MON-178 - A Survey of Internal Medicine Residents Reveals Strong Knowledge and Interest in Polycystic Ovary Syndrome

Introduction: Polycystic ovary syndrome (PCOS) is a common endocrine disorder and a major risk factor for type 2 diabetes in young women. Despite its cardiometabolic sequela, gaps in clinician knowledge contribute to diagnostic delays and patient dissatisfaction. We evaluated internal medicine residents’ education and practices related to PCOS.

Methods: We conducted a survey of internal medicine residents at two large urban residency programs at the end of the 2024-2025 academic year. The survey assessed demographics, prior PCOS training, knowledge, and intended diagnostic and management practices for patients with PCOS using previously validated questions.

Results: The response rate was 16% (64/386). Seventy percent of respondents were women, compared with 50% women in the surveyed residency programs. Postgraduate years 1–3 were equally represented. Most participants reported PCOS training during medical school (90%). Of the 21 graduating respondents, only 13 (62%) reported training during residency. The majority sometimes or often (as opposed to rarely or never) would use menstrual cycle disturbances (97%), hirsutism (94%), biochemical hyperandrogenism (75%), and pelvic ultrasonography (81%) to diagnose PCOS. For assessment of biochemical androgen excess, 75% selected total testosterone, and 64% selected free testosterone from a list of options. Most recognized reduced fertility (92%), type 2 diabetes (90%), pregnancy complications (78%), depression (69%), increased cardiovascular risk (59%), and fatty liver disease (52%) as related conditions from a list of 19 items. However, 81% incorrectly associated PCOS with ovarian cysts. Obesity and type 2 diabetes (listed as a combined option) were identified as the primary long-term concern by 64%, selected over infertility, cardiovascular disease, endometrial cancer, and psychosocial concerns. Most residents would recommend oral contraceptives (78%), lifestyle modifications (73%), and metformin (70%) for treatment. However, 70% reported rarely or never serving as the primary physician managing PCOS. Over 90% requested additional training on PCOS.

Conclusion: While knowledge gaps exist, internal medicine residents demonstrated overall competence in PCOS diagnosis. They also showed a heartening awareness of the associated type 2 diabetes and cardiovascular risks of PCOS, which are recognized by the American Diabetes Association and the American College of Cardiology, respectively. As future primary care providers and specialists, internal medicine residents’ lack of ownership over PCOS management may contribute to the known delays in diagnosis and treatment. Our results may overestimate the PCOS-specific knowledge among trainees due to a participation bias and limited survey complexity. Future research should explore PCOS training in additional cohorts and barriers to diagnosis and treatment.

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