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1.  Residents as Role Models: The Effect of the Obstetrics and Gynecology Clerkship on Medical Students' Career Interest 
Background
Medical students' choice of residency specialty is based in part on their clerkship experience. Postclerkship interest in a particular specialty is associated with the students' choice to pursue a career in that field. But, many medical students have a poor perception of their obstetrics and gynecology clerkships.
Objective
To determine whether fourth-year medical students' perceptions of teaching quality and quantity and amount of experiential learning during the obstetrics-gynecology clerkship helped determine their interest in obstetrics-gynecology as a career choice.
Methods
We distributed an anonymous, self-administered survey to all third-year medical students rotating through their required obstetrics and gynecology clerkship from November 2006 to May 2007. We performed bivariate analysis and used χ2 analysis to explore factors associated with general interest in obstetrics and gynecology and interest in pursuing obstetrics and gynecology as a career.
Results
Eighty-one students (N  =  91, 89% response rate) participated. Postclerkship career interest in obstetrics and gynecology was associated with perceptions that the residents behaved professionally (P < .0001) and that the students were treated as part of a team (P  =  .008). Having clear expectations on labor and delivery procedures (P  =  .014) was associated with postclerkship career interest. Specific hands-on experiences were not statistically associated with postclerkship career interest. However, performing more speculum examinations in the operating room trended toward having some influence (P  =  .068). Although more women than men were interested in obstetrics and gynecology as a career both before (P  =  .027) and after (P  =  .014) the clerkship, men were more likely to increase their level of career interest during the clerkship (P  =  .024).
Conclusions
Clerkship factors associated with greater postclerkship interest include higher satisfaction with resident professional behavior and students' sense of inclusion in the clinical team. Obstetrics and gynecology programs need to emphasize to residents their role as educators and professional role models for medical students.
doi:10.4300/JGME-D-09-00070.1
PMCID: PMC2951771  PMID: 21976080
2.  Preferences of program directors for evaluation of candidates for postgraduate training. 
OBJECTIVE: To determine the preferences of program directors for various grading systems and other criteria in selecting students for residency training positions through the Canadian Resident Matching Service (CaRMS). DESIGN: Questionnaire survey. PARTICIPANTS: All 110 directors of residency training programs in Ontario. SETTING: Ontario medical schools. OUTCOME MEASURES: Weighting of importance of different screening tools (e.g., grading systems, personal interview, dean's letter) used during undergraduate training. RESULTS: Of the 110 directors 96 (87%) responded. Of the 92 who rated the various grading practices 35 (38%) preferred a numeric grading system, 26 (28%) a letter grading system, 23 (25%) an honours/pass/fail system and 8 (9%) a pass/fail system. Most of the respondents from each school favoured a grading system that was more discriminating than the one used at their location. The personal interview was regarded as the most important screening tool by 80 (83%) of the respondents; the dean's letter was considered to be very useful by only 16 (17%). CONCLUSIONS: More value was placed by program directors on a numeric or other more discriminating grading system than on the pass/fail system. Although the grading system provides only one type of screening mechanism it raises the question of whether there should be a policy for uniform grading practices for all Canadian students.
PMCID: PMC1487372  PMID: 7553493
3.  Evaluation of Infectious Disease Knowledge in Obstetrics and Gynecology and the Effects of Varying Durations of Training 
Objective: The amount, origin, and resources of infectious disease knowledge in the field ofobstetrics and gynecology were investigated. If this knowledge is lacking, the exact length of the specific infectious disease training during residency should be defined to meet the ever-increasing knowledge required in training.
Methods: A 50-question test was developed by one faculty member utilizing questions that incorporated the basic sciences of microbiology and pharmacology and clinical knowledge of infectious diseases in the area of obstetrics and gynecology. Multiple choice and matching questions were structured so as to ascertain the source of the knowledge, including medical school curriculum, recent journal articles, and clinical experience.
Results: The test was given yearly to all students and residents on the Obstetric and Gynecology Service over a period of 2 year's. The questions were the same for each group, but were reshuffled each exam period. Three hundred and seven tests were properly administered and recorded. There was no statistical improvement in any successive year’s scores unless specific infectious disease training occurred. Increasing improvement in scores was noted, with an increasing duration of infectious disease training specific for obstetrics and gynecology, beginning at 2 weeks (22% improvement), 4 weeks (30% improvement), and 6 weeks (31% improvement) (P = .05–.001). Basic science questions were most frequently answered correctly by medical students and early residents, while correctly answered clinical questions correlated with increasing clinical experience except in the area of ambulatory care.
