Recruiting to the OB/GYN Team

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Recruiting to the OB/GYN Team

• Dee E. Fenner, M.D.
• 2004 APGO President

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APGO
JUST ONE MORE STUDENT!!!
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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.

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Market AnalysisSWOT

• 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?

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What is your product?
We are Obstetricians and Gynecologists. We are
Womens Health Care providers. We are
Surgeons. We are reproductive biologists. We are
high risk pregnancy specialists and gynecologic
oncologists.
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What is your market share?How has it changed?
We are recruiting from only HALF the medical
students
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Ob-Gyn PGY1Positions filled
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Women as of total Medical School Graduates
AAMC
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The percent of total women grads choosing OB/GYN
has been constant 9
AAMC
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Ob/GYN Residents Matched by Gender from Total
US Grads
Males Females Ratio M to F
1993 3.6 (345) 8.7 (513) 40/60
2003 2.1 (180) 8.7 (608) 23/77
AAMC
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Women prefer female Obstetrician/Gynecologist?

• 40 prefer female
• 10 prefer male
• 50 Want a good doctor

Cockburn J. BJOG 19961032-3 Chandler PJ Mil Med
2000 165938-940 Fennema K. J Fam Pract
199030441-446
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Myths and Misperceptions?

• Male graduates couldnt find jobs?
• Male Ob/gyns paid less?
• TRUTHS?
• Deans telling male students not to apply
• Chairs telling male students not to apply

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Womens attitudes to the sex of medical students
in a gyn clinic cross sectional surveyOFlynn
N. BMJ 2002325683-684.

• 33 of women refused to see a medical student
• 42 accepted any student
• 25 would not see a male student

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The impact of Perceived gender bias on Obstet and
Gynec skills acquisition by third-year medical
studentsEmmons SL. Academic Medicine
200479326-332

• 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

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Gender Bias Against Male Obstetrician-Gynecologist
s in Womens MagazinesKincheloe LR. Obstet
Gynecol 20041041089

• 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)

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GENDER DISCRIMINATION
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What is the competition?

• The controllable lifestyle specialties?

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Specialty Lifestyles
Controllable Noncontrollable
Anesthesiology Obstet and Gynec
Dermatology Family Practice
Radiology Int. Med.
Neurology Ortho. Surgery
Ophthalmology Pediatrics
Pathology Gen. Surgery
Psychiatry Urology
ENT
Schwartz RW. Acad Med 199065207-210.
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Influence of Controllable Lifestyle on Recent
Trends in Specialty Choice of US Med
StudentsDorsey ER. JAMA 20032901173-1177

• ? 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

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What impacts career choice?

• Extracurricular clinical experiences
• Premed and undergrad experiences
• Yr 1 and 2 exposure
• Role models

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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 198317295 Zeldow PB. Med
Educ 199226327 Kassebaum DG. Acad Med
199570938
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Considering obstetrics and gynecology as a
specialty current attractors and
detractorsMetheny WP. Obstet Gynecol
199178308-312

• 11 medical schools
• 50 response
• Attractors
  Detractor
• Female
  Insurance
• Healthy patients life-style
• Reproductive issues
• Surgical procedures
• Mentors

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Statistically significant and nonsignificant
factors in influencing one to choose OB/GYN
Creighton University Grads 1991-2001

Fogarty CA. AJOG 2003189652-654.
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What influences medical students to pursue
careers in obstetrics and gynecology?Schnuth R.
AJOG 2003189639-643

• 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

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What are our strengths?

• Mentors like YOU
• Dedication
• Quality education

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MENTORS

• 79 of the students that choose a surgical
  specialty do so because of a mentor and faculty
  influence.

Bland KI, Ach Surg 2002137259-267
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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

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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!!
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Weaknesses/Obstacles

• Bad mouthing
• Legal impact
• Bad press
• Perception of unhappiness?

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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)

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• 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
  cant 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 couldnt fight back,
  and to be rude to the students who couldnt say
  anything in defense.

Mutha S. Acad Med 199772635-640.
OB/GYN was not far behind surgery in negative
comments!!
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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

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