Gynecology Residents Research Articles

Out-of-State Abortion Training Rotations for Residents in States With Limited Access

State laws that restrict abortion also impede abortion training, which is required by the Accreditation Council for Graduate Medical Education for obstetrics and gynecology programs. After the enactment of Texas Senate Bill 8 in September 2021 and 1 year after Dobbs v. Jackson Women's Health Organization, the Ryan Program facilitated partnerships between 13 obstetrics and gynecology residency programs in restrictive states and 13 programs in protective states for resident training. We describe the experiences of residents who traveled within these partnerships through postrotation surveys about training experiences, practice intentions, and alignment with the learning objectives. From April 2022 to August 2023, 60 residents traveled and 35 completed surveys (58.3%). Residents reported that the rotation met learning objectives, including extensive exposure to all abortion methods, and most intend to provide abortions in practice.

Need for formalized robotic training and curriculum in obstetrics and gynecology residency: an examination of current resident outlooks and perspectives

The objectives of this study were to evaluate current robotic surgery training methodologies for ACGME-accredited obstetrics and gynecology (OB/GYN) residency programs, better understand current resident perspectives, and explore potential areas for improvement within resident education. A cross-sectional study was done of ACGME-accredited OB/GYN residents in the 2023–2024 academic year. The study was done on a national setting via web-based survey. 75 surveys were included. The study was conducted via a 33-question survey study using a mixture of multiple choice, multiple answer, and Likert scale questions. Participants noted that 98.7% of their institutions perform robotic surgery and 90.7% have access to robotic console trainers. Outside of the operating room, slightly more than half of participants (57.3%) have formalized robotics training curriculums. A variety of training modalities were noted to be utilized by residents with the most helpful being hands-on training (67.7%) followed by dual-assist console (45.6%). The least helpful was noted to be online modules (58.7%). Most residents either strongly agree (45.3%) or agree (36.0%) that standardized robotics curriculums should be implemented for all OB/GYN residency programs. The largest barriers to completion of this training were noted to be attending comfort with resident participation in the case (74.0%), personal time (58.9%), and availability or access to trainers (42.5%). A formalized and standardized robotic training curriculum should be considered for OB/GYN residents with a multi-modal model utilizing a combination of training modalities as well as dedicated didactic hours.

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.

Factors that influence the formation and impact of mentorship relationships for OB/GYN residents

Background Mentorship is critical for successful careers in academic medicine. There is a gap in the literature regarding specific qualities that make effective mentorship relationships for Obstetrics and Gynecology (OB/GYN) residents. This study aimed to identify the attributes most valued by OB/GYN residents in their mentorship relationships and to explore the factors influencing their choice of mentors. Methods We conducted a cross-sectional survey among OB/GYN residents, distributed electronically November 2021-March 2022. Demographic data, mentor qualities, satisfaction with current mentorship and mentee factors were identified. The survey incorporated questions adapted from the validated Ideal Mentor Scale assessing three mentor attributes: Integrity, Guidance, and Relationship. Data analysis involved descriptive statistics, Student’s t-tests, chi-squared tests, and Fisher’s Exact tests where appropriate. Results 48 of 60 (80%) of surveyed residents responded. Among the respondents, 72.9% were female and 29.1% identified as non-white. Integrity emerged as the most valued Ideal Mentor attribute. No statistically significant gender-based differences were observed in the preferences for mentor characteristics including gender of a mentor. Non-white respondents placed greater importance on having a mentor of the same race (p&lt;0.01). Residents interested in subspecialties expressed a stronger preference for mentors with fellowship training (p&lt;0.01) and shared research experiences (p=0.03). Conclusions OB/GYN residents seek mentors characterized by integrity and who are active in research and professional societies aligned with their interests. The data highlight the importance of considering race and subspecialty preferences in fostering influential and equitable mentorship for all residents.

