helen morgan

BackgroundClerkship grades in obstetrics and gynecology play an increasingly important role in the competitive application process to residency programs. An analysis of clerkship grading practices has not been queried in the past 2 decades in our specialty.ObjectiveThis study aimed to investigate obstetrics and gynecology clerkship directors’ practices and perspectives in grading.Study DesignA 12-item electronic survey was developed and distributed to clerkship directors with active memberships in the Association of Professors of Gynecology and Obstetrics.ResultsA total of 174 of 236 clerkship directors responded to the survey (a response rate of 73.7%). Respondents reported various grading systems with the fewest (20/173 [11.6%]) using a 2-tiered or pass or fail system and the most (72/173 [41.6%]) using a 4-tiered system. Nearly one-third of clerkship directors (57/163 [35.0%]) used a National Board of …

OBJECTIVEThere are few published accounts of the obstetrics and gynecology (OBGYN) specialty-specific experience with a formal signaling program. Prior studies examining other medical specialties’ experiences with signaling are quantitative, having not examined the complexity of the residency applicant experience by directly engaging applicants; therefore, this study aimed to describe the lived experiences of OBGYN residency applicants who employed a formal signaling program during the 2022-2023 residency application cycle to assist and guide future residency applicants.DESIGNA phenomenological approach was chosen to prescribe a common meaning for OBGYN residency applicants' experiences. purposeful sampling was employed to ensure racial, ethnic, and institutional geographic diversity in participant representation. Semi-structured interviews were conducted virtually between April and May …

ImportanceState-specific abortion restrictions currently affect the training of approximately 44% of obstetrics and gynecology (OBGYN) residents in the US. Examination of where future trainees apply for residency is important.ObjectiveTo assess changes in the percentage of applicants to OBGYN residency programs by state based on abortion restrictions in place after theDobbs v Jackson Women’s Health Organization(hereafter,Dobbs v Jackson) US Supreme Court decision and examine whether applicants’ preference for programs, as suggested by the distribution of application signals that express higher interest, was associated with abortion bans.Design, Setting, and ParticipantsThis serial cross-sectional study used anonymized data for all applicants to OBGYN residency programs in the US during September and October from 2019 to 2023. Data were obtained from the Association of American Medical …

Background Medical trainees are expected to perform complex tasks while experiencing interruptions, which increases susceptibility to errors of omission. In our study, we examine whether documentation of clinical encounters increases reflective thinking and reduces errors of omission among novice learners in a simulated setting. Methods In 2021, 56 senior medical students participated in a simulated paging curriculum involving urgent inpatient cross‐cover scenarios (sepsis and atrial fibrillation). Students responded to pages from standardized registered nurses (SRNs) via telephone, gathered history, and discussed clinical decision‐making. Following the phone encounter, students documented a brief note (documentation encounter). A ‘phone’ score (number of checklist items completed in the phone encounter) and a ‘combined’ score (number of checklist items completed in the phone and documentation …

Background As the gender demographics of medical students have evolved over the past decades, it is important to understand potential stressors and challenges that may affect clinical learning experiences. This study investigated the prevalence of prior sexual assault (SA) and interpersonal violence (IPV) in medical students and how these affect their clinical clerkship experiences. Methods A survey was distributed to third‐ and fourth‐year medical students at a single institution in August 2022 querying respondents on demographics and prior experiences with SA/IPV at any point in their lives. Respondents who indicated they had previously experienced SA/IPV were directed to questions about how these experiences affected clerkships. Findings Of 419 students, 125 responded to the survey (30.8% response rate). Forty (31.1%) reported a history of SA/IPV—32 (80.0%) women, five (12.5%) men, and three (7 …

Transition to Residency (TTR) courses help ease the critical transition from medical school to residency, yet there is little guidance for developing and running these courses. In this perspective, the authors use their expertise as well as a review of the literature to provide guidance and review possible solutions to challenges unique to these courses. TTR courses should be specialty-specific, allow for flexibility, and utilize active learning techniques. A needs assessment can help guide course content, which should focus on what is necessary to be ready for day one of residency. The use of residents in course planning and delivery can help create a sense of community and ensure that content is practical. While course assessments are largely formative, instructors should anticipate the need for remediation, especially for skills likely to be performed with limited supervision during residency. Additionally, TTR courses …

