A Cross-sectional Survey of Fertility Knowledge in House Officers and Clinical Medical Students in a Low Resource Setting

Background: Infertility rates in the general population are around 12.5% and up to 40% in West Africa. In Ghana, a pronatalist society, infertility carries significant implications. It is imperative for new doctors to be knowledgeable about fertility and infertility to counsel women. This study aimed to understand the knowledge of house officers and clinical medical students in Kumasi, Ghana to provide insight into knowledge gaps and misconceptions and inform medical education efforts. Methods: This cross-sectional study utilized a validated, 29-question survey, the Fertility and Infertility Treatment Knowledge Score, to assess the knowledge of house officers and clinical medical students at Kwame Nkrumah University of Science and Technology in Kumasi, Ghana. The primary outcome was score. Permission to use the survey was obtained and approval was granted by university CHRPE. Participants gave consent in the survey. Statistical analysis was performed in R using appropriate tests with significance set at p < 0.05. Results: 231 respondents completed the survey (54% female, 46% male). Most were senior clinical students: 13% year four, 44% year five, 28% year 6, and 16% house officers. The average score overall was 64% (SD = 11%). There was no significant difference in score based on sex (p = 0.193). House officers averaged the highest score (66%, SD = 11%); fourth years averaged the lowest (56%, SD = 11%). Scores increased significantly with level of training, from fourth years to fifth years (p < 0.001), sixth years (p = 0.016), and house officers (p = 0.002). Frequently missed topics included age-related fertility decline, natural fertility, and IVF efficacy. Scores were high on mechanisms of conception and infertility treatments. Knowledge of factors influencing fertility, including contraceptive use and male age, was variable. Conclusions: Students’ knowledge improves in clinical training, but critical misconceptions persist. Only level of training predicts score, not demographic differences. These findings reflect the efficacy of the current curriculum at one university, but may not generalize nationally. Addressing and correcting misconceptions through enhancements in curriculum is essential to improve counseling and prevent perpetuating stereotypes surrounding infertility in Ghanaian society.