Scope of Global Health Training in US Obstetrics and Gynecology Residency Programs

OBJECTIVE: To enumerate global health training activities in U. S. obstetrics and gynecology residency programs and to examine the worldwide distribution of programmatic activity relative to the maternal and perinatal disease burden. METHODS: Using a systematic, web-based protocol, we searched for global health training opportunities at all U. S. obstetrics and gynecology residency programs. Country-level data on disability-adjusted life-years resulting from maternal and perinatal conditions were obtained from the Global Burden of Disease study. We calculated Spearman's rank correlation coefficients to estimate the cross-country association between programmatic activity and disease burden. RESULTS: Of the 243 accredited U. S. obstetrics and gynecology residency programs, we identified 41 (17%) with one of several possible predefined categories of programmatic activity. Thirty-three residency programs offered their residents opportunities to participate in one or more elective-based rotations, eight offered extended field-based training, and 18 offered research activities. A total of 128 programmatic activities were dispersed across 64 different countries. At the country level, the number of programmatic activities had a statistically significant association with the total disease burden resulting from maternal (Spearman's rho=0.37, 95% confidence interval [CI] 0.14-0.57) and perinatal conditions (rho=0.34, 95% CI 0.10-0.54) but not gynecologic cancers (rho=-0.24, 95% CI -0.46 to 0.01). CONCLUSIONS: There are few global health training opportunities for U. S. obstetrics and gynecology residents. These activities are disproportionately distributed among countries with greater burdens of disease.