OSABSS: An authentic examination for assessing basic surgical skills in surgical residents

ObjectivesThis study aimed to develop and validate the OSABSS (Objective Structured Assessment of Basic Surgical Skills), a modified Objective Structured Clinical Examination (OSCE), to assess basic surgical skills in residents. DesignA developmental study conducted in two phases. Basic skills were identified through literature review and gap analysis. The OSABSS was then designed as a modified OSCE. SettingThis study took place at Alborz University of Medical Sciences in Iran. InterventionsThe OSABSS was created using Harden's OSCE (Objective Structured Clinical Examination) methodology. Scenarios, checklists, and station configurations were developed through expert panels. The exam was piloted and implemented with residents as participants and faculty as evaluators. Participants32 surgical residents in gynecology, general surgery, orthopedics, and neurosurgery participated. 22 faculty members were evaluators. Primary and secondary outcome measuresThe primary outcome was OSABSS exam scores. Secondary outcomes were written exam scores, and national residency entrance ranks. Main resultsThe mean OSABSS score was 16.59 ± 0.19 across all stations. Criterion validity was demonstrated through correlations between OSABSS scores, written scores and entrance ranks. Reliability was high, with a Cronbach's alpha of 0.87. No significant inter-rater score differences were found. ConclusionsThe rigorous OSABSS development process produced an exam demonstrating strong validity and reliability for assessing basic surgical skills. The comprehensive station variety evaluates diverse technical and non-technical competencies. Further research should expand participant samples across surgical disciplines.

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] vs 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.

Impact of a Mentorship Program to Prepare Medical Students for the Military Residency Match.

Mentorship programs have well-documented benefits to both mentees and mentors. Military medical students face unique challenges in medical school given their service-specific requirements and separate military match process. We therefore aimed to determine whether military medical students' participation in a mentorship program impacts their confidence in applying to obstetrics and gynecology (OB/GYN) residency. First, a needs assessment survey regarding the use of a mentorship program was sent to medical students, residents, fellows, and attendings. A structured mentorship program was then developed for military medical students applying to OB/GYN residency based on the survey results. Mentors were randomly paired with mentees and asked to appraise curriculum vitaes, review personal statements, and perform mock interviews. Following completion of these activities, participants were sent a post-intervention questionnaire. This project was exempt by our institution's Institutional Review Board. Our program had 56 participants, with 29 individuals completing our post-intervention survey (response rate 51.8%). After participating in the program, 92.3% of mentors stated they plan to continue a relationship with their mentee. All the mentee respondents stated they would participate in this program again. Before participating in the program, 16.7% of mentees felt "prepared" or "extremely prepared" for the match, compared to 87.6% post-intervention. Most mentee respondents (75%) reported that this program made them a more competitive applicant. Following the mentorship program, 66.7% of participants successfully matched into OB/GYN residency. This reproducible, well-received intervention can be implemented to facilitate mentoring connections regardless of geographic location. As the OB/GYN specialty develops its own application process, civilian medical schools should consider adopting similar programs to aid their students in navigating the match process.

Inequities at the Transition to Obstetrics and Gynecology Residency

Although approximately one-fifth of obstetrics and gynecology (OBGYN) residents matriculate from osteopathic or international medical schools, most literature regarding the transition to residency focuses on allopathic medical school graduates. To create comprehensive interventions for this educational transition, we must understand the needs of all incoming residents. Our objective was to examine OBGYN residents' perceptions of their transition to residency, and to understand how residents' background and medical school environment influence their perceived sense of readiness. A 16-item survey asked questions about demographics, the transition to residency, resident well-being, burnout, and the transition to fellowship. Perception of preparedness was assessed with the question "I felt that I was well-prepared for the first year of residency" (1=strongly agree, 5=strongly disagree). Chi-squared and Fisher's exact tests and logistic regression explored association of perceived preparedness with residents' backgrounds. Survey administered at time of the in-training examination in 2022. All OBGYN residents. Of 5761 eligible participants, 3741 (64.9%) provided consent and completed the survey. Of the 3687 participants who answered the question, 2441 (66.2%) either agreed or strongly agreed that they felt well-prepared. Fewer osteopathic graduates reported feeling prepared compared to allopathic graduates (379/610, 62.1% vs 1,924/2,766, 69.6%) (OR 0.72, 95%CI 0.60-0.86, p < 0.01). International medical school graduates were seven times less likely to report feeling prepared compared to those from allopathic institutions (137/304, 45.1% vs 1924/2776, 69.6%) (OR 0.60, 95%CI 0.53-0.68, p < 0.01). Respondents from underrepresented racial and ethnic backgrounds were less likely to report feeling prepared compared to White respondents (276/535, 51.6% vs 1738/2387, 72.8%) (OR 0.39, 95%CI 0.33-0.48, p < 0.01). Differences in residents' perceptions of their transition to residency highlight the need to begin offsetting pervasive inequities with comprehensive and accessible resources.

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.

