Enhancing Cultural and Religious Sensitivity: Tracking Changes in OB/GYN Residency Programs from 2021 to 2024

Introduction: Cultural competency training, which includes understanding and respecting diverse religious beliefs and practices, is crucial for providing culturally sensitive patient care. In residency programs, a focus on this type of competency may not only enhance patient care but also promote mental health and wellness for resident trainees. The Accreditation Council for Graduate Medical Education (ACGME) suggests integrating this training into core competencies such as interpersonal and communication skills, patient care, and professionalism. Promoting inclusivity within residency training prepares residents to effectively care for patients from diverse backgrounds, enhancing their ability to provide personalized care. This research study seeks to track and analyze the evolution of cultural and religious support purported on Obstetrics and Gynecology residency websites over three years. Methods: In 2021 and 2024, a comprehensive evaluation of the websites of ACGME-accredited OB/GYN residency programs in the U.S. was conducted, focusing on data from the recently concluded interview cycles. A unique set of evaluation criteria was developed to assess the incorporation of cultural and religious diversity, as well as the integration of corresponding competency training into resident education. The process of devising the 18 key questions for the assessment involved rigorous formulation, validation, and refinement by a group of religiously and culturally diverse medical students. The collection of data was conducted by students from two larger medical schools, one in the Midwest and another in the South. The number of analyzed websites between the two time periods was noted to be discrepant due to the rise in accredited programs and/or improved website accessibility. Thus, instead of absolute numbers, percentages were utilized to optimize comparison. Data was also categorized based on geographical/administrative CREOG regions to facilitate easier understanding and regional comparison. The evaluation criteria included factors such as the program’s efforts in recruiting and respecting the needs of residents of diverse religious backgrounds, the presence of cultural, religious, and racial non-discrimination statements, and the program’s support towards residents’ religious obligations, among others. Results: A total of 577 OB/GYN residency program websites were analyzed: 285 in 2021 and 292 in 2024. There was a positive trend toward supporting cultural and religious competencies across all CREOG regions in OB/GYN residency programs. Programs expressing an interest in recruiting residents from diverse religious backgrounds nearly doubled from 12% to 26%. The percentage of residency programs providing formal cultural competency education to staff rose from 7% to 17%. Additionally, there were improvements in support for resident involvement in advocacy or policy issues related to cultural competency and an increase in programs allowing residents to opt out of practices conflicting with their beliefs. The proportion of residency programs implementing a holistic review of applications increased from 17% to 33%. Regional analysis highlighted significant shifts across different CREOG regions. Regions 1 and 3 showed a marked rise in the percentage of programs demonstrating interest in investment to recruit residents of diverse religious backgrounds, indicating increased acceptance of religious variety. Specifically, Region 1 saw an increase from 12% to 38%, while Region 3 jumped from 0% to 20%. Regions 2 and 4 experienced substantial growth in implementing formal cultural competency education, rising from 5% to 18% in Region 2 and from 9% to 46% in Region 4. Region 5 stood out overall in multiple areas, such as integrating cultural competency into the residents’ didactic curricula and supporting residents in researching religious and cultural diversity issues. Despite improvements in most areas, some criteria showed minimal progress. Support for residents with religious obligations remained static at 0% across all regions. Similarly, explicit policies addressing time off for religious holidays declined from 2% to 1%. In Regions 3 and 4, there was a decline in the percentage of programs addressing opportunities and procedures for reporting harassment on their websites, with Region 4 experiencing a significant drop from 16% to 1%. This decline suggests a potential lack of transparency and support for residents facing such cultural issues. Lastly, specialized cultural mentorship programs to accommodate International Medical Graduates remained largely absent, with only 1% of programs offering such support in both cycles. Conclusion: Our study provides a comprehensive analysis of cultural and religious competencies in OB/GYN residency programs across the US, based on data from 2021 and 2024. The findings suggest a generally positive trend in the improvement of these competencies over the three years with significant progress noted in most areas. However, the regional analysis revealed varied trends across CREOG regions, showcasing the need for region-specific strategies. This research underscores the importance of continuous evaluation and enhancement of cultural and religious competency training in residency programs to ensure that future healthcare providers are well-equipped to deliver inclusive and respectful patient care.