Medical student knowledge of global health problems: obstetric fistulas in developing countries

J Reprod Med. Sep-Oct 2012;57(9-10):427-30.


Objective: To evaluate medical students in the United States at several medical schools regarding their knowledge of the global health burden of obstetric fistulas.

Study design: A cross-sectional survey was conducted in 8 schools across the United States over a period of 6 months. The survey was composed of 18 questions on epidemiology, pathology, and treatment of fistulas. It was a web-based module accessed through an emailed link. It was sent to 5,103 medical students' email addresses at the 8 institutions once a week for 4 weeks. SPSS paired student t tests was used for statistical analysis.

Results: Of the 1,089 students from 8 medical schools that initially began the survey, 965 completed this voluntary and anonymous survey, with a 21% response rate and 19% completion rate. Overall the students averaged 11/18 (60.7%) correct on this survey. The knowledge of obstetric fistula improved, but not significantly, with increasing level of medical school education, with first-year medical students achieving 10/18 (55%) correct and senior medical students achieving 12/18 (67%) correct (p = 0.1).

Conclusion: U.S. medical students' knowledge of obstetric fistulas in developing countries does not increase significantly over 4 years of medical school education. While this condition presents largely in the developing world, given rapid globalization as well as increased international health experiences for U.S.-trained health professionals,further effort should be placed in improving medical student knowledge of this devastating condition.

MeSH terms

  • Adult
  • Clinical Competence*
  • Cross-Sectional Studies
  • Developing Countries
  • Female
  • Humans
  • Obstetric Labor Complications* / epidemiology
  • Obstetric Labor Complications* / etiology
  • Obstetric Labor Complications* / therapy
  • Pregnancy
  • Rectovaginal Fistula* / epidemiology
  • Rectovaginal Fistula* / etiology
  • Rectovaginal Fistula* / therapy
  • Students, Medical*
  • Surveys and Questionnaires
  • Vesicovaginal Fistula* / epidemiology
  • Vesicovaginal Fistula* / etiology
  • Vesicovaginal Fistula* / therapy
  • Young Adult