Family Physicians Should Be Trained in Contraceptive Options

Last week we learned that the Accreditation Council for Graduate?Medical Education (ACGME)--the organization that sets the training standards and?accredits all residency training programs in the US-- is updating the?training standards for those training in Family Medicine. Unfortunately, their proposed changes include weakening the existing standards so that they omit key requirements.

• Training in contraception is no longer required.?
• Training in providing pregnancy options counseling is no longer?required.?
• Training in IUD and contraceptive implant insertion (the two?most effective contraceptive methods available) will continue to not be?required.?
• ?Learning how to do a uterine evacuation, which can be used for?miscarriage or abortion care, will continue to not be required.

It's especially important for young people, who already experience many barriers to care, that their family doctors understand these options so that they can stay healthy and avoid unintended pregnancy. ?Along with dozens of health care and family planning advocacy groups, Advocates submitted comments to the ACGME urging them to revise their new requirements.

Dear Family Medicine Residency Review Committee Members,

We are writing to urge you not to dismantle the requirements for the teaching of reproductive and sexual health, including contraception to family medicine graduating residents.

The United States has among the highest rates of teen pregnancy in the industrial world, and 750,000 U.S. teens experience pregnancy every year ? the vast majority unintended. Among teens that give birth, 50 percent were not using birth control at the time they became pregnant.

Family medicine doctors can play an important role in helping to reduce these rates by dispelling myths among youth people, normalizing the stages of adolescent sexual development for their patients and helping sexually active teens to make informed and responsible decisions about contraception.

Many young women do not visit an OB-GYN until after they have become sexually active. Many young men ONLY visit their family doctors. Adolescents are at a critical stage of development, both physically and emotionally, and are beginning to establish their own identity and autonomy. Confidential health services provided by family medicine doctors are essential in promoting teens' sexual health.

As such, we are concerned about removing the requirement that family medicine residents learn about contraception. Prior requirements were meant to ensure that patients are provided with the best care possible. Having specific requirements that family medicine residents learn about contraception prior to graduation supports best practices in the provision of family medicine?offering patients a holistic approach to their health, including their sexual health. The federal decision to include contraception in preventive services covered without a co-pay under the ACA underscores that this is a core service that primary care physicians must provide.

The prior requirements stated, ?All residents must be trained to competency in normal gynecological examinations, gynecological cancer screening, preventive health care in women, common STD's and infections, reproductive and hormonal physiology including fertility, family planning, contraception, options counseling for unintended pregnancy?Residents should become competent in the performance of appropriate procedures.?

The new requirements state only: ?Residents must have at least 100 hours or one month or 125 patient encounters dedicated to the care of women with gynecologic issues, including well woman care.? These requirements also only state, for procedures, that ?Endometrial biopsy, pap smear, and wet mount? must be performed to competency. Meanwhile, the STFM Group on Procedural Training has recommended expanded procedural training to meet educational and workforce needs and includes IUD and contraceptive implant insertion and uterine aspiration.

We write to encourage you to retain the requirement that family medicine residents learn contraception and options counseling for unintended pregnancy and that the procedures list be expanded to include IUDs, implants and uterine aspiration.

Sincerely,?

Debra Hauser

President

Advocates for Youth

Source: http://www.advocatesforyouth.org/blogs-main/advocates-blog/2168-family-physicians-should-be-trained-in-contraceptive-options

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