Women's health training in gastroenterology fellowship: a national survey of fellows and program directors.
OBJECTIVE
The Gastroenterology Core Curriculum requires training in women's digestive disorders; however, requirements do not necessarily produce knowledge and competence. Our study goals were: (1) to compare perceptions of education, fellow-reported levels of competence, and attitudes towards training in women's gastrointestinal (GI) health issues during fellowship between gastroenterology fellows and program directors, and (2) to determine the barriers for meeting training requirements.


METHODS
A national survey assessing four domains of training was conducted. All GI program directors in the United States (n = 153) and a random sample of gastroenterology fellows (n = 769) were mailed surveys. Mixed effects linear modeling was used to estimate all mean scores and to assess differences between the groups. Cronbach's alpha was used to assess the consistency of the measures which make up the means.


RESULTS
Responses were received from 61% of program directors and 31% of fellows. Mean scores in perceived didactic education, clinical experiences, and competence in women's GI health were low and significantly differed between the groups (P < 0.0001). Fellows' attitudes towards women's GI health issues were more positive compared to program directors' (P = 0.004). Barriers to training were: continuity clinic at a Veteran's Administration hospital, low number of pregnant patients treated, low number of referrals from obstetrics and gynecology, and lack of faculty interest in women's health.


CONCLUSIONS
(1) Fellows more so than program directors perceive training in women's GI health issues to be low. (2) Program directors more so than fellows rate fellows to be competent in women's GI health. (3) Multiple barriers to women's health training exist.
Division of Gastroenterology and Hepatology, University of Wisconsin School of Medicine and Public Health, UW Medical Foundation Centennial Building, Room 4224, 1685 Highland Avenue, Madison, WI 53705, USA. ssaha@medicine.wisc.edu
Sumona
S
Saha
Erica
E
Roberson
Kelly
K
Richie
Mary J
MJ
Lindstrom
Silvia Degli
SD
Esposti
Arnold
A
Wald
D002983:Clinical Competence; D003479:Curriculum / Q000592:standards; D004503:Education, Medical, Graduate / Q000592:standards*; D005257:Fellowships and Scholarships; D005260:Female; D005762:Gastroenterology / Q000193:education*; D006801:Humans; D008297:Male; D008486:Physician Executives; D011247:Pregnancy; D011795:Surveys and Questionnaires; D014481:United States; D014930:Women / Q000193:education*; D016387:Women's Health
Clin Gastroenterol Hepatol. 2008 Jun;6(6):682-688.e2
18356116
J Womens Health (Larchmt). 2010 May;19(5):1005-43
20392158
Public Opin Q. 1979 Summer;43(2):206-17
10242341
Am J Med. 1997 Jun;102(6):507-12
9217662
Teach Learn Med. 2007 Summer;19(3):257-63
17594221
Gastroenterology. 2003 Apr;124(4):1055-104
12671902