties and their training programs. The recent emphasis on wellness and inclusivity partly stems from the concern for burnout and higher attrition rates among Underrepresented In Medicine (URIM) learners. However, limited assessment exists of how residency programs have addressed this focus nationally. As virtual interviews have become the ‘current’ standard, timely updates have become critical as websites are an essential resource for residency applicants. As the perceived value of some updates differs by program, an assessment of the inclusivity and wellness variations over the years has been limited, especially across Obstetrics and Gynecology (ObGyn) residency program websites. This study aimed to identify the annual variations in website depictions of wellness and inclusivity across CREOG districts in the past two years, while suggesting optimized platforms to convey the commitment to such efforts. Methods: This study is a cross-sectional analysis of the websites of ACGME-accredited ObGyn residency programs across the United States in April 2022 and again in April 2023. The assessment was based on a compilation of 22 attributes devised by a nine-person focus group and piloted and tested on a 40-person focus group. Six medical students and two residents at Louisiana State University in Shreveport and the University of Toledo conducted the website benchmarking comparison. All cohorts were racially, ethnically, and gender diverse to ensure representative benchmarking. Racial diversity in this study was defined by visual representation as identified by the medical student researcher’s self-perceived report of at least one African-American/Black, Hispanic/Latino, American Indian/Alaska Native, or Native Hawaiian/Pacific Islander faculty member and resident among their colleagues based on publicly-accessible website photographic representation. Gender diversity was defined similarly by visual representation as identified by the medical student researcher’s photo-based self-perceived report of at least one member of a differing gender compared to the majority (a minimum of female and/or one male) within the faculty members and resident class. Percentages were used to compare the data due to the program count discrepancy across both years, as a result of an increase in accredited programs and website accessibility. Results: A total of 560 websites were analyzed. Minimal change in inclusivity sections of websites was noted across the two years, but a reduction in leadership referencing inclusivity (by 30%) and wellness (by 22%) occurred in 2023. Wellness efforts remained unchanged in both years from the standpoint of website investment, dedicated support personnel, and group activities. Wellness support was persistently the highest in District 5, with overall wellness efforts appearing unchanged between the two years across all districts. Similarly, District 5 had the highest DEI referencing with dedicated staff and webpage support across both years. References to holistic reviews were less identified in 2023 (by 7%), while curricula referenced DEI less frequently in their mission statement (by 15%). Similarly, a 14% reduction in DEI-focused research was noted on the websites, with an 8% reduction in resident testimonies to such efforts. District I showed the highest incorporation (32%) and increase (7%) in inclusive pronoun usage between the two years, whereas District 5 had the highest increase in supplementary LGBTQI verbiage (8%) on their website. A 17% increase in the use of inclusive pronouns was noted, whereas a reduction in gender diversity was identified in 9% of faculty and 5% of residents. Similarly, a 6-7% reduction in URIM faculty and residents was noted. Regarding racial representation, District 4 had the highest loss of resident body diversity (21%), whereas District 3 had the highest loss of faculty diversity (22%). Regarding gender diversity, District 1 was impacted by a 30% decline in gender diversity, while District 3 by 23%. Conclusion: This study demonstrates the variations in support across the country and the past two years. With some components of inclusivity being adopted more readily, the hope is that websites ultimately provide an accurate reflection of the investment in resident wellness and equity efforts across all districts.