Effect of Texas Abortion Laws on Reproductive Health Attitudes Among Medical Students, Residents, and Faculty: A TTUHSC Study [ID 2683579

INTRODUCTION: In response to Texas Senate Bill 8 and the overturning of Roe v. Wade, we investigated the effect of new abortion laws on attitudes toward reproductive health and abortion within the TTUHSC community in Lubbock, Texas. As abortion remains a vital aspect of reproductive health care, understanding current and future doctors’ sentiments is essential. METHODS: The Omnibus survey was sent electronically to TTUHSC School of Medicine students as well as medical residents, fellows, and faculty. The survey included 25 question sets that branched according to respondent groups and received 318 responses from the TTUHSC community. Using a single predictor model in RStudio, we analyzed gender influence on attitudes toward post-law changes. All participants provided consent for their responses to be used for research purposes. This project was approved for exempt review by the TTUHSC IRB. RESULTS: Of 76 responses, 63% strongly agreed that medical education should address Texas abortion law changes. Females showed more desire (73%) for education changes (P=.0059). Gender also affected opinions on counseling limitations due to new laws (P=.0167) and obstetrics and gynecology residents’ abortion training (P=.0063). CONCLUSION: Most participants favored educating students about law changes, perceived counseling limitations, and obstetrics and gynecology training for abortions. Females consistently aligned with these sentiments. The gender-based disparities underscore a medical education gap exacerbated by the new laws. Ambiguities in current laws may affect clinical practice. Addressing these findings is crucial and encompasses integrating ethical considerations, legal nuances, and procedures into the medical education framework to produce competent, compassionate practitioners.

Effect of Dobbs v. Jackson Women's Health on Obstetrics and Gynecology Residency Applicants [ID 2683390

INTRODUCTION: Abortion restrictions affect not only provision of abortion care but also experience for trainees. Data from the 2023 match showed a decrease in obstetrics and gynecology residency applications in restrictive states. Our national survey of medical students applying to obstetrics and gynecology residency sought to assess the effects of the Dobbs decision on their application process. METHODS: Medical students who applied to obstetrics and gynecology residency for the 2023 match were surveyed via an electronic questionnaire. Convenience sampling was used. Institutional review board waiver was granted. RESULTS: One hundred seventy-eight students, from 39 different states, completed the survey. The average age was 27.8 years, and the majority identified as women (89%) and White (80.9%). The majority (72.7%) of respondents reported that the Dobbs decision influenced which residency programs they applied to, and of those, 96.9% report that they applied to programs in states with fewer abortion restrictions. Similarly, 66.5% reported that the decision influenced their rank list, and of those, 98.3% report they ranked programs in states that are less restrictive on abortion services higher. CONCLUSION: Access to abortion training was identified as important to a majority of survey respondents. Students reported applying to states with less abortion restrictions and that access to abortion training influenced their rank list. Prior studies have surveyed third- and fourth-year students about predicted effects of the Dobbs decision on residency applications. This is the first to assess perspectives among students who completed the residency application process.

Multidisciplinary Simulation Improves Resident Comfort With Perinatal Bereavement Care [ID 2683378

INTRODUCTION: Physicians have difficulty delivering bad news because of discomfort and lack of appropriate education. We introduce an initiative to enhance trainee comfort in delivering the diagnosis of intrauterine fetal demise (IUFD) through multidisciplinary simulation training. METHODS: Twelve obstetrics and gynecology residents participated in perinatal bereavement training with a palliative care specialist utilizing the SPIKES framework, followed by an immersive simulation of an IUFD case and debrief with multidisciplinary physicians. Pre- and post-training surveys were administered. This study was approved by the IRB. RESULTS: Participants were equally distributed in training year (58% female, 33% male). 92% had previously delivered the diagnosis of IUFD, yet 50% had no previous bereavement training, and of those with training, most (84%) had less than 2 hours. Wilcoxon signed-ranks tests showed statistically significant increase in comfort level of delivering bad news (Z=66; P=.003), delivering a diagnosis of fetal demise (Z=64; P=.005), and having the skills and foundation to deliver the news of a fetal demise (Z=28; P=.017). Qualitative responses identified acquisition of verbal and nonverbal skills such as direct patient communication, using the word death, and sitting down at the patient’s eye level prior to delivering the news. Most described the experience as real, immersive, and a safe learning environment. One hundred percent would recommend the course to others. CONCLUSION: Perinatal bereavement education in obstetrics and gynecology residency training is lacking. Multidisciplinary, immersive simulation training significantly increased residents’ comfort and perceived preparedness in delivering the diagnosis of fetal demise.

