An innovative program to provide adequate women's health education to residents with VA-based ambulatory care experiences

Background: The Accreditation Council for Graduate Medical Education (ACGME) requires internal medicine residents to spend 25% continuity clinic time seeing patients of each gender. This requirement is a challenge for programs that use a Veterans Administration Hospital (VA) as the sole site for residents' continuity clinic, because of its predominately a male patient population. Purpose: To ensure VA- clinic-based residents meet the ACGME requirement regarding gender care and receive adequate training in women's-health issues and to assess and evaluate a novel program designed to fulfill these needs.. Methods: We developed a program that allows VA-based residents to spend 75% continuity practice time in VA clinic and 25% in a university-based clinic. We surveyed program participants annually regarding their experiences and in post graduate years (PGY) 1 and 3 assessed all residents' knowledge of women's health (WH). Results: Thirty-five residents were paired with faculty preceptors over 3 years. In annual program surveys, program residents reported seeing a gender mix of patients and feeling more comfortable with women's health. In knowledge surveys, mean score of all residents improved from 46% to 54% (p = .002). Factors associated with improvement were female resident gender (p = .004), having VA continuity clinic (p = .001), having specialized women's health preceptors (p = .006), and seeing at least 30% female patients (p = .01). In the multivariable model, resident gender and having a VA continuity clinic remained significant. Conclusions: Our program provides a novel, effective method to ensure VA-based internal medicine residents receive adequate educational experiences in gender-specific care.