(062) IMPLEMENTING A VALIDATED SEXUAL DYSFUNCTION SCREENING TOOL AT AN INNER-CITY WOMEN’S HEALTH CLINIC

Abstract Introduction The American College of Obstetricians and Gynecologists (ACOG) reports 43% of American women experience sexual health problems, including Female Sexual Interest and Arousal Disorder, Female Orgasmic Disorder, Genito–Pelvic Pain and Penetration Disorder, and Substance or Medication-Induced Sexual Dysfunction. Objective At Women’s Ambulatory Health Services (WAHS), an inner-city clinic associated with Hartford HealthCare, at which UConn Health ObGyn residents work, there is no routine screening in place for sexual dysfunction. This project aimed to implement the Female Sexual Function Index (FSFI) for screening for sexual dysfunction at this clinic to identify patients who may benefit from treatment. Methods We implemented the FSFI-short version, a six-question screening tool for sexual dysfunction that has been validated in English and Spanish and utilized in many countries on July 1st, 2022. Patients presenting for a new gynecologic visit or an annual gynecologic exam were asked to complete the screening tool. Patients who scored equal to or less than 18 on the FSFI-short version were identified as at risk for female sexual dysfunction and were offered referral to a health psychologist specializing in sexual dysfunction. We utilized the RE-AIM framework for implementation science to guide the implementation evaluation. We collected data on patients from July 1 through December 1, 2022. We collected patient demographics and implementation outcomes, including rate of survey completion, candidacy for referral and referral completion. Results 196 surveys were reviewed between July 1st and December 1st of 2022. 44 surveys were excluded for various reasons, including not meeting study inclusion criteria or invalid responses. 152 screening forms were included and 45 patients screened positive. Subjective patient barriers were gathered from comments written directly onto the paper survey as well as quotes documented by their providers in the visit note. These subjective barriers included hesitancy to discuss sexual health and lacking knowledge that the gynecologist provider offers assessment and management for these disorders. Conclusions The introduction of the FSFI-sv at WAHS has both expanded the resources offered to patients, enhanced the environment surrounding topics of women’s health both between staff members as well as within the patient-provider relationship, and has unearthed multiple opportunities for improving the screening process, referral selection and work flow for sexual dysfunction amongst the patient population. Disclosure No.

The importance of abortion training for obstetrician-gynecologists: A comparison of the United States, Sweden, and Ghana.

Since 2020, World Health Organization guidelines state that universal access to abortion care is critical for individual and community health, and for the realization of human rights. Yet the right to access safe abortion care is severely restricted in many countries. This article outlines institutional and educational systems in the USA, Sweden, and Ghana, which all require obstetrics and gynecology (ob-gyn) training to include abortion care but vary in implementation. It argues that regardless of the political environment, the specialty should protect abortion training worldwide. In Sweden and Ghana, ob-gyn residents are required to participate in abortion training, while in the USA they are permitted to opt out. In Sweden, practicing ob-gyn specialists are required to provide abortion care, whereas in Ghana and the USA, this care is optional, leading to geographic disparities in abortion care access in these two countries. In the USA, the Supreme Court's Dobbs ruling jeopardizes programs' abilities to meet the training mandate, a requirement that was insufficiently implemented even before the ruling. It is critical that all clinicians are well-equipped to provide accurate information to their patients and provide pre- and post-abortion care. For this reason, we recommend that abortion is included in all undergraduate medical education programs in accordance with the recommendations of FIGO (the International Federation of Gynecology & Obstetrics). To meet WHO guidelines that require ob-gyn specialists to provide abortion care in an emergency, we urge FIGO to create a guideline about expectations for abortion training integration in obstetrics and gynecology.

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.

Professional activity and experience after a residency training program in ObGyn: A 10-year analysis.

To describe the profile and professional trajectory of the obstetrics and gynecology (ObGyn) graduates over the past decade, at a referral university hospital. A cross-sectional study was conducted, utilizing a survey that targeted graduates of the ObGyn residency program from the last decade, asking about demographics, medical undergraduate, residency details, post-residency trajectory, satisfaction levels, and social media usage. A descriptive analysis was performed. Comparative analyses, including gender-based differences, were assessed using chi-squared or Fisher exact tests (P < 0.05). Among 126 graduates, 84 agreed to participate (66.67%), predominantly comprising females with an average age of 33 years. Most identified themselves as white. The majority had pursued their undergraduate studies at the same institution (78.6%) and subsequently acquired specialized titles in ObGyn from the national society. Most of them were employed in both public and private sectors (71.08%). Male graduates held the majority of medical shifts in obstetrics. A significant gender-based salary discrepancy was noted, favoring males. More than half of the professionals utilized social media for work-related purposes. Many expressed the necessity for supplementary education beyond public health, particularly career management. The findings highlight a predominance of female and white individuals among the graduates. Overall, graduates expressed contentment with their education and professional engagements. A gender-based income disparity was identified, favoring male graduates. Studies like this can provide insights for improving medical residency education.