The graduate medical education community must recognize and address the potential ramifications of the removal of the constitutional right to abortion on its learners. There have been profound changes in gender demographics of the residency workforce during the 5 decades since the US Supreme Court’s passage of Roe v Wade. In 1973, women comprised 9% of residency graduates, 1 compared with 46.4% of all residents currently. 2 In the 6 months since the Dobbs v Jackson Women’s Health Organization US Supreme Court decision, 13 states have enacted complete abortion bans and an additional 5 states have enacted gestational limits for abortion ranging from 6 to 20 weeks estimated gestational age. 3 Notably, 3880 (32.0%) residency programs—with 44 361 (30.6%) residents in the US—are within these 18 states 2 (Table). Given that resident physicians are both employees of hospital systems and …

PurposeTransition to residency (TTR) courses facilitate the medical student–residency transition and are an integral part of senior medical student training. The authors established a common set of skills for TTR courses and an expected level of entrustment students should demonstrate in each skill on TTR course completion.MethodA modified Delphi approach was used with 3 survey iterations between 2020 and 2022 to establish skills to be included in a TTR course. Nine TTR experts suggested general candidate skills and conducted a literature search to ensure no vital skills were missed. A stakeholder panel was solicited from email lists of TTR educators, residency program directors, and residents at the panelists’ institutions. Consensus was defined as more than 75% of participants selecting a positive inclusion response. An entrustment questionnaire asked panelists to assign a level of expected entrustment …

Purpose: Transition To Residency (TTR) courses are designed to prepare graduating medical students to more seamlessly transition into the role of an intern and have become increasingly common in US medical schools. 1–3 There is variation in the goals and structure of these curricula and some have begun to conceptualize the “transition to residency” as encompassing most of the post-clerkship timeframe of medical education. 4 There is a need for evidence-informed guidance for curriculum development in existing and new TTR courses. Establishing a consensus-based common set of TTR course skills will facilitate standardized internship preparation and would encourage collaboration amongst TTR educators at different schools.Method: We conducted a modified Delphi approach to establish a set of skills that should be taught in a TTR course. We used a predefined definition of consensus as> 75% of the …

Obstetrician-gynecologists can improve the learning environment and patient care by addressing implicit bias. Accumulating evidence demonstrates that racial and gender-based discrimination is woven into medical education, formal curricula, patient-provider-trainee interactions in the clinical workspace, and all aspects of learner assessment. Implicit bias negatively affects learners in every space. Strategies to address implicit bias at the individual, interpersonal, institutional, and structural level to improve the well-being of learners and patients are needed. The authors review an approach to addressing implicit bias in obstetrics and gynecology education, which includes: (1) curricular design using an educational framework of antiracism and social justice theories, (2) bias awareness and management pedagogy throughout the curriculum, (3) elimination of stereotypical patient descriptions from syllabi and …

ObjectiveTo evaluate residency program director views on the purpose and value of an away rotation for students applying to a residency application in Obstetrics and Gynecology (OBGYN).Design, Setting, and ParticipantsThe Council on Resident Education in Obstetrics and Gynecology administered a 28-question survey to current U.S. program directors in OBGYN in 2022. Program directors were asked if they offered away rotations to visiting medical students and if so, what the purpose the rotation played in their application process and whether rotating students were automatically offered a residency interview. Program characteristics such as program size, geographic location, and program type (university, community, or military based) were ascertained. A test of proportions was utilized to understand the relationship between program description and survey responses.ResultsSeventy-nine percent (224/285) of …

Purpose: Many factors can lead to a challenging transition to residency for some learners. 1, 2 In order to create interventions that address the needs of all incoming residents, it is important to understand potential systemic differences. Our goal was to examine obstetrics and gynecology residents’ perceptions of their transition to residency and to understand how residents’ background and medical school environment influence their transition experience—especially their perceived sense of readiness.Method: A 16-item survey was designed and administered to all obstetrics and gynecology residents at the time of their in-training examination in January 2022. Perception of preparedness was assessed with the question “I felt that I was well prepared for the first year of residency”(1= strongly agree, 2= agree, 3= neutral, 4= disagree, 5= strongly disagree). Respondents indicated whether they participated in a …

Introduction Interprofessional experiences provide critical exposure to collaborative health care teams, yet medical students often lack this experience during clinical clerkships. We created a labor and delivery triage rotation exclusively staffed by certified nurse‐midwives in the obstetrics and gynecology clerkship to address this gap. We sought to evaluate the clinical learning experiences of medical students rotating on this midwife‐supervised collaborative team. Methods Between 2018 and 2020, we electronically sent all medical students an evaluation after each required clerkship. Our primary outcome was the quality of teaching score, as defined by level of agreement on a 5‐point Likert scale with a statement regarding teaching quality. A secondary outcome evaluated scores from the National Board of Medical Examiners (NBME) Obstetrics and Gynecology subject examination taken by all students at the end …

