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Purpose: To describe the frequency at which students are refused from patient care, and to evaluate the impact of interventions designed to reduce medical student refusal. Background: Medical student refusal from patient care is perceived to be a common problem during the Ob-Gyn clerkship at the University of Iowa. Review of the literature shows that medical student refusal is common in a variety of clerkships1-4. Few studies have evaluated interventions to reduce the rate of refusal.

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PURPOSE: Characterize and reduce the frequency at which medical students are 'cast off' from patient care in the Ob-Gyn clerkship. BACKGROUND: For optimal medical education and patient care, it is imperative to have 'all hands on deck'. Review of the literature shows that medical student refusal is an issue nationally in Ob-Gyn as well as other clerkships (1-3). Review of our Ob-Gyn clerkship data shows that students report that patients refuse their involvement in 14% of patient interactions. Furthermore, in 19% of interactions, students felt refusal was related to their gender. METHODS: Beginning in 2017, surveys measuring medical students' perception of refusal were administered upon completion of our Ob-Gyn clerkship. Interventions to reduce refusal of these 'castaways' were implemented with each subsequent clerkship. Faculty mentors: Sarah Shaffer DO & Colleen Stockdale MD, MS. RESULTS: Data collection is on-going. To date, 85% reported exclusion from a patient interaction on the Ob-Gyn clerkship due to being a medical student. Twenty-three percent reported greater than five episodes of exclusion from patient care. Forty-three percent perceived that restricted participation was related to their gender with multiple qualitative responses describing patient discomfort with the presence of male 'comrades'. DISCUSSION: Data from our institution suggests that exclusion from patient care in the Ob-Gyn clerkship occurs for the majority of medical students queried. Further, gender-based exclusion is likely a related problem. Future exploration includes analysis of trends after the implementation of interventions designed to keep patients and staff 'abreast' of the presence and role of medical students.