(152) Institutional and Faculty-Level Barriers to Sexual Medicine Training in OB/GYN Residency: A Scoping Review Reanalysis

Abstract Introduction Sexual medicine is a core component of women’s health, yet training in this field remains highly variable across OB/GYN residency programs. While prior analyses have emphasized trainee knowledge gaps, little attention has been directed toward institutional and faculty factors that hinder the development, delivery, and sustainability of sexual medicine education. Understanding these barriers is essential for implementing meaningful curricular reform. Objective To examine faculty- and institution-level barriers to implementing sexual medicine education in OB/GYN residency programs through a thematic analysis of a previously conducted scoping review. Methods This study reanalyzed data from a scoping review of 14 studies conducted across multiple countries (including Finland, Brazil, Singapore, Israel, Canada, and the United States) evaluating sexual medicine education within OB/GYN or multispecialty residency programs. Studies were identified through PubMed, Scopus, and ERIC using search terms related to sexual health, residency training, and education. Inclusion criteria captured global evaluations involving OB/GYN residents; exclusion criteria removed studies focused solely on reproductive health, urogynecology, or gynecologic oncology. For this secondary analysis, data extracted from each study were reviewed for themes related to faculty expertise, institutional prioritization, curricular structure, and resource availability. Results Across all 14 studies, system-level barriers emerged as major contributors to inadequate sexual medicine training: Insufficient faculty expertise: Multiple studies identified gaps in faculty-driven clinical skills training. One national survey reported that fewer than half of residents had ever been taught clitoral, vestibular, or pelvic floor physical examination by a trained instructor, with only 23% receiving clitoral exam training, 45% vestibular exam training, and 35% pelvic floor exam training. Additional studies reinforced these gaps: 66% of residents reported having no formal education in managing sexual problems, and more than 50% indicated low confidence due to inadequate faculty instruction and limited opportunities for supervised clinical skill development. Lack of institutional prioritization: Formal curricula were rare, with 83% of Finnish OB/GYNs and 79% of Brazilian residents reporting inadequate residency training in sexual medicine. Structural barriers: Programs lacked curricular time, with limited clinic scheduling and competing procedural priorities cited as barriers by 57–76% of providers and trainees across multiple studies. Minimal clinical exposure: Only 51% of OB/GYN residents completed a urogynecology rotation, reducing opportunities for supervised sexual pain evaluation. Faculty discomfort and absence of assessment tools: Faculty frequently lacked confidence in diagnosing and treating female sexual dysfunction, mirroring trainee discomfort. No study identified a standardized, validated assessment for resident competence in sexual medicine. Conclusions This secondary analysis highlights that deficiencies in sexual medicine training extend beyond trainee gaps and reflect deeper institutional and faculty-level shortcomings. Because OBGYN certifying organizations do not provide national curricular guidelines outlining objectives for education on women’s sexual function, dysfunction and sexual pain, institutions often overlook these areas, underscoring the need for governing and licensing bodies to require their inclusion to ensure comprehensive training. Addressing these deficits will require development of faculty training programs, national competency standards, protected curricular time, and validated assessment tools. Strengthening institutional capacity is essential to ensuring that OB/GYN residents graduate with the skills to manage women’s sexual health concerns. Disclosure No.