Abstract
Objectives
To characterize perceived proficiency in immediate postpartum long-acting reversible
contraception (LARC) provision among resident physicians in obstetrics and gynecology
and family medicine in Wisconsin.
Study Design
We queried 254 Wisconsin obstetrics and gynecology or family medicine residents about
competency and attitudes regarding family planning services via a confidential electronic
survey. We used logistic regression to identify factors associated with the primary
outcome of self-reported proficiency in immediate postpartum LARC.
Results
We recruited participants from 3 of 3 (100%) obstetrics and gynecology and 9 of 15
(60%) family medicine residency programs, achieving a 74% response rate among trainees
(187/254 individuals). Seven of 12 programs (58%) offered immediate postpartum LARC
training [100% (3/3) obstetrics and gynecology; 44% (4/9) family medicine]. Forty-eight
percent of residents [68% (27/40) obstetrics and gynecology and 60/141 (43%) family
medicine, p < 0.01)] reported immediate postpartum LARC proficiency (subdermal implant placement:
48%; immediate postpartum intrauterine device (IUD) placement: 16%). Residents (versus
interns), who were younger, training in a program without religious affiliation, and
who hoped to provide immediate postpartum LARC provision in practice, were more likely
to report subdermal implant proficiency. Interns and family medicine trainees were
less likely to report immediate postpartum IUD proficiency.
Conclusions
Only 44% of participating family medicine programs provide immediate postpartum LARC
training. Two-thirds of obstetrics and gynecology residents report proficiency in
immediate postpartum LARC, compared to fewer than half of family medicine residents.
Given that many Wisconsin counties do not have a practicing obstetrician/gynecologist,
improving immediate postpartum LARC training among family medicine residents is paramount.
Implications
Statement
Family medicine physicians provide a significant portion of obstetric care, especially
in rural areas. Family medicine residency programs should be supported to ensure that
all trainees are proficient in placing subdermal implants and family physicians planning
to provide obstetric care are trained in postpartum IUD placement.
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References
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Association of American Medical Colleges. Report on Residents, 2019. https://www.aamc.org/data-reports/students-residents/interactive-data/report-residents/2019/table-c4-physician-retention-state-residency-training-last-completed-gme. Date accessed: October 25, 2020.
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Article info
Publication history
Published online: May 30, 2021
Accepted:
May 20,
2021
Received in revised form:
May 18,
2021
Received:
October 25,
2020
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
