Article Text

  1. H. Certain1,
  2. K. Fabiato1,
  3. S. Call1,
  4. W. Klein1
  1. *Wm. S. Middleton Veteran Affairs Hospital, Madison, WI; VCU Health Systems, Richmond, VA


Introduction Several surveys demonstrate that internal medicine residents do not feel adequately trained in women's health areas during residency. In response, many institutions have begun women's health tracks. The purpose of our study is to evaluate the effect of a women's health track on clinical competencies in core women's health areas among women's health residents and categorical residents. We hypothesize that participation in a women's health track improves the women's health education of internal medicine residents.

Method In May and June of 2006, a survey was e-mailed to all internal medicine and medicine/pediatrics residents at four institutions, two of which had a women's health track and two of which did not. The survey addressed demographic data, residents' self-perceptions of competency in women's health, and residents' thoughts on a women's health track. The survey used a scale of 1 (beginner) to 5 (advanced). The primary outcome was whether women's health residents perceived themselves as more competent in women's health. Logistic regression was used to analyze the association between residency track and level of ability in women's health. Odds ratios and 95% confidence interval were obtained.

Results Responses were obtained from 96 residents. For all residents, the mean response on women's health topics was less than 3.7. Compared with categorical residents at an institution without a women's health track, women's health residents were more likely to rate themselves as advanced (“4” or “5”) in performing a bimanual examination (odd ratio [OR] 6.76 (95% confidence interval [CI] 1.05-43.2), performing a Pap smear (OR 14.39, 95% CI 1.21-170), knowing when women can stop being screened for cervical and breast cancer (OR 6.10, 95% CI 1.01-34.6), knowing when to stop hormone replacement therapy (OR 12.37, 95% CI 1.88-80.9), and in diagnosing and treating incontinence (OR 21.2, 95% CI 2.81-159).

Conclusions Our study showed that residents in a women's health track feel more competent in certain key areas of women's health. Although our study numbers are small, we feel that an important conclusion resounds. Many internal medicine residents lack a strong ability in several core areas of women's health, suggesting that residency programs must continue to improve the women's health education of all internal medicine residents.

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