Research Letter
Student intentions to pursue obstetrics and gynecology training and practice in underserved areas

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Objective

Diversity of healthcare providers increases patient engagement, satisfaction, and health outcomes, highlighting the importance of representation and culturally humble care.1 Obstetrics and gynecology is one of the most racially and ethnically diverse medical specialties with a higher proportion of Black and Hispanic physicians who are more likely to practice in areas of higher poverty than other specialties.2,3 However, the need for increased diversity among obstetrics and gynecology trainees

Study Design

The Association of American Medical Colleges provided deidentified, self-reported data from its annual Student Record System and Graduation Questionnaire for respondents who matriculated at US MD-conferring medical schools in the academic years 2007 to 2012 (Supplemental Figure), as previously described.5 Descriptive statistics were reported as frequencies with percentages. We used multivariable log-binomial regression to estimate crude risk ratios (RRs) and adjusted RRs (aRRs) and 95%

Results

A total of 57,307 medical graduates (65.1%) completed the questionnaire (Supplemental Figure) and specified a specialty; 3649 medical graduates (6.4%) reported intention to pursue obstetrics and gynecology, of which 1361 (37.3%) intended to practice in an underserved area. Male respondents were significantly less likely than females to report intention to pursue obstetrics and gynecology (aRR, 0.15; 95% CI, 0.14–0.17) and practice in an underserved area (aRR, 0.82; 95% CI, 0.71–0.96) (Table).

Conclusion

This comparative study focused on US medical school graduates to explore the association of sociodemographic factors and medical school experiences with intent to practice in underserved areas within obstetrics and gynecology. We found that race and ethnicity, sex, debt, and medical school experiences were associated with intention to practice in both obstetrics and gynecology and underserved areas. Specifically, respondents who identified as non-Hispanic Black or African American and Hispanic

Acknowledgments

The authors wish to thank Dr Hyacinth Mason, formerly at Albany Medical College, now at Tufts University School of Medicine, and Dr Ashar Ata, at Albany Medical College, for their mentorship, sponsorship, and enthusiasm for this research project. Their contributions have been invaluable. We are grateful to Drs Rebecca Adler, Ifeoluwa Adelugba, and John Dinelli for sharing their insights on the development of this manuscript.

References (5)

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Cited by (0)

The authors report no conflict of interest.

This project was supported by the Association of American Medical Colleges’ Northeast Group of Educational Affairs Medical Education Scholarship Research and Evaluation Grant Program (Mason) and the National Institutes of Health (NIH) National Institute of General Medical Sciences (grant numbers F30AI157227 [M.N.] and R01GM085350 [D.B.J.]). This work was conducted with support from Harvard Catalyst, The Harvard Clinical and Translational Science Center (National Center for Advancing Translational Sciences, NIH Award [grant number UL1TR002541]), and financial contributions from Harvard University and its affiliated academic healthcare centers. The NIH, Harvard Clinical and Translational Science Center, and Albany Medical College had no role in the design, conduct, writing, or decision to submit the study.

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