Hou Melody Y, Hodgens Tiffany M, Nguyen Mytien, Westervelt Marjorie J, Toland Melissa A, Boatright Dowin, Lopez Claudia L, Fancher Tonya L
Department of Obstetrics and Gynecology, University of California, Davis, 4860 Y Street, Suite 2500, Sacramento, CA, 95817, USA.
Office of Medical Education, University of California, Davis School of Medicine, Sacramento, CA, USA.
BMC Med Educ. 2025 Jul 29;25(1):1125. doi: 10.1186/s12909-025-07690-x.
Recruitment of a more diverse obstetrics and gynecology workforce may help improve patient outcomes in the US, particularly among women of color. Visiting rotations play a role in competing for a position in an obstetrics and gynecology residency, however, not all students may be able to complete these expensive experiences. Our objective was to evaluate socioeconomic and other demographic differences among US obstetrics and gynecology-bound students who participate in visiting rotations versus those who do not.
We obtained de-identified data from the Association of American Medical Colleges for students graduating in US allopathic medical schools 2019 or 2020. We analyzed self-reported receipt of state and/or federal assistance to obtain postsecondary education, medical education debt, sex, and race and ethnicity data using chi-square and ANOVA analyses and logistic regression.
Of 33,287 US graduating medical students, 1978 (5.9%) indicated "Obstetrics and Gynecology" as their intended practice and included socio-demographic data; 1110 (56.1%) of these completed at least one visiting rotation. In multivariable analysis controlling for medical education debt, race and ethnicity, and sex, students with moderate debt were less likely to complete any visiting rotation (aOR 0.68, 95% CI: 0.52, 0.89) and students with any debt were less likely to complete two or more visiting rotations than those without debt. However, Black students were significantly more likely to complete two or more rotations than white students when adjusted for debt and sex (aOR 1.48, 95% CI: 1.02, 2.11).
Among US obstetrics and gynecology-bound medical students, moderate medical education debt was associated with lower odds of completing visiting rotations when adjusted for race and ethnicity and sex. Black students were more likely to complete two or more visiting rotations compared to their white counterparts when adjusted for levels of debt, perhaps to improve the likelihood of a successful match that is lower than that of their white colleagues despite the risk of worsening their debt. Providing more financial support or deemphasizing the visiting rotation as part of the application could help recruit a workforce that better reflects the diversity of the general population.
招募更加多元化的妇产科医护人员可能有助于改善美国患者的治疗效果，尤其是有色人种女性患者。见习轮转在竞争妇产科住院医师职位方面发挥着作用，然而，并非所有学生都能够负担得起这些费用高昂的经历。我们的目标是评估参与见习轮转的美国妇产科专业学生与未参与的学生在社会经济和其他人口统计学方面的差异。
我们从美国医学院协会获取了2019年或2020年在美国攻读全科医学学位的医学院毕业生的匿名数据。我们使用卡方检验、方差分析和逻辑回归分析了自我报告的接受州和/或联邦高等教育援助情况、医学教育债务、性别、种族和族裔数据。
在33287名美国医学院毕业生中，1978名（5.9%）表示打算从事“妇产科”工作并提供了社会人口统计学数据；其中1110名（56.1%）完成了至少一次见习轮转。在控制医学教育债务、种族和族裔以及性别的多变量分析中，中等债务的学生完成任何见习轮转的可能性较小（调整后比值比为0.68，95%置信区间：0.52，0.89），与无债务的学生相比，有任何债务的学生完成两次或更多次见习轮转的可能性较小。然而，在调整债务和性别后，黑人学生完成两次或更多次轮转的可能性显著高于白人学生（调整后比值比为1.48，95%置信区间：1.02，2.11）。
在美国妇产科专业医学生中，调整种族和族裔以及性别因素后，中等医学教育债务与完成见习轮转的几率较低相关。与白人学生相比，黑人学生在调整债务水平后更有可能完成两次或更多次见习轮转，尽管这可能会增加债务恶化的风险，但或许是为了提高成功匹配的可能性，因为他们的成功匹配率低于白人同事。提供更多经济支持或不将见习轮转作为申请的重要组成部分，可能有助于招募一支能更好反映普通人群多样性的医护队伍。
