To assess the status of psychiatry education in Ob/Gyn residencies, focusing on perceived barriers in education.BACKGROUND:
One-third of women in the U.S. receive primary care exclusively from Obstetrician/Gynecologists. Recent literature reveals gaps in recognition of common psychiatric issues by Ob/Gyns.METHODS:
Program directors (PDs) of all 249 accredited Ob/Gyn residency programs received a 17-item anonymous questionnaire. Analysis of responses included descriptive statistics, Student’s t-tests, and logistic regression.RESULTS:
111 programs responded to the survey (44.5%); 20 responses were partial. 85% offer didactic instruction in psychiatric topics, of which 82% are taught by Ob/Gyn faculty. Academic institutions were more likely to offer didactics in psychiatry than community institutions (OR=3.2, P=.04). Only 20% of programs offered an elective rotation in mental health. 20% of programs formally evaluate residents on their management of psychiatric disorders. 81% of PDs do not agree that their residents are fully equipped to identify patients; psychiatric needs; however, only 23% believe that mental healthcare should be included as an ACGME milestone. Community programs were more likely to agree with adding a milestone (P=.002). The most common barriers to providing additional psychiatric training were lack of sufficient integration between Ob/Gyn and psychiatry (44%), ACGME surgical requirements (41%), and lack of sufficiently knowledgeable instructors (36%). In addition, valuable qualitative comments were received from respondents.DISCUSSION:
While most programs deliver didactic training in psychiatric topics, most PDs perceive that residents are not fully equipped to identify psychiatric needs. The most common barrier to providing additional training was lack of integration between Ob/Gyn and psychiatry.