Race, Ethnicity, and Sex Representation Trends Among Minimally Invasive Gynecologic Surgery Fellowship Trainees and Graduates

Study ObjectiveTo study the race, ethnicity, and sex representation and annual trends of AAGL FMIGS fellows and graduates. DesignA retrospective cross-sectional study. SettingAAMC databases were queried for demographic information between 2011 and 2023. Patients/subjectsAAGL FMIGS fellows and graduates. InterventionsN/A Measurements and Main ResultsDescriptive statistical analysis and the actual-to-expected (AE) ratio of each race, ethnicity, and sex were performed. AE ratio was calculated by dividing the 13-year average actual percentage of FMIGS trainees and graduates by the expected percentage based demographics of OBGYN residents and the US general population.477 fellows graduated or were in training between 2011 and 2023; race and ethnicity information was obtained for 347 (72.7%) individuals, and sex information was available for 409 (85.7%). Representation of females ranged from 66.7% in 2017 to 93.3% in 2022. There was a significantly increasing slope for the representation of females (+1.3% per year; 95% CI 0.00–0.03; p = .027). Compared to their distribution among US OBGYN residents, White fellows’ representation was lower [AE ratio, 95% CI 0.60 (0.44–0.81)] and of Asian fellows was higher [AE ratio, 95% CI 2.17 (1.47–3.21)]. Female fellows’ representation was lower than expected [AE ratio, 95% CI 0.68 (0.48–0.96)] compared to their distribution among US OBGYN residents.Compared to the general US population, White fellows [AE ratio, 95% CI 0.65 (0.48–0.87)] and Hispanic fellows [AE ratio, 95% CI 0.53 (0.34–0.83)] representation was lower. Asian fellows’ representation was higher compared to the general US population [AE ratio, 95% CI 5.87 (3.48–9.88)]. ConclusionWhite and Hispanic fellows’ representation was lower than expected, while Asian fellows’ representation was higher in AAGL-accredited FMIGS programs. Female representation increased throughout the years, but overall, female fellows’ representation was lower than expected compared to their distribution among OBGYN residents. These findings may help develop equitable recruitment strategies for FMIGS programs and reduce health disparities within complex gynecology.

HPV Vaccination Practices Among Medical Trainees in Pediatrics, Obstetrics and Gynecology, and Family Medicine.

The human papillomavirus (HPV) vaccine has been proven effective in preventing HPV-related cancer. However, vaccination uptake in the United States remains unacceptably low. The aim of this study is to determine whether residents' HPV vaccination status, demographics, or residency training setting are predictive of vaccination prescribing practices. This was an anonymous, IRB-approved, opt-in survey of OBGYN, Family Medicine, and Pediatric residents. Using the National Residency Match Program Web site, surveys were sent to program directors requesting their residents' participation. Demographics, practice settings, HPV vaccination status, reasons for being inappropriately vaccinated, and resident vaccination-prescribing practices were analyzed. A total of 853 residents participated. A total of 56.7% of respondents were fully vaccinated against HPV. The most common reasons for being unvaccinated were as follows: age (51.7%, n = 122), monogamous (30.9%, n = 73), do not believe it works (22.5%, n = 53), and affordability/insurance did not cover (14.4%, n = 34). Residents working in an urban setting were more likely to be vaccinated than those in suburban (odds ratio [OR] = 1.93, 95% confidence interval [CI], 1.364-3.229, p < .001) or rural (OR = 2.08, 95% CI 1.461-3.359, p 0.01) settings. Males were less likely than females (OR = 0.90, 95% CI 0.702-0.997, p < .001) to be vaccinated. Single residents were more likely to be vaccinated than married (OR = 2.56, 95% CI 2.444-2.704, p < .001) or divorced (OR = 2.15, 95% CI 1.822-3.264, p 0.21) residents. Vaccinated residents were more likely to recommend HPV vaccination to their patients than those who were unvaccinated (OR = 1.83, 95% CI 1.321-2.548, p .004). A significant portion of Family Medicine, Pediatrics, and OBGYN residents have not received appropriate vaccination against HPV. Vaccination is highest among residents who identify as female, single, or working in urban settings. Vaccinated residents were also found to be almost 2 times as likely to recommend vaccination to their patients. As such, our data suggest that targeted provider education is needed to increase vaccination rates for both trainees and their patients.

An Obstetrics &amp; Gynecology Resident Education Program to Address Gaps in the Knowledge, Screening, and Treatment of Postpartum Mood and Anxiety Disorder (PMAD)

Background: Postpartum mood and anxiety disorders has been shown to cause significant problems for caregivers, their newborn and children. Despite this widespread issue, only 55% of healthcare providers assess for these symptoms/disorders. Objective: The objective of this study is to design a training class to increase OBGYN residents’ knowledge and confidence in diagnosing and treating postpartum mood and anxiety disorders. Methods: In 2023 we implemented a program designed to educate Obstetrics &amp; Gynecology resident physicians about the symptoms of postpartum mood and anxiety disorders as well as interventions for validated screening and treatment modalities. Results: A total of 26 residents participated in this training program at of the 49 who were recruited. This resulted in an improvement in foundational knowledge, notably the recognition of postpartum blues versus depression, as well as understanding how to screen for postpartum depression. Conclusions: The program increased resident confidence in recognizing and treating postpartum mood and anxiety disorders.

