Recruiting to the OB/GYN Team
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Transcript of Recruiting to the OB/GYN Team
Recruiting to the OB/GYN Team
Dee E. Fenner, M.D.2004 APGO President
JUST ONE MORE STUDENT!!!
APGO
Do we have a “problem”
• NOT a crisis• Maybe not even a problem• But certainly a disturbing trend • A symptom of the times and our specialty
that we must address IT.
Market Analysis“SWOT”
• What is your product?• What is your market share?• What is your market?
– Has it changed? • What is the competition?• What are your strengths and weaknesses?• Obstacles?• Threats?
We are Obstetricians and Gynecologists.We are Women’s Health Care providers.
We are Surgeons.
We are reproductive biologists.
We are high risk pregnancy specialists and gynecologic oncologists.
What is your product?
What is your market share?How has it changed?
We are recruiting from only HALF the medical students……
Ob-Gyn PGY1Positions filled
60
70
80
90
100
Perc
ent
1980 1998 1999 2000 2001 2002 2003 2004Year
Positions filled USG
10.75.1 9.2
24.9
36
43 45.3
05
101520253035404550
Women as % of total Medical School Graduates
AAMC
The percent of total women grads choosing OB/GYN has been constant ~9%
0
1000
2000
3000
4000
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6000
7000
1950 1970 1990 2003
women grads
womenchoosingobgyn
AAMC
Ob/GYN Residents Matched by Gender from
Total US GradsMales Females Ratio
M to F
1993 3.6%(345)
8.7%(513)
40%/60%
2003 2.1%(180)
8.7%(608)
23%/77%
AAMC
Women prefer female Obstetrician/Gynecologist?
• 40% prefer female• 10% prefer male• 50% Want a “good” doctor
Cockburn J. BJOG 1996;103:2-3
Chandler PJ Mil Med 2000; 165:938-940
Fennema K. J Fam Pract 1990;30:441-446
Myths and Misperceptions?
• Male graduates couldn’t find jobs?• Male Ob/gyns paid less?
TRUTHS?• Deans telling male students not to apply• Chairs telling male students not to apply
Women’s attitudes to the sex of medical students in a gyn clinic:
cross sectional surveyO’Flynn N. BMJ 2002;325:683-684.
• 33% of women refused to see a medical student
• 42% accepted any student• 25% would not see a male student
The impact of Perceived gender bias on Obstet and Gynec skills acquisition
by third-year medical studentsEmmons SL. Academic Medicine 2004;79:326-332
• 78% of men felt gender negative effect• 67% of women felt gender positive effect• Males felt they would NOT be able to
achieve a good grade.
• REALITY:– Minimal difference is exams and deliveries– No difference in grades
Gender Bias Against Male Obstetrician-Gynecologists in Women’s Magazines
Kincheloe LR. Obstet Gynecol 2004;104:1089
• Females ob/gyns interviewed more than men in magazines
• Females 20 times more likely to have an identifying picture
• Negative comments about physicians –especially ob/gyn more like to use male pronouns (17% vs. 77%)
GENDER DISCRIMINATION
What is the competition?
• The “controllable lifestyle” specialties?
“Specialty Lifestyles” Controllable Noncontrollable
Anesthesiology Obstet and GynecDermatology Family Practice
Radiology Int. Med.Neurology Ortho. Surgery
Ophthalmology PediatricsPathology Gen. SurgeryPsychiatry Urology
ENT
Schwartz RW. Acad Med 1990;65:207-210.
Influence of Controllable Lifestyle on Recent Trends in Specialty Choice of
US Med StudentsDorsey ER. JAMA 2003;290:1173-1177
• ∆ 1996 to 2002 US Med Grads• Lifestyle, work hours, yrs. Residency,
potential income• Log linear models• Lifestyle = 37% Income = 9% Work hours = 2% Yrs of res. = 4%
What impacts career choice?
• Extracurricular clinical experiences• Premed and undergrad experiences• Yr 1 and 2 exposure• Role models
When do they decide?
• 15% of students chose specialty before medical school
• 45% during the first TWO years• But 20 to 40% of students change their
mind during the third year• 40% during the third year
Markett RJ. J Fam Prac 1983;17:295
Zeldow PB. Med Educ 1992;26:327
Kassebaum DG. Acad Med 1995;70:938
Considering obstetrics and gynecology as a specialty: current attractors and detractorsMetheny WP. Obstet Gynecol 1991;78:308-312
• 11 medical schools• 50% responseAttractors DetractorFemale InsuranceHealthy patients life-styleReproductive issuesSurgical proceduresMentors
Statistically significant and nonsignificant factors in influencing one to choose OB/GYN
Fogarty CA. AJOG 2003;189:652-654.
Creighton University Grads 1991-2001
What influences medical students to pursue careers in obstetrics and gynecology?
Schnuth R. AJOG 2003;189:639-643
• ½ of 205 medical students at MI State• 64% women, 35% men• Females felt negative factors for entering
ob/gyn: length of training, stress, time demands, insurance costs, time on call
• Males were most interested in opportunities to perform surgery and not concerned about pressure, length of training, insurance or time on call
What are our strengths?
• Mentors like YOU• Dedication• Quality education
MENTORS
79% of the students that choose a surgical specialty do so because of a mentor and faculty influence.
Bland KI, Ach Surg 2002;137;259-267
2001 AAMC Senior Survey (GQ)VS. NRMP OB/GYN Match
Question 10 : Do you consider the OB/GYN clerkship to be excellent?
On a 4-point Likert Scale, what were the top programs, as defined by over half of the medical students marking 1.
11/125 US Medical Schools met this criteria
2001 AAMC Senior Survey (GQ)VS. NRMP OB/GYN Match
• Comparing the top 11 schools by the GQ to the number of students from each US Medical School choosing OB/GYN –
• 7/11 of the TOP GQ schools were in the top 15% of schools by recruitment numbers
QUALITY TEACHING DOES IMPACT
CAREER CHOICE!!
Weaknesses/Obstacles
• Bad mouthing • Legal impact• Bad press• “Perception” of unhappiness?
“Bad Mouthing”
• 17% of males vs. 6% of females were discouraged from ob/gyn. Schnuth 2003
• 2/3 of OB/GYN chairs discourage male students to enter field. (APGO survey)
Surgeons, I have to say honestly, they shred each other to pieces. That was a big turn-off. I can stand sleep deprivation for 10 years, but I can’t stand five minutes with the way they get at each other; to be rude to each other, to be rude to the house officers who couldn’t fight back, and to be rude to the students who couldn’t say anything in defense.
Mutha S. Acad Med 1997;72:635-640.
OB/GYN was not far behind surgery in negative comments!!
APGO• Recruitment “Playbook”• Medical student task force• Letters to the chairs• Working with ACOG and LCOG• CUCOG task force• “Benchmarking” top clerkships
HELPING YOU BE BETTER TEACHERS