APGO

Poster
Clark T Johnson, MD, MPH

Detian Deng, BS, Carol Thompson, MS, MBA, Jessica Bienstock MD, MPH , Nancy Hueppchen, MD, MSc

Objective: To identify characteristics of medical schools reported by Obstetrics and Gynecology (OB/GYN) clerkship directors, and their relationship to the number of students pursuing residency in OB/GYN.

Methods: Using a cross-sectional design, the clerkship director or assistant clerkship director from each of the 122 medical schools within the United States was contacted with a survey regarding characteristics of their medical school curriculum and its qualities with respect to OB/GYN. Data were also collected from 2006-2011 with respect to the total number of applicants to residency, as well as the number of applicants applying to OB/GYN via the ERAS system from each institution. The survey assessed the attributes individual clerkship directors considered most beneficial and most inhibitory for encouraging students to pursue residency in OB/GYN.

Further responses analyzed included the length of the OB/GYN clerkship, whether or not students were allowed to take the clerkship during their fourth year, the relative activity of student interest groups, and the participation of faculty in preclinical curricula. A general linear model adjusting for institutional size was performed to evaluate the association between survey responses and the relative number of students that applied for OB/GYN residency.

Results: 47 responses from the 122 medical schools were received and included for analysis (38.5%). The most popular strengths of individual programs for OB/GYN residency selection were the clerkship experience (n=35, 75%) and clinical OB/GYN activities (n=14, 30%). The most popular weaknesses of individual programs were that students had decided specialty prior to medical school (n=13, 28%), preclinical curriculum (n=11, 23%), and the School of Medicine advisory program (n=18, 38%).

In comparing survey responses to the number of students pursuing the specialty: programs with eight-week rotations had a non-significant advantage over programs with less than eight-week rotations , Odds Ratio (OR): 1.11 (95% Confidence Interval (CI): 0.99-1.25). Year in which students were required to take the rotation was not significantly related to level of residency selection, OR: 0.99 (95% CI: 0.91-1.07). Schools with student groups hosting greater than 10 events annually had an OR of 1.06 (95% CI: 0.96-1.16) compared to less active student groups. Participation of the faculty in the first or second year curriculum was associated with a decreased odds of students pursuing OB/GYN, OR: 0.80 (95% CI: 0.74-0.88) and 0.81 (95% CI: 0.72-0.92), respectively.

Conclusions: Many clerkship directors agree that recruitment is helped by clinical activities in OB/GYN, and impaired by activities prior to the clinical years. Interventions prior to clinical activities may not have the desired effect, and interventions to improve clinical exposure early may not be as significant as they are thought to be.