Conclusions: The infectious disease knowledge of residents in obstetrics and gynecology can be improved with 4 weeks of intensive training. Re-exposure to basic science knowledge and improved training in ambulatory care in this resident group appear to be necessary. This test or similar tests can be helpful in defining areas of deficiencies and their possible remedies.
doi:10.1155/S1064744993000274
PMCID: PMC2364306  PMID: 18475330
4.  The Utility of Letters of Recommendation in Predicting Resident Success: Can the ACGME Competencies Help? 
Background
The Accreditation Council for Graduate Medical Education (ACGME) core competencies are used to assess resident performance, and recently similar competencies have become an accepted framework for evaluating medical student achievements as well. However, the utility of incorporating the competencies into the resident application has not yet been assessed.
Purpose
The objective of this study was to examine letters of recommendation (LORs) to identify ACGME competency–based themes that might help distinguish the least successful from the most successful residents.
Methods
Residents entering a university-based residency program from 1994 to 2004 were retrospectively evaluated by faculty and ranked in 4 groups according to perceived level of success. Applications from residents in the highest and lowest groups were abstracted. LORs were qualitatively reviewed and analyzed for 9 themes (6 ACGME core competencies and 3 additional performance measures). The mean number of times each theme was mentioned was calculated for each student. Groups were compared using the χ2 test and the Student t test.
Results
Seventy-five residents were eligible for analysis, and 29 residents were ranked in the highest and lowest groups. Baseline demographics and number of LORs did not differ between the two groups. Successful residents had statistically significantly more comments about excellence in the competency areas of patient care, medical knowledge, and interpersonal and communication skills.
Conclusion
LORs can provide useful clues to differentiate between students who are likely to become the least versus the most successful residency program graduates. Greater usage of the ACGME core competencies within LORs may be beneficial.
doi:10.4300/JGME-D-11-00010.1
PMCID: PMC3179231  PMID: 22942969
5.  An obstetrics and gynaecology graduate residency programme in Venezuela. 
Postgraduate Medical Journal  1998;74(867):25-27.
We present our experience on the design and development of a gynaecology and obstetrics graduate residency programme, developed in the Department of Obstetrics and Gynecology at the Dr Adolfo Prince Lara Hospital, Puerto Cabello, Venezuela, in which medical specialists and residents participate synergistically. From January to September 1993, curricular activities were planned and students selected. The programme started in October 1993, with six residents for a three-year programme. Courses were given by medical specialists from the Department. In addition to a Programme Coordinator, there is also a Residents' Coordinator, appointed for a two-month term of office; specific functions were assigned for residents occupying this position. All the programmed activities for three years were accomplished, including lectures and rotations, with an important record of surgical interventions. In our grade system, residents got an average of 18 over a maximum of 20 points. Residents also participated as speakers in workshops, special courses and national medicinal meetings, in which they presented a total of nine papers. Activities were evaluated bimonthly in meetings with students and each semester by the Graduate Committee. The first class graduated in September 1996. Results suggest that resident participation in graduate programmes is an important part of their education.
PMCID: PMC2360801  PMID: 9538482
6.  Successfully Matching Into Surgical Specialties: An Analysis of National Resident Matching Program Data 
Objective
We explored the impact that attributes of US medical school seniors have on their success in matching to a surgical residency, in order to analyze trends for National Resident Matching Program (NRMP) match outcomes in surgical specialties between 2007 and 2009.
Methods
Using Electronic Residency Application Service data and NRMP outcomes, we analyzed medical students' attributes and their effect in successfully matching students into residency positions in surgery, otolaryngology, orthopedic surgery, plastic surgery, and obstetrics and gynecology. Attributes analyzed included self-reported United States Medical Licensing Examination (USMLE) Step 1 and Step 2 scores, Alpha Omega Alpha (AOA) Honor Medical Society membership, research experience, additional graduate degree status, and graduation from a top 40 National Institutes of Health (NIH)–funded medical school. Odds ratios were calculated for each criterion, and 95% confidence intervals were used to determine significance.
Results
Between 2007 and 2009, the number of surgical specialty residency positions increased by 86, and the number of applicants increased by 34. Membership in AOA, USMLE Step 1 and Step 2 scores, research experience, and graduation from a top 40 NIH-funded medical school frequently had a significant impact on residents successfully matching into many specialties, while additional graduate degrees had no effect on matching into surgical specialties (range 0.64 to 1.2).
Conclusions
Although the statistical significance varied across specialties, higher USMLE Step 1 and Step 2 scores, AOA membership, research experience, and graduation from a top 40 NIH-funded medical school generally had a positive impact on match success to surgical residency for US allopathic seniors. Test preparation and seeking research experience during undergraduate medical education may be effective approaches for increasing the likelihood of success for US seniors matching into a surgical specialty.
doi:10.4300/JGME-D-09-00020.1
PMCID: PMC2951766  PMID: 21976075
7.  An Alumni Survey as a Needs Assessment for Curriculum Improvement in Obstetrics and Gynecology 
Background
The Accreditation Council for Graduate Medical Education requirements recommend using outside measures to perform annual residency program evaluations to identify areas for program improvement.
