Current Trends in Psychiatric Education Among Obstetrics and Gynecology Residency Programs
This study sought to evaluate the status of psychiatric education in Ob/Gyn residencies.
A 17-item anonymous questionnaire was sent to program directors of 239 Ob/Gyn US residencies. Data analysis was performed using STATA 14.2.
Ninety-five programs participated (40%), including partial responses. The majority of Ob/Gyn programs offered didactics in psychiatric topics (84%), with most of the sessions provided by Ob/Gyn faculty. Programs that reported didactics led by psychiatric faculty (57.9%) were more likely to have a higher number of mental health didactics in total. Fewer than half of programs covered intimate partner violence (47%), non-obstetric depression (44%), anxiety (43%), medication management (30%), eating disorders (26%), human trafficking (20%), or PTSD (11%). Elective rotations involving mental health were offered by 20% of programs. Barriers to psychiatric training were lack of integration between Ob/Gyn and psychiatry (46%), ACGME surgical requirements (42%), and lack of knowledgeable instructors (38%). Most program directors (81%) disagreed that residents are fully equipped to identify psychiatric needs in patients.
Lack of integration between Ob/Gyn and psychiatry was the most cited barrier to effective psychiatric education of Ob/Gyn residents, highlighting the importance of increased partnership between the two fields. Didactic instruction decreased compared to 2001, and considerable gaps still remain. Most program directors perceive that residents are not equipped to identify patients’ psychiatric needs.
KeywordsEducation, medical, graduate Obstetrics and gynecology Psychiatry Curriculum—interdisciplinary studies Surveys and questionnaires
The authors would like to acknowledge Dr. Uma Ramamurthy, Vivek Ramanathan, Xingquan Lu, and the entire Dan L. Duncan Institute for Clinical and Translational Research for generously donating their time to create and administer the survey. These individuals are employed by our institution and were provided no additional compensation for their work.
There was no funding that supported this study.
Compliance with Ethical Standards
Ethical approval for this study was granted by the Institutional Review Board (protocol H-40300). Informed consent was implied by completion of the questionnaire.
On behalf of all authors, the corresponding author states that there is no conflict of interest.
- 2.Poleshuck EL, Woods J. Psychologists partnering with obstetricians and gynecologists: meeting the need for patient-centered models of women’s health care delivery. Am Psychol [Internet]. 2014;69:344–54 Available from: http://www.ncbi.nlm.nih.gov/pubmed/24820684. Accessed 27 Jan 2017.
- 3.Center for Disease Control. Reproductive health: depression among women [Internet]. 2018. Available from: https://www.cdc.gov/reproductivehealth/depression/index.htm. Accessed 03 Feb 2017.
- 4.Council on Resident Education in Obstetrics and Gynecology Educational Objectives. Core Curriculum in Obstetrics and Gynecology. 11th ed. Washington, DC: American College of Obstetricians and Gynecologists Washington, DC; 2016. [Internet] Available from: https://www.acog.org/About-ACOG/ACOGDepartments/CREOG/CREOG-Search/CREOG-11th-Edition-of-Educational-Objectives?IsMobileSet=false. Accessed 03 Jan 2017.
- 5.Bienstock J, Adams KE, Brigham TP, Connolly A, Ciotti M. Edgar L, et al. In: The obstetrics and gynecology milestone project obstetrics and gynecology milestones; 2013.Google Scholar
- 6.Smith MV, Rosenheck RA, Cavaleri MA, Howell HB, Poschman K, Yonkers KA. Screening for and detection of depression, panic disorder, and PTSD in public-sector obstetric clinics. Psychiatr Serv [Internet]. 2004;55:407–14 Available from: https://www.researchgate.net/publication/8634747_Screening_for_and_Detection_of_Depression_Panic_Disorder_and_PTSD_in_Public-Sector_Obstetric_Clinics. Accessed 27 Jan 2017.
- 7.Coleman VH, Carter MM, Morgan MA, Schulkin J. United States obstetrician-gynecologists’ accuracy in the simulation of diagnosing anxiety disorders and depression during pregnancy. J Psychosom Obstet Gynaecol [Internet]. 2008;29:173–84 Available from: http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=med5&NEWS=N&AN=18608826. Accessed 27 Jan 2017.
- 8.Ell K, Sanchez K, Vourlekis B, Lee PJ, Dwight-Johnson M, Lagomasino I, et al. Depression, correlates of depression, and receipt of depression care among low-income women with breast or gynecologic cancer. J Clin Oncol. 2005;23:3052–60.Google Scholar
- 10.Rowan P, Greisinger A. Why don’t depressed pregnant women follow through with mental health referral? Women’s Heal Issues … [Internet]. 2013;2:1–8 Available from: http://www.scitechnol.com/why-dont-depressed-pregnant-women-follow-mental-health-referral-usSZ.php?article_id=1657. Accessed 03 Feb 2017.
- 13.LaRocco-Cockburn A, Reed SD, Melville J, Croicu C, Russo JE, Inspektor M, et al. Improving depression treatment for women: integrating a collaborative care depression intervention into OB-GYN care. Contemp Clin Trials [Internet]. Elsevier Inc. 2013;36:362–70. https://doi.org/10.1016/j.cct.2013.08.001.CrossRefGoogle Scholar
- 16.U.S. Department of Commerce. Census regions and divisions of the United States [Internet]. Washington, DC; 2010. Available from: https://www2.census.gov/geo/pdfs/maps-data/maps/reference/us_regdiv.pdf. Accessed 03 Feb 2017.
- 20.American Medical Association. FREIDA Residency Database [Internet]. FREIDA. 2017 [cited 2017 Jan 3]. Available from: https://freida.ama-assn.org/Freida/user/search/programSearch.do. Accessed 03 Jan 2017.