Family Medicine Residency Programs Should Include Contraception and Abortion Training

August, 2023 – Scientists from the Fitzhugh Mullan Institute for Health Workforce Equity published research in JAMA Network Open highlighting training factors associated with family medicine physicians’ use of reproductive health services.

Using Medicaid claims data, they compared how physicians’ provision of contraception treatment and D&C services (a procedure used for abortion, management of early pregnancy loss, and other pregnancy-related care) were related to the type of residency training program they attended.

The researchers found that if a family medicine physician attended a residency program that included community-based care or integrated family planning training, they were more likely to be providers of these essential reproductive health services for Medicaid beneficiaries. This research emphasizes the need for Family Medicine residency programs to integrate contraception and abortion training to their curriculum.

The authors gave recommendations for how to move forward:

1. Utilize and expand on well-developed programs, such as Reproductive Health Education in Family Medicine (RHEDI) programs
2. Accreditation bodies should make contraception and abortion training a requirement for family medicine physician residency programs

Additionally, they suggest physicians should have more exposure to underserved populations through their training. Teaching Health Centers emphasize community-based care, and such programs should receive greater investment.

Act Now

1. If you are a family medicine resident, see if your program is listed as an RHEDI program or affiliated program. Not listed? Ask your program director to contact RHEDI and become one. Here is an example email to send.
2. Residents, host your own virtual papaya workshop. No prior expertise required, RHEDI will provide you with what you need for this opportunity to learn methods to provide early abortion and miscarriage management – using fruit!
3. If you are an educator, use resources provided by RHEDI to advance resident education and training in reproductive health care.
4. Get involved in the action by joining the Medical Students for Choice movement.

Go Deeper, Learn More

From the sample of over 21,000 family medicine physicians, more than half provided prescription contraception to their patients, but fewer than 20% provided IUD or implants, and less than 1% performed a D&C. Family medicine physicians who graduated from a RHEDI program had significantly greater odds of providing prescription contraception, an IUD or implant, and D&C, while physicians who completed Teaching Health Center residency programs in community based settings had greater odds of providing IUD or implant. 

“Family medicine physicians are an important part of the workforce providing contraception and abortion care, especially in populations that have limited access overall. In rural areas, women are more likely to see an family medicine physician than an obstetrician-gynecologist (OBGYN) for office-based well woman care.”

Strasser et al., 2023

Reproductive Health Education in Family Medicine (RHEDI) programs offer opt-out abortion and sexual and reproductive health (SRH) training, and meet full program expectations. Affiliated programs also support full spectrum reproductive health training, but might vary in the amount and type of training available.

You can find a list of RHEDI programs and affiliated programs on their website. Students applying to residency should use this list to inform them where they can go to receive an inclusive training.

References

Strasser, J., Schenk, E., Luo, Q., Bodas, M., Anderson, O., & Chen, C. (2023). Training in Residency and Provision of Reproductive Health Services Among Family Medicine Physicians. JAMA Netw Open, 6(8):e2330489. doi: 10.1001/jamanetworkopen.2023.30489 

Reproductive Health Education in Family Medicine, https://rhedi.org/