Objective
The aim of the study was to identify areas for residency program improvement via an alumni survey.
Methods
An anonymous online survey was sent to the last 10 years of graduates from our obstetrics and gynecology residency program.
Results
Response rate was 63% (34 of 54). All respondents reported being comfortable serving as gynecologic consultants. More than 75% (26 of 54) reported being comfortable performing abdominal hysterectomies, vaginal hysterectomies, basic and complex laparoscopies, and vaginal surgery. Regarding management of urologic injuries, the participants' responses varied, with 58% (20 of 34) reporting they felt prepared, 21% (7 of 34) with neutral responses, and 21% (7 of 34) reporting they felt unprepared. For total laparoscopic hysterectomy, 65% (22 of 34) reported feeling prepared, 29% (10 of 34) reported they felt unprepared, and 9% (3 of 34) reported they felt neutral. All respondents indicated that he or she would still choose the obstetrics and gynecology residency program at the University of Michigan.
Conclusion
An alumni survey can provide useful outside measures for training programs to assess their effectiveness in preparing their graduates for independent practice. Results of alumni surveys can provide a blueprint for program improvement.
doi:10.4300/JGME-D-11-00122.1
PMCID: PMC3444184  PMID: 23997875
8.  Obstetrics and Gynecology: Considerations in Career Selection 
Western Journal of Medicine  1981;134(1):77-79.
Current training programs in obstetrics and gynecology are not producing an excess of specialists in view of future manpower needs. In addition to being specialists and consultants, obstetrician-gynecologists also function as providers of primary care for women. During the last decade, three formal sub-specialties of obstetrics and gynecology have evolved: gynecologic oncology, maternal-fetal medicine and reproductive endocrinology. These have improved patient care and have altered the structure of resident education. With more American medical school graduates entering this specialty, the quality of resident applicants has improved, creating intense competition for desirable training positions. Those inclined toward a career in obstetrics and gynecology can be assured that it will provide an increasingly favorable and challenging environment for professional activity in the future.
PMCID: PMC1272472  PMID: 7210670
9.  Impact of the Medical Liability Crisis on Postresidency Training and Practice Decisions in Obstetrics-Gynecology 
Introduction
The liability crisis may affect residency graduates' practice decisions, yet structured liability education during residency is still inadequate. The objective of this study was to determine the influence of medical liability on practice decisions and to evaluate the adequacy of current medical liability curricula.
Methods
All fourth-year residents (n  =  1274) in 264 Accreditation Council for Graduate Medical Education–accredited allopathic and 25 osteopathic US obstetrics and gynecology residency training programs were asked to participate in a survey about postgraduate plans and formal education during residency regarding liability issues in 2006. Programs were identified by the Council on Resident Education in Obstetrics and Gynecology directory and the American College of Osteopathic Obstetricians and Gynecologists residency program registry. Outcome measures were the reported influence of liability/malpractice concerns on postresidency practice decision making and the incidence of formal education in liability/malpractice issues during residency.
Results
A total of 506 of 1274 respondents (39.7%) returned surveys. Women were more likely than men to report “region of the country” (P  =  .02) and “paid malpractice insurance as a salaried employee” (P  =  .03) as a major influence. Of the respondents, 123 (24.3%) planned fellowship training, and 229 (45.3%) were considering limiting practice. More than 20% had been named in a lawsuit. Respondents cited Pennsylvania, Florida, and New York as locations to avoid. In response to questions about medical liability education, 54.3% reported formal education on risk management, and 65.2% indicated they had not received training on “next steps” after a lawsuit.
Discussion
Residents identify liability-related issues as major influences when making choices about practice after training. Structured education on matters of medical liability during residency is still inadequate.
doi:10.4300/JGME-D-11-00135.1
PMCID: PMC3399611  PMID: 23730440
10.  Subtest Scores From the In-Training Examination: An Evaluation Tool for an Obstetric-Anesthesia Rotation 
Objective
To evaluate resident performance in the obstetric-anesthesia rotation using resident portfolios and their In-Training Examination scores, which are provided by the American Board of Anesthesiology/American Society of Anesthesiologists.
Methods
We reviewed academic portfolios for second- and third-year anesthesiology residents at a single institution from 2006–2008 to examine United States Medical Licensing Exam Step 1 and 2 scores, grade for obstetrics-gynecology in medical school, and performance on the In-Training Examination. Faculty evaluation of medical knowledge and correlations for the various scores were obtained.
Results
We examined scores for 43 residents. The subtest score for obstetric anesthesia increased after completing a rotation in obstetric anesthesia, 26.1 ± 10.3 versus 36.3 ± 10.6 (P  =  .02). The subtest score correlated with United States Medical Licensing Exam Step 2, r  =  0.46 (P  =  .027) but not with United States Medical Licensing Exam Step 1 or with the grade obtained in medical school. There was no correlation between faculty evaluations of medical knowledge and resident subtest scores in obstetric anesthesia.