Assessment of Burnout in Obstetrics and Gynaecology Residents: A Longitudinal Cohort Study

Assessment of Burnout in Obstetrics and Gynaecology Residents: A Longitudinal Cohort Study

Applicant Use of Residency Program Websites During Virtual Interviews [ID 2683623

INTRODUCTION: Program websites are the most common online resource applicants use to access information about residency programs. During the COVID-19 pandemic, online resources have had to take place of site visits when interviews transitioned to the virtual setting. At this time, the Accreditation Council for Graduate Medical Education does not have a plan for a transition back to in-person interviews. The objective of this study is to assess applicant use, and information that is sought for development of high-quality residency websites. METHODS: A survey was shared to interviewees on their interview day with Creighton University–Phoenix obstetrics and gynecology residency during the 2022–2023 application cycle. To remove the possibility of influence or coercion, the survey was kept anonymous. This was found to be IRB exempt. RESULTS: Of the 88 survey respondents, 100% marked they visited the program website. Only 32 of the 88 respondents indicated they did not find the information they were looking. The most-sought information by respondents was current resident profiles (75% of respondents), hospital/training site information (68%), rotation schedule (63%), and faculty profiles (60%). Other notable categories respondents were hoping to find information about included the following: surgical training, family planning training, and benefits offered by the program. CONCLUSION: Program websites are highly utilized by residency applicants. Information traditionally shared on interview day is now found through online resources; most-sought information included resident and faculty profiles, rotation schedules, and training site information.

Trends and Predictors of Cost in the Obstetrics and Gynecology Residency Application Process [ID 2683644

INTRODUCTION: Travel restrictions from the COVID-19 pandemic required residency programs to transition from an in-person to virtual interview process. Obtaining an obstetrics and gynecology residency position is known to be competitive and places a considerable financial burden on applicants. This study aims to quantify the total costs in the application process before and after virtual interviews were implemented. METHODS: The Texas STAR database was queried to identify obstetrics and gynecology residency applicants from 2019 to 2023. The primary outcome was applicant-reported spending on the residency application process. Descriptive statistics and linear regression models were used to evaluate for associations with sociodemographic, temporal, and geographic factors. RESULTS: A total of 2,315 obstetrics and gynecology applicants were included. Applicants reported significantly less average total spending on the residency application process after the start of the COVID-19 pandemic compared to the years prior ($2,515 [SD 2,055] versus $4,909 [SD 2,869]; P&lt;.001). Applicants who identified as underrepresented in medicine (P=.022), had a DO degree (P&lt;.001), completed a research year (P=.030), participated in the couples match (P&lt;.001), or were from the Western region (P&lt;.001) reported significantly more total spending. There was a significant positive correlation between total non-interview-related spending and the number of interviews received (P&lt;.001). CONCLUSION: There was a significant reduction in applicant spending after the start of the COVID-19 pandemic, likely related to transition to virtual interviews and limitations on in-person away rotations. The association of applicant spending with the number of interview offers raises concern for possible equity implications.

Lecture-based and Hands-on Ergonomic Training for Junior Obstetrics and Gynaecology Residents: A Quality Improvement Pilot Study

Lecture-based and Hands-on Ergonomic Training for Junior Obstetrics and Gynaecology Residents: A Quality Improvement Pilot Study

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.

The Association of Master Adaptive Learning With Less Burnout and More Resilience in Obstetrics and Gynecology Residents.

Medical education should prepare learners for complex and evolving work, and should ideally include the Master Adaptive Learner (MAL) model-meta-learning skills for continuous self-regulated learning. This study aimed to measure obstetrics and gynecology (OB/GYN) residents' MAL attributes, assess associations with burnout and resilience, and explore learning task associations with MAL. OB/GYN residents were surveyed electronically at an in-training examination in January 2022. The survey included demographic information, the 2-item Maslach Burnout Inventory, the 2-item Connor-Davidson Resilience Scale, 4 MAL items (e.g., "I take every opportunity to learn new things"), and questions about training and learning experiences. Of 5,761 residents, 3,741 respondents (65%) were included. A total of 1,478 of 3,386 (39%) demonstrated burnout (responded positive for burnout on emotional exhaustion or depersonalization items). The mean (SD) Connor-Davidson Resilience Scale score was 6.4 (1.2) of a total possible score of 8. The mean (SD) MAL score was 16.3 (2.8) of a total possible score of 20. The MAL score was inversely associated with burnout, with lower MAL scores for residents with (mean [SD] MAL score, 16.5 [2.4]) vs without (mean [SD], 16.0 [2.3]) burnout (P < .001). Higher MAL scores were associated with higher resilience (R = 0.29, P < .001). Higher MAL scores were associated with the statement, "I feel that I was well prepared for my first year of residency" (R = 0.19, P < .001) and a plan to complete subspecialty training after residency (mean [SD] of 16.6 [2.4] for "yes" and 16.2 [2.4] for "no," P < .001). Residents who scored higher on MAL showed more resilience and less burnout. Whether less resilient, burned-out residents did not have the agency to achieve MAL status or whether MAL behaviors filled the resiliency reservoir and protected against burnout is not clear.

