**10. Conclusions**

18 From Preconception to Postpartum

example, when the University of Colorado Health Science Center restructured their clerkship to emphasize teaching and mentoring, they doubled the number of third year students interested in OB/GYN. Timely and constructive feedback from residents and faculty increased student satisfaction from 67% to 85%. There were highly significant increases in instructors being viewed as positive role models, being enthusiastic about

In concert with good teaching, is good mentoring that adequately describes the duties of an OB/GYN physician, e.g., explaining the pros and cons of a private practice vs. an academic appointment. Furthermore, it is advantageous to let students know what to expect in the clerkship or residency, and to develop and nurture a professional rapport. Engaging the students in active learning and problem solving, while providing timely constructive vs. destructive criticism, is deeply appreciated by students. Asking students or residents to selfreflect on the improvements they need to make, shows the students the clerkship cares about helping them to become competent OB/GYNs. Finally, avoid telling students or residents "how it was" when you were in their position — often with a verbalized or implied statement that it was tougher "back then". Students and residents are concerned about mastering their current educational challenges and are not interested in the past.

In 2005, Bienstock and Laube wrote an article about how to recruit medical students into OB/GYN. Foremost, they concluded that clerkships can be improved by writing clear learning objectives for each session. Further, the relative importance of each objective needs to be stated, and the assessment of each objective needs to be clearly explained. Having students exposed to good OB/GYN role models during their basic science years of medical training gives them an early, positive exposure to the discipline. Furthermore, instructors need to give very organized lectures which can be understood by undergraduate medical students who have no clerkship experience. All too often, the author of this chapter has seen faculty or residents (in any specialty) give the freshmen or sophomore students a lecture that was the equivalent of a grand rounds presentation. The lectures were too detailed and contained far too many PowerPoint slides to be shown in a 50 minute period. Student frustration was compounded by the lecturer not emphasizing key, important concepts.

The development of OB/GYN Student Interest Groups (SIGs) can help stir excitement in OB/GYN. Setting up an OB/GYN display during medical school orientation, which is manned by a dynamic resident or faculty member, attracts student attention to your discipline. If other specialties have these SIGs and your OB/GYN department doesn't, it is missing a valuable opportunity to influence interested medical students into sustaining their initial interest in OB/GYN. Furthermore, developing a well-structured OB/GYN elective will maintain student interest, and help sway those students who are considering OB/GYN,

In 1998, Jacoby and colleagues accurately predicted that within the US, females would soon constitute the majority of OB/GYN physicians. This prediction is becoming reality in many nations. If the increasing number of patients in the aging population is combined with the decreased productivity of female OB/GYNs, especially in their child-bearing and child– rearing years, then there will be a shortage of OB/GYNs (Pearse et al., 2001). Laborists,

along with other specialties, to enter an OB/GYN residency.

**9. The future** 

teaching, and contributing to student professional development (Dunn et al., 2004).

There are several major points which need to be considered by OB/GYN residency programs. First, the student population is changing and there are increasing numbers of students who desire specialties with controllable lifestyles. Therefore, enticing students into an OB/GYN program, that is considered to have a non-controllable lifestyle, needs to be started early in their medical school career. Organizing OB/GYN SIGs which expose medical students to good role models is important. Ensuring that faculty and residents make a positive impression upon students in the OB/GYN clerkship will help overcome the decline in OB/GYN interest that occurs during undergraduate medical education. Furthermore, the recent perception that males are not welcome in the profession has to be aggressively overcome.

Second, students and residents must be made fully aware of the varied roles an OB/GYN may have to assume. These future OB/GYNs must be prepared for the obstetric, surgical and increasing primary care roles they may need to provide. Finally, departmental chairs must be aware of the burnout and emotional exhaustion suffered by many of their residents and faculty. Increasing career satisfaction by reducing burnout will be challenging.

Evidence that the empathy of students is declining needs to be taken into account. Therefore, OB/GYN residency programs need to ensure that good physician/patient communication skills are continually reinforced, and that cynicism will not be tolerated. Every academic institution needs to have a review board who addresses breeches in professionalism. Each OB/GYN program needs to ensure that every medical student and resident receives equal opportunities to practice skills and obtain career advice. In this regard, ensuring that OB/GYN departments are not overly dominated by a single gender or ethnic group will help guard against perceived discrimination, as well as provide the students and residents with role models they can emulate.