Conclusions
Subtest scores in obstetric anesthesia are valid and provide a tool for the assessment of the educational program of a rotation. Knowledge as assessed by a faculty member is different from the knowledge assessed on a written examination. Both methods can help provide a more complete assessment of the resident and the rotation.
doi:10.4300/JGME-D-09-00066.1
PMCID: PMC2941385  PMID: 21975629
11.  Compliance with universal precautions: knowledge and behavior of residents and students in a department of obstetrics and gynecology. 
OBJECTIVES: To assess the knowledge of universal precautions for the delivery and operating rooms by residents and students and to evaluate their use of universal precautions. STUDY DESIGN: Obstetrics and gynecology (ob/gyn) residents (n = 30) and students (n = 31) from an inner-city, teaching hospital were polled by anonymous questionnaire to assess their knowledge of the appropriate barrier equipment for certain ob/gyn procedures. To determine actual compliance with universal precautions, 459 ob/gyn procedures were observed. We noted the use of appropriate barrier equipment for each procedure: gloves for pelvic exam and face shields, gowns, gloves, and booties for vaginal delivery, cesarean delivery, and dilation and curettage. The True Epistat statistical software program was used to perform simple regression analysis. RESULTS: Thirty residents (100%) knew the appropriate barrier equipment required for each type of procedure performed. One student (< 1%) did not know that booties were appropriate for the surgical procedures. Rationale for lack of compliance with universal precautions elicited by the questionnaire included time constraints (64%), inconvenience (52%), and presumption that patient was not infected (34%). The observed rate of compliance with universal precautions by participants indicates that individual compliance was inversely related to the years of experience (overall compliance rate of students was 96%; for first-year residents, 92%, second-year residents, 89%, third-year residents, 84%, fourth-year residents, 78%; r = -0.9918, P = 0.0009). CONCLUSIONS: Knowledge regarding universal precautions was nearly 100%, while overall observed compliance was only 89%. Compliance with universal precautions was better among students (96%) than among residents (88%). Compliance with universal precautions was inversely related to years of experience.
doi:10.1002/(SICI)1098-0997(1998)6:3<123::AID-IDOG5>3.0.CO;2-Y
PMCID: PMC1784790  PMID: 9785108
12.  The Effect of Student Gender on the Obstetrics and Gynecology Clerkship Experience 
Journal of Women's Health  2010;19(1):87-92.
Abstract
Objectives
To explore the effects of the students' gender on their perception of quality and quantity of teaching, the amount of experiential learning, and their interest in obstetrics and gynecology.
Methods
Anonymous, self-administered surveys to third-year medical students rotating on the obstetrics and gynecology clerkship.
Results
Eighty-one of 91 students participated (89% response rate): 33 men, 46 women, 2 declined to reveal their gender. No significant gender differences existed regarding number of interactions with residents and faculty; number of deliveries, surgeries, or examinations performed; perceived quality of teaching; or feeling included as part of the clinical team. Male students were more likely to report performing specific surgical procedures, such as operating the bovie cautery during gynecological surgeries (p = 0.005). More men experienced patients refusing to allow them to participate in the clinical interview (p < 0.0001) and physical examination (p < 0.0001). Male students were also more likely to report feeling that their gender negatively impacted their clerkship experience (p < 0.0001). Although less likely to report preclerkship and postclerkship career interest in obstetrics and gynecology, male students were more likely to report that their interest increased at the end of the clerkship.
Conclusions
Male students were more likely to experience gender bias from patients on the obstetrics and gynecology service. Male students also described feeling socially excluded from female-dominated clinical teams. Obstetrics and gynecology educators need to consider methods of encouraging patients to accept medical student participation regardless of gender. Obstetrics and gynecology faculty and residents need to be sensitive to subtle forms of gender bias and ensure equal inclusion for both male and female medical students.
doi:10.1089/jwh.2009.1357
PMCID: PMC2828191  PMID: 20088663
13.  Training at a Faith-Based Institution Matters for Obstetrics and Gynecology Residents: Results From a Regional Survey 
Background
Prior data suggest that opportunities in family planning training may be limited during obstetrics and gynecology (Ob-Gyn) residency training, particularly at faith-based institutions with moral and ethical constraints, although this aspect of the Ob-Gyn curriculum has not been formally studied to date.
Objectives
We compared Ob-Gyn residents' self-rated competency and intentions to provide family planning procedures at faith-based versus those of residents at non-faith-based programs.
Methods
We surveyed residents at all 20 Ob-Gyn programs in Illinois, Indiana, Iowa, and Wisconsin from 2008 to 2009. Residents were queried about current skills and future plans to perform family planning procedures. We examined associations based on program and residents' personal characteristics and performed multivariable logistic regression analysis.
