Available online 4 May 2024

Author links open overlay panel, , , , , , Highlights•

Most data on the transition to residency is from allopathic medical schools.

•

We explored applicants’ perceptions of readiness and preparedness for residency.

•

International and DO graduates reported feeling less prepared.

•

Applicants from underrepresented racial and ethnic backgrounds felt less prepared.

•

Specialty-wide initiatives need to address inequities at the transition to residency.

Objective

Although approximately one-fifth of obstetrics and gynecology (OBGYN) residents matriculate from osteopathic or international medical schools, most literature regarding the transition to residency focuses on allopathic medical school graduates. To create comprehensive interventions for this educational transition, we must understand the needs of all incoming residents. Our objective was to examine OBGYN residents’ perceptions of their transition to residency, and to understand how residents’ background and medical school environment influence their perceived sense of readiness.

Design

A 16-item survey asked questions about demographics, the transition to residency, resident well-being, burnout, and the transition to fellowship. Perception of preparedness was assessed with the question “I felt that I was well-prepared for the first year of residency” (1=strongly agree, 5=strongly disagree). Chi-squared and Fisher's exact tests and logistic regression explored association of perceived preparedness with residents’ backgrounds.

Setting

Survey administered at time of the in-training examination in 2022.

Participants

All OBGYN residents.

Results

Of 5761 eligible participants, 3741 (64.9%) provided consent and completed the survey. Of the 3687 participants who answered the question, 2441 (66.2%) either agreed or strongly agreed that they felt well-prepared. Fewer osteopathic graduates reported feeling prepared compared to allopathic graduates (379/610, 62.1% vs 1,924/2,766, 69.6%) (OR 0.72, 95%CI 0.60-0.86, p < 0.01). International medical school graduates were seven times less likely to report feeling prepared compared to those from allopathic institutions (137/304, 45.1% vs 1924/2776, 69.6%) (OR 0.60, 95%CI 0.53-0.68, p < 0.01). Respondents from underrepresented racial and ethnic backgrounds were less likely to report feeling prepared compared to White respondents (276/535, 51.6% vs 1738/2387, 72.8%) (OR 0.39, 95%CI 0.33-0.48, p < 0.01).

Conclusions

Differences in residents’ perceptions of their transition to residency highlight the need to begin offsetting pervasive inequities with comprehensive and accessible resources.

Section snippetsINTRODUCTION

The medical student to resident transition is complex,1,2 and can be especially challenging for some learners.3 Both residents’ personal experiences and their medical school environments may influence how ready they are for the abruptly intensified workload, stress, and responsibility of residency. The first months of residency are associated with increased rates of depression4 and suicide.5 Additionally, higher residency attrition rates for learners from underrepresented backgrounds in

MATERIAL AND METHODS

This observational, cross-sectional study of OBGYN residents was performed using an electronic survey. The authorship team, consisting of medical school and residency educators, created the 16-item survey that included questions about demographics and content pertaining to the transition to residency, resident well-being, burnout, and the transition to fellowship. Respondents self-reported race and ethnicity from 8 selections, with the option to choose all that applied (African American or

RESULTS

Of the 5761 participants who took the in-training examination, 3741 (64.9%) respondents reported being current residents, provided postgraduate year, gave consent to take the survey, and were included in the survey analysis. The remaining 1965 (34.1%) either did not consent to taking the survey or closed their exam window after accessing their survey and were excluded. The demographics of the survey respondents are in Table 1. The distribution of gender, race and ethnicity, and type of medical

DISCUSSION

This comprehensive snapshot of OBGYN residents’ perception of their transition to residency revealed marked differences based on medical school type and race. These findings highlight how learners’ lived experiences can impact their perceptions of preparedness and underscore the need for comprehensive learner-centered interventions to begin leveling structural inequities.

This work exposes many important systems-level differences in the transition to residency, including the widening gap between

CONCLUSION

This work demonstrates the potential inequities that contribute to a more pronounced chasm at the medical school to residency transition for some learners. It will be important to be intentional in creating comprehensive supports to level this uneven playing field.

ACKNOWLEDGMENTS

The authors wish to thank Ms. Sarah Block for her assistance with manuscript preparation. Ms. Block is employed by the University of Michigan and did not receive additional compensation for her contributions.

REFERENCES (32)HL Yeo et al.Association of time to attrition in surgical residency with individual resident and programmatic factors

JAMA Surg

(2018)

SE Brotherton et al.Graduate Medical Education, 2021-2022

JAMA

(2022)

CA Germann et al.Senior-year curriculum in U.S. medical schools: a scoping review

Teach Learn Med

(2020)

Association of American Medical Colleges. Curriculum reports. Accessed December 16, 2022....RM Minter et al.Transition to surgical residency: a multi-institutional study of perceived intern preparedness and the effect of a formal residency preparatory course in the fourth year of medical school

Acad Med

(2015)

LA Heidemann et al.Internal medicine paging curriculum to improve physician-nurse interprofessional communication: a single center pilot study

J Interprof Care

(2020)

View full text

© 2024 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.