Training International Medical Graduate Internal Medicine Residents in Pelvic Examinations and Pap Smears.

Abstract

Background: Nearly 39% of Internal Medicine (IM) residents in American training programs are international medical graduates (IMGs), whose prior training in women's health is variable. There is a paucity of data about women's health training programs that train IMG IM residents in pelvic examinations/Pap smears.

Aim: To train IMG IM residents to competently perform pelvic examinations/Pap smears.

Setting: Montefiore Wakefield IM residency clinic, Bronx NY.

Participants: IMG categorical IM residents.

Program description: In 2015, we established the Women's Health Clinic (WHC) to train residents in pelvic examinations/Pap smears. The educational model includes one hour of didactics followed by trainees seeing up to four patients, supervised by WHC faculty in 1:2 preceptor to resident ratio.

Program evaluation: We evaluated the impact of WHC on IMG residents' self-reported competence in performing pelvic examinations/Pap smears by using McNemar's test to compare self-reported competence in pelvic examinations and Pap smears before and after WHC participation.

Discussion: WHC improved self-reported competence among IMG residents by utilizing standardized didactics reinforced through immediate and repeated patient interactions. It is an educational model that could be reproduced by other IM programs to improve training for IMG residents.