Results
A total of 232 of 340 residents (68%) from 17 programs (85%) returned surveys. Seven programs were faith-based. Residents from non-faith-based programs were more likely to be completely satisfied with family planning training (odds ratio [OR]  =  3.4, 95% confidence limit [CI], 1.9–6.2) and to report they “understand and can perform on own” most procedures. Most residents, regardless of program type, planned to provide all surveyed family planning services.
Conclusions
Despite similar intentions to provide family planning procedures after graduation, residents at faith-based training programs were less satisfied with their family planning training and rate their ability to perform family planning services lower than residents at non-faith-based training programs.
doi:10.4300/JGME-D-12-00109.1
PMCID: PMC3693688  PMID: 24404267
14.  Attrition Rates Between Residents in Obstetrics and Gynecology and Other Clinical Specialties, 2000–2009 
Background
As resident attrition disrupts educational and workload balance and reduces the number of graduating physicians to care for patients, an ongoing goal of graduate medical education programs is to retain residents.
Objective
We compared annual rates of resident attrition in obstetrics and gynecology (Ob-Gyn) with other clinical specialties of similar or larger size during a recent 10-year period, and explored the reasons for resident attrition.
Methods
In this observational study, we analyzed annual data from the American Medical Association Graduate Medical Education Census between academic years 2000 and 2009 for residents who entered Ob-Gyn and other core clinical specialties. Our primary outcome was the trend in averaged annual attrition rates.
Results
The average annual attrition was 196 ± 12 (SD) residents, representing 4.2% ± 0.5% of all Ob-Gyn residents. Rates of attrition were consistently higher among men (5.3%) and international medical school graduates (7.6%). The annual rate of attrition was similar to that for other clinical specialties (mean: 4.0%; range: from 1.5% in emergency medicine to 7.9% in psychiatry). The attrition rates for Ob-Gyn residents were relatively stable for the 10-year period (range: 3.6% in 2008 to 5.1% in 2006). Common reasons for attrition were transition to another specialty (30.0%), withdrawal/dismissal (28.2%), transfer to another Ob-Gyn program (25.4%), and leave of absence (2.2%). These proportions remained fairly constant during this 10-year period.
Conclusions
The average annual attrition rate of residents in Ob-Gyn was 4.2%, comparable to most other core clinical specialties.
doi:10.4300/JGME-D-12-00141.1
PMCID: PMC3693692  PMID: 24404271
15.  Duty Hour Restrictions, Ambulatory Experience, and Surgical Procedural Volume in Obstetrics and Gynecology 
Background
Prior studies of resident experience in gynecology looked only at the year before and after adoption of ACGME duty hour standards. This study sought to determine whether procedure volume differed after completion of a 4-year residency training program, before and after work hour reform.
Method
Inpatient and outpatient procedures performed by MetroHealth Medical Center/Cleveland Clinic program residents from 1998 to 2006 were obtained from Annual Reports of Institutional and Resident Experience. Four-year experience before and after duty hour restrictions were compared: hours worked were collected from resident schedules, ambulatory hours and procedures were compared directly, surgical procedures and deliveries were compared using a 2-tailed t test. Data were also obtained for institutional volume changes, and a corrected value, based on the rates of resident cases per available cases, was analyzed.
Results
Ambulatory hours worked per resident decreased after implementing work hour reform from 674 to 366 hours. The types of ambulatory and surgical procedures performed varied over time. Overall, basic surgical and obstetrical volume per resident did not change before and after work hour reform (mean before reform, 723 ± 117, mean after reform, 781 ± 200, P  =  .58 for gynecologic procedures; mean before reform, 611 ± 107, mean after reform, 535 ± 73, P  =  .18 for basic obstetrics and vaginal and cesarean deliveries). Institutional volume did not change significantly, although the percentage of the institutions' cases performed by residents did decrease for some procedures.
Conclusion
The ACGME duty hour restrictions do not limit the overall ambulatory or surgical procedural volume in an obstetrics and gynecology residency-training period.
doi:10.4300/JGME-D-10-00076.1
PMCID: PMC3010935  PMID: 22132273
16.  Oncology education in Canadian undergraduate and postgraduate medical programs: a survey of educators and learners 
Current Oncology  2014;21(1):e75-e88.
Background
The oncology education framework currently in use in Canadian medical training programs is unknown, and the needs of learners have not been fully assessed to determine whether they are adequately prepared to manage patients with cancer.
Methods
To assess the oncology education framework currently in use at Canadian medical schools and residency training programs for family (fm) and internal medicine (im), and to evaluate opinions about the content and utility of standard oncology education objectives, a Web survey was designed and sent to educators and learners. The survey recipients included undergraduate medical education curriculum committee members (umeccms), directors of fm and im programs, oncologists, medical students, and fm and im residents.