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.

(052) Sexual Health and Clinical Sexology Specific Training Needs of Residents in Gynecology and Obstetrics

Abstract Introduction Assuming that the Obstetrician and Gynecologist (ObGyn) is the natural and first interlocutor for sexual questions in women, particular attention should be paid to their specific training in sexual health and clinical sexology. However, it turns out that the latter is neglected with little attention given to the development or implementation of specific curricular programs within the gynecologists’ residency programs. Objective This study aims to: - Identify and analyze the specific needs of the ObGyn residents in terms of education and training in Sexual Health and Clinical Sexology. - Discuss the methods of integrating a specific sexology training into their residency program to be adapted to the needs thus identified. Methods It is a knowledge, attitudes, and practices cross-sectional online study that took place over 5 weeks starting May 1st, 2021. All the ObGyn residents registered at the National College of Gynecology and Obstetrics were contacted through the College’s social media groups. The online questionnaire was a 9-item Google form elaborated in concertation with the Frequency, Gravity Problem (FGP) grid leading to 33 questions. Results With a response rate of 34 %, 94 residents participated in the survey. The participants were representative of the local population of ObGyn residents with an equal proportion of participants from the 5 years of the program. According to 69% of the participants, complaints or sexual disorders are rarely encountered during the ObGyn residency program courses. This finding was not correlated with the participants' residency level (R= 0.258, p&amp;gt; 0.05). The most frequently encountered sexual disorders during the clinical consultations were sexual disorders with pain (44.68%) and in particular vaginismus (75%). Regardless of the frequency of the disorders, the difficulties reported were primarily in the domain of knowledge (67.5%); then in the domain of know-how or practices (68%), and often in the domain of interpersonal skills (42.2%). Following the application of the rating system of the FGP grid, the main problems identified concerned sexual disorders with pain, in particular, vaginismus and then a decrease in female desire. Conclusions Following the analysis of these results and a review of the literature, we were able to propose the outline of a project to implement basic academic education and training in clinical sexology for the ObGyn residents. Disclosure No.

Treating Infertility without Assisted Reproduction Techniques

Reproductive Endocrinology/Infertility, programs today emphasize in vitro fertilization-embryo transfer (IVF-ET), intracytoplasmic sperm injection, and pre-implantation genetic diagnosis. When the infertility specialist begins his/ her career, unfortunately, most are not trained to solve infertility problems by non-expensive means without assisted reproductive technology. Thus, today it becomes more important for the generalist in obstetrics and gynecology to learn the principles of treating infertility using methods that are best suited for most patients which are methods generally reimbursed by third party insurance carriers that will not financially deplete the patients. Unfortunately, during OB-GYN residency the teaching of methods for treating infertility is by rotation through REI practices where the emphasis is on IVF-ET. This review is written for the purpose of providing a basis for those OB-GYN physicians who want to know more about diagnosis and treating infertility, to help their patients conceive without expensive procedures e.g., IVF-ET. The “expert” opinion is not only based on 50 years of extensive clinical experience but will provide the published research studies by the authors that provide at least a good starting point for learning methods of treating infertility. Nevertheless, these suggestions need to be modified by the OB-GYN generalist to conform to their patient population, their findings based on their own experience, and based on the nature of their own practice to determine how much time can be dedicated to treat infertility problems themselves.

Obstetrics and Gynecology residency training in transgender care: a national survey of residents and program directors

