Faculty Bibliography

OBJECTIVE:The purpose of this study was to identify academic differences between male and female candidates applying to our obstetrics and gynecology (OBGYN) residency. METHODS:We reviewed the Electronic Residency Application Service applications of candidates applying to our residency program from 2005 to 2009. Academic qualifications of male and female candidates were compared using the Fisher exact and Student t tests. RESULTS:Of 2263 applicants, 1710 (75.6%) were women. Compared with male candidates, female candidates in the United States were more likely to have earned honors in OBGYN (51.3% vs 41.2%, p = 0.02) and internal medicine clerkships (27.6% vs 19.1%, p = 0.03). There was a nonsignificant trend toward more female membership in the Alpha Omega Alpha. There were no differences in United States Medical Licensing Exam scores based on gender. CONCLUSIONS:Although no difference in United States Medical Licensing Exam scores were observed, female applicants performed better in select clerkships during medical school than their male counterparts. This difference in clerkship grades may contribute to the low proportion of male residents in OBGYN, although the overall low proportion of male applicants is likely an important factor as well.

A 41-year-old pregnant African-American woman noticed rapid growth of her cesarean delivery skin scar beginning at 14-week gestation. Skin biopsy, which was performed at 31 weeks, revealed poorly differentiated cutaneous melanoma. At 34 weeks, she underwent repeat cesarean delivery with tumor excision, pelvic lymphadenectomy and abdominal wall reconstruction. Locally advanced disease and anatomical limitations prevented attainment of negative surgical margins. Despite adjuvant chemotherapy and radiation, she died 1 year after diagnosis. Deferring biopsy of a suspicious skin lesion during pregnancy may have delayed the diagnosis of melanoma in this case and possibly affected the long-term outcome.

BACKGROUND:Rhabdomyosarcomas, particularly those of gynecologic origin, are very rare in adults. As a result, there is little literature on the optimal staging procedure and treatment modalities for this population. CASE/METHODS:A 43-year-old woman presented with a long-standing history of menorrhagia and was subsequently diagnosed with embryonal rhabdomyosarcoma of the cervix. She underwent a total abdominal hysterectomy, bilateral salpingo-oophorectomy, lymph node dissection, omentectomy, and appendectomy, which also revealed a synchronous tubular carcinoid tumor of appendiceal origin. Plans for treatment involve adjuvant chemotherapy with vincristine, dactinomycin, and cyclophosphamide. CONCLUSION/CONCLUSIONS:This case adds to the small body of literature surrounding cervical embryonal rhabdomyosarcoma in women over the age of 40 years and proposes that appendectomy be considered during surgical management.