Results
Survey responses were received from 677 educators and learners. Oncology education was felt to be inadequate in their respective programs by 58% of umeccms, 57% of fm program directors, and 50% of im program directors. For learners, oncology education was thought to be inadequate by 67% of medical students, 86% of fm residents, and 63% of im residents. When comparing teaching of medical subspecialty–related diseases, all groups agreed that their trainees were least prepared to manage patients with cancer. A standard set of oncology objectives was thought to be possibly or definitely useful for undergraduate learners by 59% of respondents overall and by 61% of postgraduate learners.
Conclusions
Oncology education in Canadian undergraduate and postgraduate fm and im training programs are currently thought to be inadequate by a majority of educators and learners. Developing a standard set of oncology objectives might address the needs of learners.
doi:10.3747/co.21.1667
PMCID: PMC3921051  PMID: 24523624
Oncology education; Canada; undergraduate medical programs; postgraduate medical programs
17.  Awareness of Infectious Diseases in Obstetrics and Gynecology Among Residents and Residency Directors 
Awareness of the subspecialty of infectious diseases in obstetrics and gynecology is low among United States residents and residency directors. Objective. Given the burden of infectious diseases on women's health, we sought to assess current awareness, interest, and perceived value of the subspecialty of infectious diseases in obstetrics and gynecology among current United States obstetrics and gynecology residents and residency directors. Methods. Two separate surveys addressing awareness, perceived value and interest in the subspecialty were sent to (1) a random 20% sample of obstetrics and gynecology residents and (2) all obstetrics and gynecology residency directors. Results. Seventy percent of the residency directors were familiar with the subspecialty and 67.0% placed value on infectious disease specialists in an academic department. Thirty percent of the residents reported awareness of the subspecialty. Thirty-six percent of residency directors reported that medical infectious disease specialists deliver formal education to the obstetrics and gynecology residents. Conclusion. United States obstetrics and gynecology residents and residency directors have a low awareness of the subspecialty. An open niche exists for formal education of residents in infectious diseases in obstetrics and gynecology by department specialists. These findings can be incorporated into ongoing recruitment efforts for the subspecialty of infectious diseases in obstetrics and gynecology.
doi:10.1155/IDOG/2006/42967
PMCID: PMC1779608  PMID: 17485801
18.  Laparoscopy Training in United States Obstetric and Gynecology Residency Programs 
Objectives:
To assess laparoscopic training curriculums in US Obstetrics and Gynecology residency programs.
Methods:
A list of E-mail addresses was obtained for the accredited Obstetrics and Gynecology residency programs in the US from the CREOG Directory of ObstetricGynecologic Residency Programs and Directors. An E-mail survey containing 8 questions regarding laparoscopy training was sent to all residency directors with current E-mail addresses.
Results:
Seventy-four residency directors responded to the survey for a response rate of 41%. Residency programs from all sections of the US were included in the study. Results of the survey indicate that 69% of residency programs had implemented a formal laparoscopy training program. At least half of the program directors surveyed stated that lack of faculty time and funds were the main barriers to laparoscopic surgery training. Seventy-two percent of those surveyed thought that in the future the health-care industry would demand proof of competency in laparoscopy as standard of care.
Conclusions:
Most US Obstetrics and Gynecology residency programs have implemented a formal laparoscopy training curriculum, use more than one method to train their residents, and involve almost half of their faculty on average in training residents to perform laparoscopic surgery.
PMCID: PMC3015675  PMID: 16709349
Laparoscopy; Education; Residency; Surgery
19.  Evaluation of a Formal Mentoring Program in an Obstetrics and Gynecology Residency Training Program: Resident Feedback and Suggestions 
Objective
A formal mentoring program for residents was introduced at our Department of Obstetrics and Gynecology in 2004. The objective of this study was to assess residents' attitudes toward and suggestions for the mentoring program.
Study Design/Methods
An anonymous questionnaire with Likert-scaled questions on multiple areas of the program was distributed to all residents. The responses were scored with a rating of 0, 1, and 2, and mean ratings were calculated.
Results/Conclusions
The response rate was 28 of 40 (70.0%). Areas of the mentoring program deemed most important were “career planning” (mean score 1.85) and “scientific research” (1.51). The most negative aspects of the program were “lack of time” of the mentees (1.57) and the mentors (1.29). When matching mentees with mentors, the most important factors were “specialty/subspecialty” (1.71), “research interests”(1.65), “personality”(1.54), and the “ability to pick one's own mentor”(1.31). The majority of respondents (9 of 14, 64.3%) welcomed e-mail reminders to set up meetings with their mentor. These data have resulted in significant changes in our mentoring program. Future directions include continued surveillance of our program and collaboration between different residency programs in order to maximize the benefit of the resident mentor program.
doi:10.4300/01.01.0022
PMCID: PMC2931185  PMID: 21975720
20.  Obstetrics and gynecology clerkship for males and females: similar curriculum, different outcomes? 
Medical Education Online  2013;18:10.3402/meo.v18i0.21506.