Aim: Obstetricians and gynecologists (OB-GYN) routinely care for transgender patients though most OB-GYN practitioners do not have any transgender care-specific training. The pervasive lack of training and education leads to dire health consequences for transgender patients. Residents and program directors within U.S. OB-GYN residency programs have been surveyed separately. To our knowledge, this is the first study that compares responses from residents and program directors related to their training. Our study aims to assess OB-GYN residents’ and program directors’ levels of comfort, preparedness, and knowledge in caring for transgender patients. Methods: Electronic surveys were sent to 183 OB-GYN residency programs. Resident and program director surveys consisted of questions regarding experiences with transgender care, perceptions about current transgender care training, and levels of comfort, preparedness, and knowledge in caring for transgender patients. Data were collected via Qualtrics and analyzed using IBM SPSS Statistics. Results: Responses were collected from 37 program directors and 94 residents across five regions defined by the Council on Resident Education in Obstetrics and Gynecology (CREOG). Over 67% of program directors reported not having an established transgender care training curriculum in their program. Among those without an established curriculum, 89% of program directors reported plans to implement one within the next year. Average levels of comfort, preparedness, and knowledge in caring for transgender patients was low for both groups, with residents scoring lower on these variables. Most program directors (89%) were amenable to using standardized training materials as part of their transgender care curriculum, if available. Conclusion: While a majority of U.S. OBGYN residency programs do not have an established transgender care training curriculum, most would use standardized training materials to implement one. This is important given that the current knowledge of transgender care amongst both program directors and residents is low. This study contributes to the limited pool of data that aims to support the development of curricula within OB-GYN residency programs to improve care and reduce health inequities for transgender patients.

The association between abortion training and obstetrics and gynecology resident competence and intention to provide abortion care before Dobbs

ObjectiveTo assess the role of abortion training in fourth-year obstetrics and gynecology (OBGYN) residents’ abortion care competence and practice intentions before the Dobbs decision. Study designThis is a planned secondary analysis of survey data of fourth-year U.S. OBGYN residents. Abortion training was defined as ‘routine’ if automatically included in schedules, ‘‘optional’’ if not scheduled but available, and ‘‘not available’’. Self-assessed competence was defined as feeling prepared to independently provide care. Participants were asked about their competence and post-residency intentions to provide specific aspects of pregnancy loss and induced abortion care. ResultsOf 1241 fourth-year residents, 885 (71%) completed the questions of interest. For each skill, more residents with routine training reported competence compared to those with less comprehensive training. More residents with routine training reported intentions to include abortion care in practice (422, 79%) compared to residents with optional (171, 66%) or no training (51, 55%), p < 0.001). Residents with routine training were nearly six times more likely to intend to provide medication abortion post-residency compared to residents without training; more residents in all groups reported intentions to provide care for pregnancy loss compared to abortion. ConclusionsPre-Dobbs, residents with routine abortion training had greater self-assessed competence in abortion care than those with optional or no training and were more likely to intend to provide this after residency. Given the evolving impacts of the 2022 reversal of Roe v Wade, residency training programs must work to ensure routine access to legally permissible abortion training as routine training is associated with intention to provide fundamental, reproductive healthcare. ImplicationsRoutine training in abortion care during OBGYN residency is associated with higher competence and intention to provide post-residency – availability of this training Is severely compromised in restricted states post-Dobbs.

Evaluating the utility of a global webinar for mentoring medical students and OBGYN residents in REI.

In medical school and residency, clinical experiences influence trainee's decisions on what medical specialty they choose. Most trainees have limited access to opportunities to engage in the field of reproductive endocrinology and infertility (REI). Due to the COVID-19 pandemic and the shutdown of away electives, exposure to REI was especially limited. This study aims to evaluate the effectiveness of a live Q and A webinar on improving trainees' access to mentorship and knowledge of the path to becoming a reproductive endocrinology and infertility (REI) physician. This study is a prospective paired cohort study. Medical students and OBGYN residents participated in a global Q and A webinar featuring REI physicians and fellows. 70 pre- and post-webinar surveys were included in the analysis. Paired nonparametric tests (Wilcoxon signed-rank test) were performed to assess whether post-webinar knowledge was significantly different from pre-webinar knowledge. Of the 268 registrants, 162 (60%) attended the live webinar. A majority of the respondents who completed both surveys were female (90%) and allopathic medical students (80%). Seventy-seven percent reported receiving only minimal advice about an REI career from their medical school or residency program, while 22% reported receiving some advice, and 1% extensive advice. Thirty-four percent had previously shadowed an REI physician and 23% had rotated in an REI office. Post-webinar significantly more trainees had a better understanding of the REI field, the path required to become an REI physician, opportunities to find mentors in the field, opportunities that are conducive to learning more about REI, and applying for rotations in the REI field (p = <.00001). Eighty-two percent agreed that their interest in REI increased due to this webinar. A webinar featuring REI physicians and fellows was effective in providing mentorship and career advisement for prospective REI trainees who otherwise expressed having limited access to the field.

9410 Analysis of MIGS Exposure in OBGYN Residency

9410 Analysis of MIGS Exposure in OBGYN Residency