1 of 25

Taking the Express Lane?

Student Attitudes Towards Tracking in OB/GYN Residency

The #OBGynInternChallenge Team

2 of 25

Disclosures

  • FC and RNB are co-hosts of the podcast, CREOGs Over Coffee

​

3 of 25

Background

Certain residency programs have started resident tracking

​

Pros

Cons

Increased flexibility for trainee to explore interests and career paths early

Admin complexities in scheduling different electives and rotations

Early identification of career mentor

Trainees must know early on career path/decisions

Increased fellowship entrance

Possible that trainees may change their minds after starting a certain track

Exceed ACGME case minimums

May have decreased exposure in non-tracked areas

Siedhoff MT, Truong MD, Wright KN. Gynecologic surgery tracking in obstetrics and gynecology residency. Curr Opin Obstet Gynecol. 2020 Aug;32(4):298-303.

Reed, Vicki R. MD; Emery, Jonathan MD; Farrell, Ruth M. MD, MA; Jelovsek, J. Eric MD, MMEd. Tracking—A Flexible Obstetrics and Gynecology Residency Curriculum. Obstetrics & Gynecology 134():p 29S-33S, October 2019.

4 of 25

Background

  • Diverse opinions from PDs
    • In one study, 54% stated tracking would positively affect training
    • 80% agreed it would increase preparedness for fellowship
    • 38% had concerns it would negatively affect resident training
    • 50% thought it would decrease the number of generalists
    • Most believe tracking should not be mandatory

​

Hariton E, Freret TS, Nitecki R, Hinchcliff E, Stagg A. Program Director Perceptions of Subspecialty Tracking in Obstetrics and Gynecology Residency. J Grad Med Educ. 2018 Dec;10(6):665-670.

5 of 25

Background

  • Current Ob/Gyn Residency with Tracking
    • Only a few in the nation
    • Allows residents to tailor their tracking
    • What draws students to these programs?
    • Should more programs have them?

​

Hariton E, Freret TS, Nitecki R, Hinchcliff E, Stagg A. Program Director Perceptions of Subspecialty Tracking in Obstetrics and Gynecology Residency. J Grad Med Educ. 2018 Dec;10(6):665-670.

6 of 25

7 of 25

Question:

  1. How confident are students going into Ob/Gyn about their future careers?
  2. What do current students who matched into Ob/Gyn think about residency “tracking”?

8 of 25

Methods: Last year

​

Create and disseminate a microlearning curriculum to promote educational equity at the MS-4 → PGY-1 transition.

Understand the landscape and identify disparities in pre-OB/GYN residency preparation.

Evaluate impact of our curriculum on knowledge and confidence of participants.

Demonstrate and quantify the impact of a social, national, and accessible curriculum.

Investigate the potential of microlearning and social media in medical education.

9 of 25

Methods - This Year

​

Re-demonstrate that a microlearning curriculum can promote educational equity at the MS-4 → PGY-1 transition.

Better understand current incoming Ob/Gyn PGY-1 attitudes about the current educational landscape

We know that the #ObGynInternChallenge was feasible, accepted, and efficacious

10 of 25

Methods - Means

  • Survey Tool: REDCap�
  • SMS Engine: Arist�
  • Podcasts, Infographics: Created by study team. Podcasts created with GarageBand. Graphics created using PowerPoint and/or Canva.�
  • Social: Dedicated study accounts on GMail, Instagram/Facebook, and Twitter. Dedicated website.�

11 of 25

Methods - Design

Retrospective

  • Enrollment survey:
    • Demographic information.
    • Medical school and residency.
    • Clerkship and Sub-I information.
    • Pre-residency survey on individualized learning plans, pre-residency preparation, and tracking

June 2022

End and Evaluate

Majority finish by May 27, some into early June

May 2022

Curriculum Start

First SMS message sent May 2; ongoing late enrollments through May 9.

April 2022

Recruitment Begins

Residency program director email (x1); social media and word of mouth.

January 2022

Curriculum Design

Evaluate CREOG objectives, write course, create new content as needed.

12 of 25

Method

Survey Design:

  • Created by authors
  • Tested on faculty and residents in Ob/Gyn
  • Non-validated
  • Questions regarding:
    • Demographics
    • Residency/Fellowship presence at institution
    • Pre-residency preparation
    • Specialization preference (if any)

13 of 25

Questions asked

  1. If you had to choose today, what specialization or practice environment would you envision for yourself at the conclusion of residency and any fellowship training?

​

  • How confident are you today that this will be your ultimate career trajectory (0%-100%)?

​

  • Would you consider an option for “tracking” your training in Ob/Gyn based on your specialty interests today?

14 of 25

Results

Survey response rate: 922/1508 (61.1%)

MS4 Self-Reported Inclination Toward Specialization

​

N = 922

%

Generalist

433

47.0%

Subspecialty

474

51.4%

Alternative Specialty/Career Path

15

1.6%

15 of 25

Results

p < 0.001

MS4 Self-Reported Inclination Toward Specialization

​

MD = 782

DO = 149

Generalist

390 (49.9%)

108 (72.5%)

Subspecialty or Other Career Path

392 (50.1%)

41 (27.5%)

16 of 25

Results

MS4 Self-Reported Subspecialty Inclination

​

N = 424

%

MFM/Fetal Intervention

125

29.5%

Gyn Onc

81

19.1%

REI

61

14.4%

Family Planning

50

11.8%

MIGS

48

11.3%

FPMRS

44

10.4%

Other

15

3.5%

17 of 25

Results: Confidence in Career Trajectory

P<0.001

18 of 25

Results: Desire for Tracking

p<0.001

N = 258 (28.0%)

19 of 25

Results: Specialties and Desire For Tracking

20 of 25

Results: Confidence in Career Trajectory

In those with top quartile of confidence in career trajectory:

  • No difference in
    • Sex
    • Race
    • Presence of fellowship
    • Presence of residency
    • Degree

21 of 25

Conclusions

In current students who matched to Ob/Gyn in 2022:

  • 51% desire to continue with subspecialty training
  • Almost 40% of would-be subspecialists are interested in tracking
  • Only 15% of those interested in general Ob/Gyn are interested in tracking
  • Those who desire to pursue FPMRS and MIGS are more likely to desire tracking

22 of 25

Strengths and Limitations

Strengths

  • Large survey of students entering Ob/Gyn (>60% response rate)
  • Current study (done in 2022)

Limitations

  • Did not ask why students desired tracking
  • May have response bias

23 of 25

Future Directions

  • Further exploration of why certain students desire tracking
  • Understand what aspects of tracking are attractive to Ob/Gyn residents
  • Design education tracks in Ob/Gyn residency that are congruent with resident desires

24 of 25

Check out our other presentations and get ready for OB/GYN Intern Challenge 2023!

www.obgyninternchallenge.com/apgo-23

Thank you!

25 of 25

2022 Fellowship Match Results

​

Applicants

Percent

Matched

Percent

Current Cohort

Percent

Family Planning

33

6.1%

25

6.3%

50

11.8%

Urogyn

73

13.5%

61

15.4%

44

10.4%

Gyn Onc

105

19.4%

74

18.6%

81

19.1%

MFM

170

31.5%

136

34.2%

125

29.5%

MIGS

76

14.1%

40

10.1%

48

11.3%

PAG

13

2.4%

12

3.0%

-

-

REI

70

13.0%

49

12.3%

61

14.4%

Total

540

​

397

​

424

​

p=0.84