Objective
To determine if performance differences exist between male and female students on a 6-week obstetrics and gynecology (Ob/Gyn) clerkship and to evaluate potential variables that might underlie any observed variations.
Study Design
Final clerkship grades and component scores (clinical evaluations, objective structured clinical examination [OSCE], oral examination, and National Board of Medical Examiners [NBME] subject examination) from July 2007 to June 2010 were matched by student and analyzed by gender. Basic science grade point average (GPA) and initial United States Medical Licensing Exam (USMLE) Step 1 scores were used to establish students’ baseline medical knowledge. On a post-clerkship questionnaire, a subset of students reported the numbers of procedures they performed during the clerkship; students also completed online pre- and post-clerkship questionnaires reflecting their self-assessed confidence in women's health clinical skills.
Results
Scores were analyzed for 136 women and 220 men. Final clerkship grades were significantly higher for females than for males (89.05 vs. 87.34, p=0.0004, η 2=0.08). Specifically, females outscored males on the OSCE, oral, and NBME subject examination portions of the clerkship but not clinical evaluations. Males reported completing fewer breast examinations (p=0.001, η 2=0.14). Pre-clerkship, males were significantly less confident than females in women's health clinical skills (p<0.01) but reached similar levels upon completion of the clerkship. No gender differences were detected for basic science GPA and USMLE Step 1 scores.
Conclusion
Student gender is associated with final grades on an Ob/Gyn clerkship. Further research regarding these differences should be explored.
doi:10.3402/meo.v18i0.21506
PMCID: PMC3849500  PMID: 24300748
clerkship; gender; grades; obstetrics and gynecology clerkship; performance
21.  Relationship Between Peer Assessment During Medical School, Dean’s Letter Rankings, and Ratings by Internship Directors 
Background
It is not known to what extent the dean’s letter (medical student performance evaluation [MSPE]) reflects peer-assessed work habits (WH) skills and/or interpersonal attributes (IA) of students.
Objective
To compare peer ratings of WH and IA of second- and third-year medical students with later MSPE rankings and ratings by internship program directors.
Design and Participants
Participants were 281 medical students from the classes of 2004, 2005, and 2006 at a private medical school in the northeastern United States, who had participated in peer assessment exercises in the second and third years of medical school. For students from the class of 2004, we also compared peer assessment data against later evaluations obtained from internship program directors.
Results
Peer-assessed WH were predictive of later MSPE groups in both the second (F = 44.90, P < .001) and third years (F = 29.54, P < .001) of medical school. Interpersonal attributes were not related to MSPE rankings in either year. MSPE rankings for a majority of students were predictable from peer-assessed WH scores. Internship directors’ ratings were significantly related to second- and third-year peer-assessed WH scores (r = .32 [P = .15] and r = .43 [P = .004]), respectively, but not to peer-assessed IA.
Conclusions
Peer assessment of WH, as early as the second year of medical school, can predict later MSPE rankings and internship performance. Although peer-assessed IA can be measured reliably, they are unrelated to either outcome.
doi:10.1007/s11606-007-0117-4
PMCID: PMC1824780  PMID: 17351836
assessment; professionalism; undergraduate medical education
22.  Relationship Between Peer Assessment During Medical School, Dean’s Letter Rankings, and Ratings by Internship Directors 
Background
It is not known to what extent the dean’s letter (medical student performance evaluation [MSPE]) reflects peer-assessed work habits (WH) skills and/or interpersonal attributes (IA) of students.
Objective
To compare peer ratings of WH and IA of second- and third-year medical students with later MSPE rankings and ratings by internship program directors.
Design and Participants
Participants were 281 medical students from the classes of 2004, 2005, and 2006 at a private medical school in the northeastern United States, who had participated in peer assessment exercises in the second and third years of medical school. For students from the class of 2004, we also compared peer assessment data against later evaluations obtained from internship program directors.
Results
Peer-assessed WH were predictive of later MSPE groups in both the second (F = 44.90, P < .001) and third years (F = 29.54, P < .001) of medical school. Interpersonal attributes were not related to MSPE rankings in either year. MSPE rankings for a majority of students were predictable from peer-assessed WH scores. Internship directors’ ratings were significantly related to second- and third-year peer-assessed WH scores (r = .32 [P = .15] and r = .43 [P = .004]), respectively, but not to peer-assessed IA.
Conclusions
Peer assessment of WH, as early as the second year of medical school, can predict later MSPE rankings and internship performance. Although peer-assessed IA can be measured reliably, they are unrelated to either outcome.
doi:10.1007/s11606-007-0117-4
PMCID: PMC1824780  PMID: 17351836
assessment; professionalism; undergraduate medical education
23.  Using a Commercially Available Web-Based Evaluation System to Enhance Residents' Teaching 
Background
Residents-as-teachers (RATs) programs have been shown to improve trainees' teaching skills, yet these decline over time.
