Knowledge of PCOS in physicians-in-training: identifying gaps and educational opportunities

Abstract

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in reproductive-aged women. A recent study found that many obstetrics and gynecology (ObGyn) practicing physicians are unaware of the Rotterdam criteria recommended for diagnosis. Our objective was to identify gaps in trainee knowledge of PCOS diagnostic criteria and management. An online survey was sent out to US ObGyn physicians-in-training in 2018. The primary outcomes were identification of at least one component of each Rotterdam criteria (Rot-3): (1) oligomenorrhea/amenorrhea, (2) clinical or biochemical hyperandrogenism, and (3) ovarian volume or antral follicle count, and identification of all five components (Rot-5). Secondary outcomes were identification of comorbidities and management of PCOS. Multivariable logistic regression was used controlling for gender, seniority (PGY) status, program type, completion of an REI rotation, and number of PCOS patients seen. 85.4% of 347 trainees completing the survey reported using Rotterdam criteria to diagnose PCOS. However, only 55% identified Rot-3 and less than 10% identified Rot-5. Seniority (PGY4 OR 2.2; 95% CI: 1.2–4.1; p = .01) and completion of REI rotation (OR 1.8 95% CI: 1.2, 1.8; p = .006) were associated with identifying Rot-3. Similar findings were noted with identifying Rot-5. Our study identified significant gaps in knowledge regarding PCOS, suggesting an urgent need for improving strategies for trainee education to increase patient satisfaction and provide comprehensive care.

Chinese abstract

多囊卵巢综合征（PCOS）是育龄妇女最常见的内分泌疾病。最近的一项研究发现, 许多妇产科执业医师不知道鹿特丹标准推荐的诊断。我们的目标是找出参加培训的医生对多囊卵巢综合征诊断标准和管理知识的差距。2018年, 一项在线调查被发送到美国正在参加培训的妇产科医师手中。最重要的结果是要医生确定每个鹿特丹标准（Rot-3）的至少一个组成部分（1） 月经少/闭经；（2）临床或生化指标高雄激素血症；（3）卵巢体积或窦性卵泡计数, 以及所有五种诊断标准的识别（Rot-5）。其次是确定多囊卵巢综合征的合并症和多囊卵巢综合征的处理。多变量logistic回归用于控制性别、资历（PGY）状态、项目类型、REI轮转完成情况和PCOS患者数量。完成调查的347名受训人员中, 85.4%的人报告使用鹿特丹标准诊断多囊卵巢综合征。然而, 只有55%的人鉴别出Rot-3, 不到10%的人鉴别出Rot-5。资历（PGY4或2.2；95%CI:1.2-4.1；p¼.01）和REI轮转完成（OR 1.8 95%CI:1.2, 1.8；p¼.006）与Rot-3的识别相关。与Rot-5鉴定结果相似。我们的研究发现, 在多囊卵巢综合征的知识方面存在重大差距, 这表明迫切需要改进妇产科医生培训的教育策略, 以提高患者满意度, 并提供全面的护理。

Keywords:

• PCOS
• Rotterdam criteria
• medical education

Acknowledgements

These data were presented at the American Society for Reproductive Medicine 74th Annual Meeting, October 6–10, 2018, Denver, CO, USA.

Disclosure statement

The authors report no conflict of interest.

Additional information

Funding

This work is supported by Dickens Fellowship Fund, University of Pennsylvania Department of Obstetrics and Gynecology, Australian National Health and Medical Research Council.