Original Article

Digestive Diseases and Sciences

, Volume 56, Issue 3, pp 751-760

First online:

Women’s Health Training in Gastroenterology Fellowship: A National Survey of Fellows and Program Directors

  • Sumona SahaAffiliated withDivision of Gastroenterology and Hepatology, University of Wisconsin School of Medicine and Public Health Email author 
  • , Erica RobersonAffiliated withDivision of Gastroenterology, Department of Medicine, Oregon Health & Science University
  • , Kelly RichieAffiliated withDivision of Gastroenterology and Hepatology, University of Wisconsin School of Medicine and Public Health
  • , Mary J. LindstromAffiliated withUniversity of Wisconsin-Madison
  • , Silvia Degli EspostiAffiliated withCenter for Women’s Digestive Diseases, Women & Infants Hospital of Rhode Island, The Warren Alpert Medical School of Brown University
  • , Arnold WaldAffiliated withDivision of Gastroenterology and Hepatology, University of Wisconsin School of Medicine and Public Health

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Abstract

Background and Aims

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.

Keywords

Women’s health Gastroenterology fellowship Training guidelines