Intervention
We adapted a commercial Web-based system to maintain resident teaching skills through reflection and deliberate practice and assessed the system's ability to (1) prevent deterioration of resident teaching skills and (2) provide information to improve residents' teaching skills and teaching program quality.
Methods
Ten first-year obstetrics-gynecology (Ob-Gyn) residents participated in a RATs program. Following the program, they used a commercial evaluation system to complete self-assessments of their teaching encounters with medical students. Students also evaluated the residents. To assess the system's effectiveness, we compared these residents to historical controls with an Objective Structured Teaching Examination (OSTE) and analyzed the ratings and the free text comments of residents and students to explore teaching challenges and improve the RATs program.
Results
The intervention group outscored the control group on the OSTE (mean score ± SD  =  81 ± 8 versus 74 ± 7; P  =  .05, using a 2-tailed Student t-test). Rating scale analysis showed resident self-assessments were consistently lower than student evaluations, with the difference reaching statistical significance in 3 of 6 skills (P < .05). Comments revealed that residents most valued using innovative teaching techniques, while students most valued a positive educational climate and interpersonal connections with residents. Recommended targets for RATs program improvement included teaching feedback, time-limited teaching, and modeling professionalism behaviors.
Conclusions
Our novel electronic Web-based reinforcement system shows promise in preventing deterioration of resident teaching skills learned during an Ob-Gyn RATs program. The system also was effective in gaining resident and student insights to improve RATs programs. Because our intervention was built upon a commercially available program, our approach could prove useful to the large population of current subscribers.
doi:10.4300/JGME-D-11-00018.1
PMCID: PMC3312536  PMID: 23451309
24.  Implementing a Multifaceted Quality-Improvement Curriculum in an Obstetrics-Gynecology Resident Continuity-Clinic Setting: A 4-Year Experience 
Background
Although many residency programs are instituting quality improvement (QI) curricula in response to both institutional and external mandates, there are few reports of successful integration of resident initiated projects into these QI curricula with documented impact on health care processes and measures.
Intervention
We introduced a multifaceted curriculum into an Obstetrics-Gynecology continuity clinic. Following a needs assessment, we developed a didactic session to introduce residents to QI tools and the how to of a mentored resident-initiated project. Resident projects were presented to peers and faculty and were evaluated. A postgraduation survey assessed residents' satisfaction with the curriculum and preparedness for involvement in QI initiatives after residency. We also assessed whether this resulted in sustained improvement in health care measures.
Results
The curriculum was presented to 7 classes of residents (n  =  25) and 17 resident initiated projects have been completed. Twenty-one residents (84%) completed the preintervention survey and 12 of 17 (71%) residents who completed the entire curriculum completed the postintervention survey. Sustained change in surrogate health measures was documented for 4 projects focused on improving clinical measures, and improvement in clinical systems was sustained in 9 of the remaining 13 projects (69%). Most of the respondents (75%, n  =  9) agreed or strongly agreed that the projects done in residency provided a helpful foundation to their current QI efforts.
Conclusion
This project successfully demonstrates that a multifaceted program in QI education can be implemented in a busy Obstetrics-Gynecology residency program, resulting in sustained improvement in surrogate health measures and in clinical systems. A longitudinal model for resident projects results in an opportunity for reflection, project revision, and a maintenance plan for continued clinical impact.
doi:10.4300/JGME-D-11-00158.1
PMCID: PMC3399619  PMID: 23730448
25.  Potentially Discriminatory Questions During Residency Interviews: Frequency and Effects on Residents' Ranking of Programs in the National Resident Matching Program 
Background
Medical students rank residency programs as part of the selection process in the National Resident Matching Program, also known as the match. Applicants to medical residency positions are protected against discriminatory employment practices by federal employment laws.
Objectives
To explore students' recall of being asked potentially illegal or discriminatory questions during the selection interview, and whether these questions affected students' ranking of the programs in the match.
Methods
Fourth-year medical students from a single medical school were surveyed after the match. Students were questioned about their recall of the frequency of potentially illegal or discriminatory interview questions and their effect on the program's rank.
Results
Ninety percent of the 63 respondents in the study remember being asked at least one potentially discriminatory question. Among these, students were asked about their marital status (86%), about children (31%), about plans for pregnancy (10%), where they were born (54%) and/or about their national origin (15%), and about religious and ethical beliefs (24%). The majority of students did not think the questions changed their decision to rank the program, although the questions changed the way some students ranked the program, either lowering or raising the rank.
Conclusion
Nearly all students reported that they were asked at least one potentially discriminatory question, although these questions for the most part do not appear to affect whether they ranked the programs.
doi:10.4300/JGME-D-10-00041.1
PMCID: PMC2951770  PMID: 21976079

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