(Poster 151) Improving Menopause Education: A Novel Curriculum for Resident Physicians

Objectives: Menopause symptoms significantly affect quality of life. Hormone replacement therapy (HRT) is the most effective therapy for symptoms, yet it is greatly under-prescribed by physicians. Furthermore, menopause education varies greatly among obstetrics and gynecology (OBGYN) residency programs, with the majority of programs lacking a dedicated menopause curriculum. Our aim is to determine the impact of initiating a menopause residency curriculum on resident knowledge of and comfort in treating menopausal symptoms.

Methods: A menopause curriculum for residents was initiated at a single high-volume OBGYN residency program. A 2 hr lecture focused on the Women’s Health Initiative findings, HRT, and treatment for genitourinary syndrome of menopause was given to OBGYN residents. Participants completed a pre- and post-course survey containing questions on basic menopause knowledge, concerns regarding HRT prescription, and the impact of the lecture on their training. Continuous variables are described as medians and analyzed using the Mann-Whitney U test, while categorical variables are written as proportions and analyzed with Fischer’s exact test.

Results: Overall, there were 19 participants including 7 interns, 5 PGYs, 4 PGY 3s, and 3 PGY4s. Prior to the lecture, only 7 residents (36.8%) discussed menopausal symptoms routinely at annual visits. Most residents (84.2%) had prescribed HRT infrequently. Reasons preventing residents from prescribing HRT included lack of knowledge, attending physician preferences, uncertainty about what to prescribe and dosage, cost of medication, and concern for hyperplasia/malignancy.

There was a significant increase in median pre- and post-lecture quiz scores improved (42.9% to 85.7%, respectively, p < 0.0001). Resident-reported comfort with counseling patients on menopausal symptom treatments also improved before and after the lecture (21.1 vs 89.5%, respectively, p< 0.0001), although reported comfort level in prescribing vaginal estrogen did not (73.7% vs 89.5%, ns). All participants agreed the lecture improved comfort levels in prescribing HRT.

Conclusions: Only a small proportion of residents routinely discussed menopausal symptoms at annual patient visits with many having zero or little experience in prescribing HRT for menopausal symptoms. Residents cited limited exposure to menopausal treatment options and general lack of knowledge as factors preventing menopause counseling and HRT prescription.This study further demonstrates gaps within OBGYN residency training regarding menopause education and underscores the need for a national standardized menopause curriculum to ensure appropriate care for patients.