Pediatric Resident Training in Prepubertal Vulvar Conditions

Area of Science:

• Pediatric Gynecology
• Medical Education
• Resident Training

Background:

• Prepubertal gynecologic conditions are common in pediatric practice.
• Effective diagnosis and management require specialized knowledge and skills.
• Current pediatric residency training may not adequately prepare residents for these specific challenges.

Purpose of the Study:

• To evaluate the current state of pediatric resident training in diagnosing and managing prepubertal gynecologic conditions.
• To assess residents' comfort, confidence, and knowledge in this subspecialty area.
• To identify areas for improvement in medical education for pediatric residents.

Main Methods:

• A voluntary 32-question survey was distributed to 7,075 US pediatric and combined internal medicine-pediatric residents via the American Academy of Pediatrics listserv.
• The survey assessed residents' training experiences, comfort, confidence, and knowledge regarding pediatric gynecologic concerns.
• Descriptive analysis, including chi-squared tests, was performed on the 866 (12%) completed surveys.

Main Results:

• Residents reported significantly lower comfort (30.4%) and confidence (32.8%) in managing prepubertal gynecologic conditions compared to general pediatric topics (88.5% comfort, 87.6% confidence).
• Comfort and confidence increased with residency year but remained low overall.
• Residents primarily learned about vulvovaginal concerns from attending physicians (79.8%) and residency didactics (34.7%).
• 97% of residents expressed a desire for additional education and training in prepubertal vulvovaginal conditions.

Conclusions:

• Pediatric residents exhibit significant deficits in comfort, confidence, and knowledge concerning prepubertal gynecologic conditions.
• While training improves these metrics, they remain suboptimal, highlighting a need for enhanced educational interventions.
• There is a clear demand from residents for more comprehensive training in pediatric gynecology.