title: An innovative program to provide adequate women's health education to residents with VA-based ambulatory care experiences.
abstract: BACKGROUND
  The Accreditation Council for Graduate Medical Education (ACGME) requires internal medicine residents to spend 25% continuity clinic time seeing patients of each gender. This requirement is a challenge for programs that use a Veterans Administration Hospital (VA) as the sole site for residents' continuity clinic, because of its predominately a male patient population.
  
  
  OBJECTIVE
  To ensure VA- clinic-based residents meet the ACGME requirement regarding gender care and receive adequate training in women's-health issues and to assess and evaluate a novel program designed to fulfill these needs..
  
  
  METHODS
  We developed a program that allows VA-based residents to spend 75% continuity practice time in VA clinic and 25% in a university-based clinic. We surveyed program participants annually regarding their experiences and in post graduate years (PGY) 1 and 3 assessed all residents' knowledge of women's health (WH).
  
  
  RESULTS
  Thirty-five residents were paired with faculty preceptors over 3 years. In annual program surveys, program residents reported seeing a gender mix of patients and feeling more comfortable with women's health. In knowledge surveys, mean score of all residents improved from 46% to 54% (p=.002). Factors associated with improvement were female resident gender (p=.004), having VA continuity clinic(p=.001), having specialized women's health preceptors (p=.006), and seeing at least 30% female patients (p=.01). In the multivariable model, resident gender and having a VA continuity clinic remained significant.
  
  
  CONCLUSIONS
  Our program provides a novel, effective method to ensure VA-based internal medicine residents receive adequate educational experiences in gender-specific care.
authors.affiliation: Division of General Internal Medicine, University of Kentucky School of Medicine, Lexington, KY, USA. rlconi2@uky.edu
authors.forename: Rosemarie L
authors.initials: RL
authors.lastname: Conigliaro
authors.forename: Rachel
authors.initials: R
authors.lastname: Hess
authors.forename: Melissa
authors.initials: M
authors.lastname: McNeil
mesh_terms: D000553:Ambulatory Care; D003625:Data Collection; D004059:Diffusion of Innovation; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D008297:Male; D010414:Pennsylvania; D015397:Program Evaluation; D014481:United States; D014493:United States Department of Veterans Affairs; D016387:Women's Health