Exposing the need for a training programme in paediatric and adolescent gynaecology for paediatric and GP trainees

ObjectiveAs paediatric and adolescent gynaecology (PAG) falls within the remit of paediatrics and gynaecology, training in both specialties is underdeveloped. There is a paucity of research investigating trainee knowledge of PAG, while postgraduate paediatric training demonstrates little focus in the field. Compounding this, a finite number of PAG specialists means clinical training is limited. We hypothesize that knowledge deficits exist among paediatric and GP trainees and that this has future implications for increased morbidity in girls. Design, Setting and ParticipantsA structured questionnaire assessing PAG was distributed to forty paediatric and GP trainees in October 2019 in a tertiary paediatric hospital. Results60% (24) incorrectly identified vulvovaginitis as candidal infection. 80% (32) were unable to identify labial adhesions. 62% (25) were unable to define menorrhagia. 100% (9) of GP trainees said they would prescribe the OCP compared with 51% (16) of paediatric trainees. 52% (21) did not consider STI screening when appropriate. 75% (30) believed genital warts invariably warrant referral to child sexual assault clinic. 70% (28) could not identify female genital mutilation. 60% (24) did not consider imperforate hymen as a cause of primary amenorrhoea. 67% (27) misdiagnosed lichen sclerosis. ConclusionsA knowledge deficit among trainees was evident in relation to PAG conditions. Misdiagnosis and delayed treatment could lead to considerable increased morbidity for girls and we postulate that a key intervention which may prove effective in improving trainee competency in PAG lies in the introduction of a structured training curriculum for all clinicians involved in PAG practice.