The June 2022 US Supreme Court decision on Dobbs v Jackson Women’s Health Organization resulted in state-specific differences in abortion care access across the country. The primary concern in the obstetrics and gynecology education community has been the impact on resident and fellowship training programs. However, the impact on undergraduate medical education and the broad implications for future generations of physicians are crucial to address. It is estimated that 48% of matriculants to MD-granting medical schools will receive their medical education in the 26 states with significant abortion restrictions or bans. Undergraduate medical educators need to continue to adequately teach the basic science, clinical care, and population health outcomes of reproductive medicine, including pregnancy and abortion. In addition, students in states with more restrictions on abortion will have less or no clinical …

The labor and delivery floor is a unique learning environment that poses challenges to teaching medical students, with a potentially detrimental effect on their evaluations of the obstetrics and gynecology clerkship. This article, from the “To the Point” series prepared by the Association of Professors of Gynecology and Obstetrics Undergraduate Medical Education Committee, offers specific suggestions for improving undergraduate medical education in obstetrics with attention to student preparation, faculty development, nonphysician staff involvement, and patient education. Optimizing the learning environment in labor and delivery would improve student experiences and perceptions of our specialty.

Purpose: The aim of this study is to explore the well-being of obstetrics and gynecology (OB/GYN) residents and to determine whether patterns observed among trainees have persisted despite changes both within and outside of the clinical learning environment.Method: An observational cross-sectional study of residents in OB/GYN taking the 2022 national in-training examination was performed using an online survey. Respondents provided demographic information and self-assessment of burnout using a 2-item Maslach Burnout Inventory and resilience using a 2-item Connor-Davidson resilience scale as well as experience with depression, anxiety, and other mental health concerns. Residents were asked about the priority of physician well-being in their training program and whether they had thoughts of leaving the residency program. Kruskal-Wallis and chi-square tests explored differences in outcomes and …

ObjectiveTo evaluate perceived gaps in preparedness, current on-boarding practices, and need for specialty wide resources in the transition to residency training in obstetrics and gynecology (OB/GYN)Design, Setting, and ParticipantsA cross-sectional survey of current U.S. OB/GYN residents and program directors (PDs) at the time of the resident in-training exam was conducted in 2022. Both groups provide demographic information and identified specific knowledge, skills, and abilities in need of more preparation at the start of residency. PDs were queried on perceptions of readiness for their current first year class, educational on-boarding practices, and their preference for standardized curricular materials and assessment tools. Chi-squared and Kruskal-Wallis tests were used to compare perceptions of skills deficits between PDs and residents, and the relationship of preparedness to program type and resident …

ImportanceIn order to equitably improve the residency application process, it is essential to understand the problems we need to address.ObjectiveTo determine how obstetrics and gynecology (OBGYN) applicants and faculty communicate applicants’ interest to residency programs, and how program directors report being influenced by these communications.Design, Setting, and ParticipantsThis survey study was conducted with email surveys of OBGYN application stakeholders in 2022. Included participants were OBGYN applicants, clerkship directors, and residency program directors in medical education associations’ email listservs.ExposuresSurveys sent by the American Association of Medical Colleges, Association of Professors of Gynecology and Obstetrics, and Council on Resident Education in Obstetrics and Gynecology.Main Outcomes and MeasuresWhether applicants themselves, or faculty on their …

BACKGROUNDGiven the increasing complexities of the residency application processes, there is an ever-increasing need for faculty to serve in the role of fourth-year medical student career advisors.OBJECTIVEThis study aimed to investigate obstetrics and gynecology clerkship directors’ confidence and fulfillment with serving in the role of faculty career advisors.STUDY DESIGNA 25-item electronic survey was developed and distributed to the 225 US obstetrics and gynecology clerkship directors in university-based and community-based medical schools with active memberships in the Association of Professors of Gynecology and Obstetrics. Items queried respondents on demographics, confidence in fourth-year advising, satisfaction with this aspect of their career, and resources used for advising.RESULTSOf 225 clerkship directors, 143 (63.6%) responded to the survey. Nearly all clerkship directors (136/143 [95 …

BACKGROUNDThe evolving landscape of application processes for obstetrics and gynecology residency applicants poses many challenges for applicants and advisors. The lack of data coordination among national groups creates crucial gaps in information for stakeholder groups.OBJECTIVEThis study aimed to identify the current state of the advising milieu for obstetrics and gynecology residency applicants and their career advisors, the annual Association of Professors of Gynecology and Obstetrics survey focused on US clerkship directors’ experiences advising students through these processes.STUDY DESIGNA 23-item anonymous survey was developed that asked respondents about demographics and outcomes for the students that they advised through the 2021 application process and their experiences with dual applicants and students not matching. The survey was sent electronically to all obstetrics and …