An Expanded Primary Care-Based Women's Health Clinic to Improve Resident Education and Patient Care in Resident Continuity Clinic.

BACKGROUND

Internal medicine (IM) residents are underprepared in women's health. Lack of properly trained faculty and clinic culture limits the ability to provide bedside teaching.

AIM: Assess the impact of a primary care-based, women's clinic on residents' quality of care for females.

SETTING

Large academic, urban primary care clinic with resident and faculty practices

PARTICIPANTS

PGY-2 IM and Med-Peds (MP) residents PROGRAM DESCRIPTION: A weekly half-day, women's clinic to provide expanded women's healthcare to primary care group patients. Residents rotate through the clinic to receive bedside teaching.

PROGRAM EVALUATION: Chart review was performed for a representative sample of reproductive-aged women seen in primary care before and after the establishment of the women's clinic. A total of 666 charts were reviewed (314 pre, 352 post). Improvement was seen in residents' rate of sexual histories (54% vs 75%, p< 0.01) with a significant decrease in women not asked about contraception (15% vs 3%, p<0.01). Overall there was a decrease in gynecology referrals (18 to 11%, p=0.02).

DISCUSSION: After implementing the women's health clinic, more women were asked about sexual health needs, and fewer were referred to gynecology, suggesting increased women's healthcare provided by residents.