APGO

Poster
Jenifer Briscoe, MD

Pamela Promecene

Background: Studies have evaluated gender discrimination in medical education. Gender discrimination is felt predominately by females; however this is not true for obstetrics and gynecology. In 2004, Emmons et al found that 78% of male students felt their gender negatively impacted their clinical experience, and students who perceived a negative bias performed fewer clinical skills and felt less confident counseling patients. Our study was to determine if medical students at our institution perceived a gender bias during the OB/Gyn clerkship. We also examined if a gender bias exists in student confidence and participation and if there was a gender difference in grade distribution.

Methods: After IRB approval, an anonymous survey was sent to all third year students who had completed their obstetrics and gynecology clerkship in the 2011-2012 year. Students reported their gender and whether they felt their gender had an effect on their OB/Gyn rotation. Students were given a list of clinical problems (vaginitis, urinary tract infection, secondary amenorrhea, preeclampsia), and asked to rate their ability to begin a workup. Students were also asked to rate their comfort level with patient counseling on clinical situations (contraception, pap screening, breast cancer screening, labor precautions). A 5-point Likert scale was used where 1= very uncomfortable and 5= very comfortable. Students were asked to estimate the number of times they performed common clinical tasks (speculum exam, breast exam, participating in a vaginal delivery, or performing a vaginal delivery).

Results were evaluated using Student’s T test. Student grades from the rotation were broken
down by rotation evaluations, NBME shelf exam grades and overall grades. Each category was evaluated with student’s T tests. Results: 171 students, 98 responded (57.3% response rate; 62% male, 38% female). Nearly half of all students felt that their clerkship was gender-neutral (Table 1). There was no difference in clinical mastery of problems (Table 2) or with comfort in counseling (Table 3). Table 1: Perceived gender bias? male 27 (44%) female 19 (51%) Table 2: Clinical problems Male Female P Vaginitis 4.3 4.51 NS UTI 4.18 4.40 NS Secondary amenorrhea 3.78 4.05 NS Preeclampsia 4.07 3.97 NS Table 3: Counseling Male Female P Contraception 4.47 4.36 NS Pap screening 4.03 4.36 NS Breast cancer screening 4.00 3.84 NS Labor precautions 4.5 4.61 NS Females performed more speculum exams (P<0.01). There was no difference in other tasks. There was no difference in evaluations, NBME grades and final grades.

Discussion: With the decrease in men choosing obstetrics and gynecology, and the decrease in interest in the field overall, it is important to encourage interested medical students while on the OB/Gyn clerkship regardless of their gender.