Training on pediatric and adolescent gynecology in the practice of gynecology and obstetric residents

Introduction:  The presence of children and adolescents has been an increasingly frequent situation in gynecologists’ offices and it is noteworthy that the care for these age groups is very different from the care for adult women. Therefore, professionals need to be prepared for this type of situation, not only with specific technical knowledge, but they must also know the laws that regulate the assistance of minors and the ethical particularities of providing care to this population. However, this training often does not occur in medical school or medical residency.

Objective:  To analyze training in Pediatric and Adolescent Gynecology (PAG) during the Gynecology and Obstetrics medical residency in Bahia, Brazil.

Method:   Cross-sectional observational study, using a convenience sample consisting of 51 Gynecology and Obstetrics residents from eight institutions in the state of Bahia, using an online questionnaire that assessed the following aspects: technical-theoretical and ethical knowledge about Pediatric and Adolescent Gynecology, self-perception of comfort, confidence, and competence in caring for children and adolescents and access to theoretical and practical content related to PAG at the medical residency institution.

Results:  The majority has already treated children and adolescents at residency (78,4%), but there was no specific outpatient clinic (86,3%) or annual exposure to PAG (86,3%) in most institutions. Most importantly, PAG was discussed at residency less than 5 times (70,6%), followed by never (23,5%). Regarding PAG, most of them considered the allocated time insufficient (90,2%), would like more training (96,1%), and to be included in practice as a specialty (66,7%). Finally, concerning self-perceived preparedness, comfort, and confidence, in most questions about children, the level was between 2 and 3, while for adolescents the level was 4 in the Likert scale. Furthermore, the majority chose the right answers to specific knowledge questions.

Conclusion:   Although most of them have demonstrated theoretical and ethical knowledge in PAG, most of the residents have little theoretical-practical training in Pediatric and Adolescent Gynecology, and they often feel unprepared, uncomfortable, and not very confident in dealing especially with children. Therefore, most of them would like more training in PAG and should receive it.

Keywords:
gynecology; pediatric; adolescent; residents; residency