Patient Sexual Wellness: A Survey of URPS Fellows

Objectives: We aimed to 1. Assess fellows’ comfortability screening for and addressing FSD and 2. Identify areas for fellowship curricular improvement on FSD.

Methods: A needs assessment survey was sent to a cross-sectional sampling of 56 URPS programs addressed to their program coordinator, to be forwarded to their respective PGY6 and PGY7 fellows. Fellows were asked about their confidence and comfort in screening for, detecting, and addressing FSD, and about their fellowship FSD education.
Comparisons between groups were assessed via the Kruskal-Wallis equality of populations rank test using average confidence, on a scale of 1 (not at all confident) to 5 (extremely confident), and average comfort, on a scale of 1 (least comfortable) to 5 (most comfortable). All tests are two-sided, with a significance threshold of P< 0.05, analyzed using STATA software.

Results: 28 fellow-completed surveys were received and analyzed. Most fellows identified as female (82%), and 100% completed OB-GYN residency. Among all respondents, the average confidence level in addressing FSD overall was 2.9 (SD 0.8). Respondents were also asked how comfortable they were screening for and detecting the four specific subsets of FSD. Overall, average comfort was highest for dyspareunia (4.4, SD 0.8), followed by decreased libido (2.9, SD 1.0), arousal difficulty (2.4, SD 0.8), and anorgasmia (2.4, SD 0.7). Summary measures revealed 14% of fellows reported not having learned about screening for or addressing FSD at all during their fellowship.
There was a significant difference in comfort level in screening for and detecting anorgasmia between males and females, with males reporting lower comfort (2.4, SD 0.7) than females (3.0, SD 0.7), p-value: 0.0391.
Overwhelmingly, 100% of respondents reported they would screen for sexual dysfunction if a standard screening protocol existed. And, 71% of fellows reported they believe there should be a curriculum change in their program regarding sexual dysfunction.

Conclusions: Our study suggests there is a need for more research, and possible addition of sexual well-being topics, into URPS fellowship curricula. Of the fellows who responded to our survey, we found most are not comfortable nor confident in screening for, detecting, or addressing types of sexual dysfunction. Further, most respondents would support a curriculum change regarding sexual dysfunction in their programs.