The COVID-19 pandemic and OBGYN residency training: We have a problem and it’s not just masks

BackgroundThe COVID-19 pandemic has left no one untouched. Resident trainees have been driven to reconsider virtually every component of their daily lives. The purpose of this pilot study is to evaluate the impact of the COVID-19 pandemic on Obstetrics and Gynecology (OBGYN) residency training and education.MethodsA cross-sectional pilot study was conducted between 2/2022 and 5/2022. A survey was created and distributed to OBGYN residents. The survey queried the effects of the pandemic on OBGYN residents’ procedure skills training and mental health.ResultsA total of 95 OBGYN residents across programs affiliated with each American College of Obstetricians and Gynecologists (ACOG) district participated in the survey. Among them, just over half (n = 52, 55%) self-identified as under-represented minorities. A significant majority, 80% (n = 81), felt their gynecological training was inadequate, with 70% of fourth-year residents expressing a lack of confidence in their ability to independently practice gynecology after graduation. This lack of confidence among fourth-year residents suggests a notable disparity in readiness for independent gynecological practice, linked to meeting ACGME requirements before completing their residency (p = 0.013). Among the residents who reported a negative impact of the pandemic on their mental health (n = 76, 80%), about 40% (n = 31) had contemplated self-harm or knew a colleague who considered or attempted suicide (p < 0.001). This issue was especially pronounced in residents experiencing burnout (n = 44, 46%), as nearly half (n = 19, 43%) reported suicidal thoughts or knew someone in their program who had such thoughts or engaged in self-harm (p = 0.048).ConclusionsResidents expressed concerns about reduced hands-on gynecological training and doubts about their readiness for independent practice post-residency, highlighting the need for enhanced support through mentorship and revised training curriculums. Additionally, despite the availability of mental health resources to address pandemic-induced burnout, their underuse suggests a need for more accessible time for residents to use at their discretion and flexible training schedules that encourage mental health support resource utilization.

Knowledge and Confidence of Obstetrics and Gynecology Residents in the Evaluation and Management of Heavy Menstrual Bleeding Due to Inherited Bleeding Disorders.

Heavy menstrual bleeding (HMB) is common, and 20-30% of patients presenting with HMB are diagnosed with an inherited bleeding disorder (IBD). Despite the frequent association of HMB with bleeding disorders, specific learning objectives on this topic are lacking for Obstetrics and Gynecology (OBGYN) residents. We sought to determine the exposure of OBGYN residents to didactics, clinical training, and confidence in evaluation and management of patients with HMB due to IBDs. Prospective survey of OBGYN residents through email solicitation. Residents were invited to complete an anonymous 26-item survey, querying residents' confidence in evaluation and management of HMB in patients with and without IBDs. In total, 239 OBGYN residency programs were invited to participate and 20 programs responded. Among 388 residents, 84 completed the survey (21.6%). The majority reported didactics on HMB evaluation (n = 71, 85.5%) and treatment (n = 77, 92.8%); however, for HMB due to IBDs, only 35 residents (42.4%) reported didactics on evaluation and 28 (33.7%) reported didactics on treatment. Confidence in evaluation and management of HMB was high but decreased significantly with an IBD. Residents who received didactics on IBDs reported more confidence in their evaluation than residents who did not receive didactics (mean Likert scale score of 3.67 vs. 3.23, p = 0.002). Increasing postgraduate year level was associated with more confidence in treatment (p < 0.001) and did not differ based on type of training program (p = 0.825). OBGYN residents have decreased confidence in evaluation and management of HMB due to IBDs. Resident confidence increases with didactics and training. Residents would benefit from curricula designed to address this deficit in training.