Menopausal Medicine Is Overlooked in US Residency Programs


Fewer than 20% of obstetrics and gynecology residents receive formal training in menopause medicine. With an expected 50 million menopausal women in the US by 2020, how will we address the knowledge gap?

Fewer than 20% of obstetrics and gynecology (ob/gyn) residents receive formal training in menopause medicine and about 70% of these residents would welcome it, according to a small survey led by investigators from Johns Hopkins University.1
To better understand the menopause curriculum in US-based ob/gyn residency programs, the investigators e-mailed the directors of all such programs asking them to forward a Web-based survey to their residents. A total of 258 residency directors were contacted, and 79 (30.6%) confirmed forwarding the link to the survey to their residents. Of the 1799 residents who received the survey, 510 (29.4%) completed it. Although this low response rate is a considerable limitation of the study, the responses that were received showed that residents have limited knowledge of menopause medicine and need to learn more about it to comfortably and confidently treat menopausal patients.
Nonhormone therapy related to menopause medicine was the area that residents reported knowing the least about. Other specific aspects of menopause medicine for which residents reported a knowledge gap were the pathophysiology of menopause symptoms, hormone therapy, bone health, cardiovascular disease, and metabolic syndrome. Tellingly, according to the study authors, 40% to 60% of fourth-year residents who responded to the survey reported a need to improve their knowledge of menopause medicine.1,2
Supervised clinics were the residents’ preferred method of learning, followed by case presentations, formal lectures, small groups, Web-based learning, and independent reading. Among the residents who completed the survey, 20.8% reported being in a residency program with a formal menopause medicine curriculum and 16.3% reported having a defined menopause clinic as part of their program.
The study authors stress that ob/gyn residency programs need to address this knowledge gap, especially considering that the US population is estimated to include 50 million menopausal women by 2020.1,2 The US census also estimates that by 2020, the average age of a woman entering menopause will be 51 years and the average life expectancy for US women will be 85 years, reported the study authors.
“Residents who participated in our study have stressed that they want more knowledge and experience in this field, and an improved comfort level in treating menopausal symptoms,” said Wen Shen, MD, senior investigator and assistant professor of gynecology and obstetrics at Johns Hopkins University School of Medicine, Lutherville, Md.2 The study authors suggested that a formal curriculum in menopause medicine would allow for ob/gyns to more adequately treat this growing patient population.

Pertinent Points:
- Most obstetrics and gynecology residents report that their knowledge of and clinical management skills related to menopause medicine are inadequate.
- Implementing formal menopause medicine curriculums in all obstetrics and gynecology residency programs would help alleviate this knowledge gap.


1. Christianson MS, Ducie JA, Altman K, et al. Menopause education: needs assessment of American obstetrics and gynecology residents. Menopause. April 29, 2013. [Epub ahead of print.]
2. What do Ob/Gyns in training learn about menopause? Not nearly enough, new study suggests [press release]. Available at: Accessed May 1, 2013.

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