The Training Needs of Malaysian House-Officers on Core Obstetrics and Gynecological Competencies

Internship prepares a newly graduated medical practitioner to be fully conversant and confident with the routines during clinical practice. Information on competencies on basic core clinical skills at an early stage of training is essential. So appropriate measures can be implemented to ensure adequate competence is acquired in the available period. This study was performed to assess the training needs of house officers overtime and the outcome of their training on core obstetric and gynecological (Ob&Gyn) competencies.

This was a longitudinal study of the level of competence and training needs of house-officers on the core (Ob&Gyn) competencies as required by the Ministry of Health Malaysia. Three domains of competencies that were the practical knowledge, procedural competencies, and the personal and professional attributes were assessed. The assessment was done at two points, which were the beginning and the end of the posting to enable evaluation of the level of competency and training needs over time.The data were obtained using a set of a questionnaire developed based on the competencies required by the Ministry of Health Malaysia. A Likert scale of 1-5 was used to measure the house officers’ perceptions of the items studied. A P value <0.05 was considered statistically significant.

Responses from 416 house-officers from eight participating hospitals were available for analysis. The mean entry scores at the beginning of (Ob&Gyn) rotation of three domains of assessment -practical knowledge, procedural competencies, and personal attributes- were 2.86 (SD 0.679), 2.21 (SD 0.222), and 3.72 (SD 0.734) and mean exit scores of the three domains of assessment at the end of the rotation were 3.84 (SD 0.553), 3.14 (SD 0.712), and 4.22 (SD 0.641), respectively. The improvements were statistically significant (P=0.0001 in all areas). Factors that were associated with higher scores at the entry-level were the female sex, number of prior clinical rotations, and where they graduated from.

Whilst the training needs of the house-officers in the core (Ob&Gyn) competencies significantly reduced over time, specific areas of unpreparedness related to undergraduate medical training were identified. These areas need attention to ensure graduates are optimally prepared for starting work.