Attitudes Towards Gynecologic Surgery

INTRODUCTION: Essentially every female patient will at some point in their life seek care from an obstetrician–gynecologist (Ob/Gyn). Ob/Gyns provide essential care in our healthcare system. In a 2018 report, there were approximately 50,800 Ob/Gyns practicing in the U.S., and this number is projected to drop to 45,800 by 2030; this predicted shortage of Ob/Gyn physicians will be inadequate for the female U.S. population. A 2021 report revealed that only 6% of medical school graduates pursue Ob/Gyn residency programs. Although there are many speculated reasons for this, including pay discrimination, limited research funding, a siloed training pathway, and political pressures on women’s health, it is possible that there is a component of bias and stereotyping in Ob/Gyn or its subspecialties contributing to this issue. A belief that gynecology is not a surgical specialty exists despite the American College of Surgeons recognizing obstetrics and gynecology as one of the surgical specialties. This potentially stems from other surgical specialties expressing a negative viewpoint towards gynecology, such that gynecologists have inadequate surgical training and therefore lack the surgical skills to perform procedures. Currently, there is no data to describe the experiences of Ob/Gyns as it relates to microaggressions from other specialties, particularly among gynecological surgeons. There is also no data to describe the onset of biases towards Ob/Gyns and their skill set through the trajectory of medical education. OBJECTIVE: To describe attitudes towards gynecologic surgery through the physician and medical student experience. METHODS: An anonymous internet e-survey questionnaire was created for Ob/Gyn faculty and medical students. For the physician experience survey, participants were asked to disclose their level of training, years in practice, gender, and sub-specialty. For the medical student survey, participants were asked to disclose their year in school, gender, clerkships completed, and specialty interests. The medical student survey also contained questions to rate the level of agreement with statements regarding Ob/Gyn. All survey participants answered questions regarding comments towards the gynecologic surgery and towards Ob/Gyn patients. RESULTS: 106 Ob/Gyn faculty and residents completed the physician survey, and 149 medical students completed the medial student survey. The physician experience survey revealed that 80% of Ob/Gyn faculty have heard negative comments regarding the surgical skills of obstetrician–gynecologists (Table 1). Notably, 42.7% of faculty participants reported hearing such comments more than 10 times. 50.9% of participants responded “Yes” to hearing negative comments about Ob/Gyn patients. Conversely, the medical student experience survey showed, respectively, that 93% of medial students either agree or strongly agree that Ob/Gyn is a surgical field (Table 2). 62.4% of medical students surveyed believe gynecologists perform complex surgery, and 35% of medical students reported having heard negative comments regarding the surgical skills of Ob/Gyns, while 65% responded “No,” although these were more common over time. CONCLUSIONS: Ob/Gyn faculty and their patients receive negative comments by non-Ob/Gyn physicians, but medical students have a more favorable impression of Ob/Gyns and their patient population, suggesting that bias may evolve over time.