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. 2023 Nov 20:15:1801-1809.
doi: 10.2147/IJWH.S424554. eCollection 2023.

Perception and Comfort with Endometriosis Management Among OB/GYN Residents

Renee T Sullender  1 , Marni B Jacobs  1 , Manpreet S Sandhu  2 , D Yvette Lacoursiere  1 , Carolina Diaz Luevano  1 , Charlotte M Pickett  1 , Sanjay K Agarwal  1
Affiliations

Perception and Comfort with Endometriosis Management Among OB/GYN Residents

Renee T Sullender et al. Int J Womens Health. .

Abstract

Purpose: The diagnosis of endometriosis often takes several years, delaying appropriate care while patients suffer from pelvic pain, dysmenorrhea, and dyspareunia. Understanding whether residents in obstetrics and gynecology (OB/GYN) are being adequately exposed to and trained in the diagnosis and management of the disease is important for improving care.

Methods: We conducted an online cross-sectional survey of OB/GYN residents to investigate their comfort level and familiarity with endometriosis diagnosis and management. Residency program directors and coordinators of 20 OB/GYN residency programs in California, USA were emailed to disseminate the 31-question, anonymous survey in January to February 2023. Responses were collected using Redcap and analysis was conducted using STATA.

Results: 67 residents answered at least one non-demographic question and were included. A resident response rate was not calculated because we were unable to determine how many programs distributed the survey. 84% of residents felt they could recognise symptoms of endometriosis but over 30% of senior residents were not comfortable with sonographic diagnosis of endometrioma. Approximately one third of residents felt comfortable managing hypoestrogenic symptoms, osteoporotic risks, and add-back progestin for certain hormonal therapies. Academic-hospital based residents had significantly more exposure to attendings prescribing long-acting reversible contraception, GnRH antagonists, and GnRH agonists but there were no significant differences in trainee prescribing practices or comfort. More respondents would feel comfortable medically managing endometriosis (52%) than surgically managing the disease (26%) if they were in practice today, with only 39% of PGY3-4 residents feeling comfortable surgically managing endometriosis.

Conclusion: There is considerable room for improvement in the education of residents in the diagnosis and medical and surgical management of endometriosis.

Keywords: GnRH antagonists; OB/GYN; endometriosis; pelvic pain; resident education; surgical training.

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Conflict of interest statement

Dr D Yvette Lacoursiere is a SASGOG Board Member. The authors have no other disclosures or conflicts of interest to report for this work.

Figures

Figure 1
Figure 1
Percentage of Residents Reporting Exposure to Attending Prescription versus Personal Experience or Comfort with Prescription.
Figure 2
Figure 2
Responses to the question “I feel comfortable managing the hypoestrogenic effects of GnRH antagonists, agonists, and aromatase inhibitors”.
Figure 3
Figure 3
Responses to the question “Have you ever had exposure to a patient being referred to the following for alternative management of endometriosis?”.
See this image and copyright information in PMC

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