Training at a Faith-Based Institution Matters for Obstetrics and Gynecology Residents: Results From a Regional Survey

Abstract

Background Prior data suggest that opportunities in family planning training may be limited during obstetrics and gynecology (Ob-Gyn) residency training, particularly at faith-based institutions with moral and ethical constraints, although this aspect of the Ob-Gyn curriculum has not been formally studied to date. Objectives We compared Ob-Gyn residents' self-rated competency and intentions to provide family planning procedures at faith-based versus those of residents at non-faith-based programs. Methods We surveyed residents at all 20 Ob-Gyn programs in Illinois, Indiana, Iowa, and Wisconsin from 2008 to 2009. Residents were queried about current skills and future plans to perform family planning procedures. We examined associations based on program and residents' personal characteristics and performed multivariable logistic regression analysis. Results A total of 232 of 340 residents (68%) from 17 programs (85%) returned surveys. Seven programs were faith-based. Residents from non-faith-based programs were more likely to be completely satisfied with family planning training (odds ratio [OR] = 3.4, 95% confidence limit [CI], 1.9–6.2) and to report they “understand and can perform on own” most procedures. Most residents, regardless of program type, planned to provide all surveyed family planning services. Conclusions Despite similar intentions to provide family planning procedures after graduation, residents at faith-based training programs were less satisfied with their family planning training and rate their ability to perform family planning services lower than residents at non-faith-based training programs.

Impact of Catholic Hospital Affiliation During Obstetrics and Gynecology Residency on the Provision of Family Planning

“…Our findings confirm prior surveys that residents at Catholic hospitals experience family planning training deficiencies despite the ACGME mandate 5,6 and show the consequences of restricted training on the actual provision of women's health care. The rising number of Catholic health system mergers may affect a greater number of residents in the future.…”

“…8 The majority (72%, 18 of 25) are Catholic. 8 Compared to residents at secular hospitals, residents at Catholic hospitals are less likely to report that they can independently perform contraceptive, sterilization, and uterine evacuation procedures, 5 and are less likely to receive abortion training. 6 Program directors of family medicine programs affiliated with religious hospitals report lower rates of training in family planning than those affiliated with secular hospitals.…”

“…2 Despite these recommendations, discrepancies in abortion and family planning training exist among accredited programs. [4][5][6] Catholic hospitals follow the Ethical and Religious Directives for Catholic Health Care Services that prohibit abortion services, and also limit the provision of and training in contraceptive and sterilization services. 7 At least 10% (25 of 250) of the current obstetrics and gynecology residency programs in the United States are at faith-based hospitals that have restrictive policies on family planning service provision.…”

Should Catholic Academic Health Centers Sponsor Residency Training in Obstetrics and Gynecology?

“…6 It is precisely these restricted aspects of reproductive care that residents graduating from programs sponsored by Catholic institutions often cite as deficiencies in their training. 7,8 The practice of gynecology has evolved, and so too have the scientific and social understandings of human sexuality, women's reproductive health, and contraceptive practice. As the specialty most aligned with these complex dimensions of the care of women, the contemporary practice of gynecology requires expertise in women's contraceptive health.…”

“…Residents training or having trained in Catholicsponsored residency programs have reported dissatisfaction with both abortion education and contraception education. 7,8 Some residents reported never having performed postpartum sterilization, considered a routine gynecological procedure, before graduation. 7 Even for those residents not participating in abortion education for personal reasons, dissatisfaction with overall contraceptive knowledge appears common and at least partially ameliorated by participation in structured, immersive family planning training.…”