Ob/Gyn residents as primary care providers: implementing a new curriculum for diagnosing and treating depression and anxiety

The Accreditation Council for Graduate Medical Education (ACGME) guidelines on resident work hours were created in 2002 in an effort to improve patient care. However, these changes may have a negative impact on resident education. Finding time to adequately prepare Ob/Gyn residents in core curriculum topics has become a challenge. Primary care topics such as behavioral medicine often become a lesser priority, yet Ob/Gyn physicians are expected to be competent in diagnosing and treating mental illness. Depression affects as many as 30% of all pregnant or postpartum women. When we evaluated the screening practices of a southeastern North Carolina residency program, we found that only 8% of prenatal patients were screened for symptoms of depression at their first visit and only 23% were screened at their postpartum visit. Education, screening, and treatment practices need to be addressed to ensure thorough management of Ob/Gyn patients. This paper suggests ways to do so.