Last week I had a day off, one of only three this month, and I used it to take an exam. This was the certifying exam to be a National Certified Menopause Practitioner by the Menopause Society.
I passed.
I’m also studying for another seemingly larger exam and I’ll discuss that later, but taking this one first was either a setup for a confidence boost or a spiral of self-doubt.
After all the exams I’ve taken in all these years, I still just never know if my preparation is enough.
So why did I choose to take this exam? It doesn’t change my job or increase my paycheck. Well, I suppose I like to do things well and right, a “go big or go home” sort of mentality. More importantly, it has given me a deep understanding of treating midlife issues. Instead of feeling uncomfortable when a patient came to talk to me about menopause, now I actually look forward for those appointments.
In today’s internet culture where anyone can say anything, it seems more important than ever to have certifications and qualifications to speak on certain topics. The media is buzzing with menopause and perimenopause discussions. Anyone from obgyns to physical therapists to naturopaths to coaches are all discussing the symptoms and management of menopause and perimenopause. I should already be set apart from the masses because I’m a physician, but surprisingly even your average obgyn isn’t qualified to treat a midlife woman.
I think as a consumer and as a patient, it’s just overwhelming. There’s just a sea of talking heads on an Instagram grid. You don’t know who to listen to, who’s telling the truth, what sources they use to get this information, or what training they have. Now on top of feeling symptomatic, you’re confused by the abundance of sometimes inaccurate information.
Residency for an obgyn lasts four years. We often use the term “training” synonymously with going through residency. In my four years of training, I remember one lecture on menopause. One. It wasn’t a formal lecture, it was an attending (supervising) physician, who enjoyed the menopausal population and discussed some hormone replacement therapy with us.
That was it.
The patients we took care of were largely young, obstetric patients so we didn’t really learn-by-doing either. I don’t recall ever prescribing HRT (hormone replacement therapy) in residency. This may be partly due to the significant decrease in prescriptions and demand after the WHI study in 2002, plus the patient population we served, plus a lack of training. If I did prescribe it, it was likely an attending telling me what they usually prescribe, so that’s what I did.
This is not just in my residency program. A survey showed that only 20% of obgyn residents felt they were trained in menopause. 80% of program directors believe there should be more training in menopause. This is staggering! One of the first physicians a woman should think to consult with these issues is her obgyn!
I didn’t feel it was enough to just tell patients that “I’ve done a lot of reading on this topic” when discussing menopause. Anyone can say that. Getting certified lends some credibility to the reading and studying I’ve done, in my opinion. It also wraps up my work in a nice bow so there’s definitely some personal satisfaction that comes from this.
I have done a lot of reading and studying though. I read The Clinician’s Guide by the North American Menopause Society (now called the Menopause Society) which is over 300 pages. I became a member of the Menopause Society which means I have access to their resources. I subscribe to the Menopause journal so I can search articles as I please. I’ve attended webinars on new topics and the annual Menopause Society conference.
Part of what helped me solidify the information was actually creating an online course about how to care for the midlife woman. I have a real gripe with the lack of training in obgyn residencies and we are not the only doctors caring for midlife women, so the training needs to extend beyond obgyn residencies. It needs to be done right with the most accurate and up to date information. Information will change as studies are done and that’s just part of how medicine evolves. Between the sheer number of women approaching or in menopause plus the new cultural awareness of it, women need reliable providers who are educated on the topic. That’s why I created this course (I just have to narrate it - almost done!). There’s a gap that needs closed in education before the gap can be closed for women seeking care.
I had the personal and professional goal of becoming a National Certified Menopause Practitioner and I accomplished that. Now, my bigxs picture goal is to inject this education into the training programs that desperately lack it.
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Some of the information contained in this article is the result of my training, medical knowledge, and personal experience without a specific source to be cited.
