Assessing the Need for Faculty Development in Women's Health among Internal Medicine and Family Practice Teaching Faculty

Abstract

Women's health education is an emerging interdisciplinary field that has recently received national attention. The American Board of Internal Medicine and the American Academy of Family Practice recently have published competencies in women's health for their residents, with increased attention to gynecological and mental health issues. Increasing women's health in the curricula of internal medicine (IM) and family practice (FP) residents will certainly require faculty development among IM and FP teaching faculty. We report a multiinstitution needs assessment among IM and FP teaching faculty for continuing medical education (CME) in multidisciplinary women's health topics. The survey (n = 100) asked whether faculty desired CME in 30 women's health topics. It also requested rates of referral to specialists for breast and menstrual problems and performance of tests commonly carried out in the care of women (e.g., endometrial biopsy, colposcopy, skin biopsy, and sigmoidoscopy) as measures of possible need for CME. Of the 69 respondents, 37% were IM physicians and 63% were FP physicians. Among the 30 women's health topics listed, breast cancer treatment alternatives, infertility for primary care providers, cervical dysplasia, medical treatment in pregnancy, vulvar disease, indications for pelvic ultrasound/endometrial biopsy, and menstrual disorders were of highest interest. The ranking of desirability of topics by IM and FP faculty correlated by .54 (Spearman rank, df = 28, p < 0.01). Analysis of variance revealed a significantly higher interest overall by IM than FP physicians, 58% vs. 42% (F = 4.1, df = 1, 50, p < 0.05). None of the IM teaching faculty performed endometrial biopsy or colposcopy compared with 57% of FP physicians, and only 12.5% of internists performed skin biopsy and sigmoidoscopy compared with 70% of FP physicians (F = 33, df = 1, 38, p < 0.001). We conclude that faculty development in women's health would benefit resident training in IM and FP, and topics of interest are identifiable. The correlation in interests between the IM and FP teaching faculty might make joint programs successful, although gynecological skills and knowledge clearly are needed more by IM teaching faculty. Obstetrics and gynecology (OB/GYN) faculty could be instrumental in improving women's health education among their IM and FP colleagues.

Teaching Internal Medicine Residents to Care for Reproductive-Age and Pregnant Women: An Effective Web-Based Curriculum

“…7 Prior research conducted both before and after the FCIM guidelines suggests that training on these topics has been inadequate. [8][9][10][11][12][13][14] The University of Pittsburgh has a 187 well-established Section of Women's Health in the Division of General Internal Medicine and therefore provides many educational experiences that pertain to the care of women to all internal medicine residents in the program. However, through informal discussion with faculty, residents, and recent graduates we found that despite this strong women's health emphasis, there seemed to be a dearth of educational opportunities that specifically pertain to the internal medicine issues that women who are or who plan to become pregnant face.…”

Meeting the Need for Women's Health Training in Gastroenterology: Creation of a Women's Digestive Disorders Program at Brown University

“…The GCC specifies that every program must provide its fellows with comprehensive training in women's health; however, it provides little guidance on how to meet this goal. In addition to absence of an implementation plan, lack of exposure to appropriate patient populations (e.g., pregnant patients), deficits in knowledge at the faculty level, 23 and poor multidisciplinary collaboration 24 all create barriers to meeting training goals. By making crossdepartment alliances, we were able to expand our consultative services to include a greater number of women's health issues and to enlist non-GI faculty in the training of our fellows.…”

Update: A Review of Women's Health Fellowships, Their Role in Interdisciplinary Health Care, and the Need for Accreditation

“…8 Not only is residency knowledge on HT lacking; studies also show even IM residents lacking in overall contraception knowledge. 25 Even among IM facility there have been reports that knowledge and procedural skills needed to teach necessary WH skills are lacking, 12 again pointing toward the functionality for WH fellowship-trained physicians to function in the gray zone between OB/GYN and IM. 22 Experiential learning on HT and other WH issues through training with fellowship-trained accredited leaders may be one way in which patient care is enhanced and practice patterns are changed for the better.…”

“…10,11 Meanwhile, while medical school and residency exposure to WH outside the lens of obstetrics and gynecology is lacking, 8 the demand for WH providers is increasing, 1 and thus the need to raise awareness of WH fellowships is of optimal importance in order to train experts and educational leaders. 12 Unfortunately, the knowledge of these specialty interdisciplinary WH fellowships is lacking. 13 To evaluate the current national awareness of WHF programs, a study was conducted by sending surveys to family practice (FP) and IM residents across the United States.…”