Perception and Comfort with Endometriosis Management Among OB/GYN Residents

• Published in: International journal of women's health 2023-01, Vol.15, p.1801-1809
• Main Authors: Sullender, Renee T, Jacobs, Marni B, Sandhu, Manpreet S, Lacoursiere, D Yvette, Diaz Luevano, Carolina, Pickett, Charlotte M, Agarwal, Sanjay K
• Format: Article
• Language: English
• Subjects: Analysis; Antagonists; Care and treatment; Endometriosis; Estrogen; gnrh antagonists; Osteoporosis; Pain; Prescription writing; resident education; Sexual disorders; surgical training; Type 2 diabetes
• ISSN: 1179-1411; 1179-1411
• DOI: 10.2147/IJWH.S424554

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