Climate Change Curriculum in a Network of US Family Medicine Residency Programs.

Physicians require climate-related training, but not enough is known about actual or desired training at the graduate medical education level. To quantify the climate curriculum provided within a network of family medicine residency programs in the Northwestern United States, to assess barriers to adoption of climate curricula, and to identify preferred climate-related content, delivery methods, and program actions. In fall 2021, residents and faculty in a family medicine residency network responded to a 25-item, anonymous, online survey about climate-related training within their programs.

Race and Ethnicity, Gender, and Promotion of Physicians in Academic Medicine.

Importance: The ranks of academic physicians do not reflect the diversity of the US population. To create a diverse and effective medical workforce, it is important to know the extent to which gender, race and ethnicity, and the intersection of these factors are associated with career advancement.

Objective: To assess whether race and ethnicity and gender are associated with appointment to or promotion within academic medicine.

Impact of State Abortion Policies on Family Medicine Practice and Training After .

Purpose: The (Dobbs) Supreme Court decision revoked the constitutional right to abortion. Now, restrictive state abortion laws may contribute to the shortage and strain already felt in primary care practice, especially related to the provision of reproductive health care. The purpose of this study is to evaluate perceived impacts of state abortion legislation on family medicine clinicians' practice and medical education regarding reproductive health care.

Race, Gender, and Faculty Retention in Academic Medicine.

Importance: Poor retention may be associated with lack of faculty diversity in academic medicine.

Objective: To examine differences in faculty retention by gender, degree type, and race and ethnicity using data from US medical schools.

Design, Setting, And Participants: This cohort study analyzed data from 155 medical schools for 1978 to 2021, which were obtained from the Association of American Medical Colleges.

Patient experiences switching from in-clinic to self-administration of injectable contraception in two Western US states.

Objective: We describe the experiences and preferences of women who switched from clinic-administered intramuscular depot medroxyprogesterone acetate (DMPA-IM) to self-administered subcutaneous DMPA (DMPA-SC) in the context of the COVID-19 pandemic.

Methods: We conducted interviews with women in California and Washington about their experiences with self-administered DMPA-SC. We interviewed women after their first or second self-administered DMPA-SC injection and conducted follow-up interviews after their third or fourth injection.

Abortion and Contraception in Medical School Curricula: A Survey of North American Family Medicine Clinical Curriculum Directors.

Contraception and abortion care are commonly accessed health services, and physicians in training will encounter patients seeking this care. Curricula that teach contraception and abortion provision during medical school equip medical students with valuable skills and may influence their intention to provide these services during their careers. Family planning is nevertheless understood to be underrepresented in most medical curricula, including in North American medical schools where the laws on providing contraception and abortion have been consequentially changing.

What's Worth Doing in Virtual Recruitment? A Regional Survey of Program Directors and Incoming Interns.

Background And Objectives: In 2020-2021, the Family Medicine Residency Network (FMRN) programs participated in virtual recruitment. We conducted a study to describe the recruitment activities utilized by programs and to identify which of these activities were most and least helpful to both students and the programs.

Methods: In May 2021, we sent an electronic survey to the incoming interns (n=242) asking which recruitment activities they participated in, which were most and least helpful in deciding their rank list, and which most positively impacted their perception of the program.

Zfp503/Nlz2 Is Required for RPE Differentiation and Optic Fissure Closure.

Purpose: Uveal coloboma is a congenital eye malformation caused by failure of the optic fissure to close in early human development. Despite significant progress in identifying genes whose regulation is important for executing this closure, mutations are detected in a minority of cases using known gene panels, implying additional genetic complexity. We have previously shown knockdown of znf503 (the ortholog of mouse Zfp503) in zebrafish causes coloboma.

Patient concerns about accessing sexual and reproductive health services outside of primary care: A survey in rural and urban settings in the Pacific Northwest.

Objectives: While primary care providers are a major source of sexual and reproductive health (SRH) services in the United States, particularly in rural areas, not all primary care settings offer a full range of SRH services. We aimed to understand primary care patient concerns regarding accessing SRH services, including abortion care, outside of their primary care clinic and if those concerns differed by urban or rural setting.

Study Design: An anonymous survey was distributed over a 2-week period between December 2019 to March 2020 to all adult patients in four primary care clinics in Idaho, Washington, and Wyoming.

Vasectomy Training in Family Medicine Residency Programs: A National Survey of Residency Program Directors.

Background And Objectives: Vasectomy is considered a permanent contraceptive method with fewer associated harms than bilateral tubal ligation. However, the number of vasectomy-trained providers may not be meeting the demand for vasectomy in the United States. We describe the vasectomy training landscape in family medicine residencies and factors related to increased procedural training.

Patient opinions on sexual and reproductive health services in primary care in rural and urban clinics.

Objectives: Primary care providers are a major source of sexual and reproductive health care in the United States, particularly in rural areas, and not all providers offer the same services. This study aimed to understand patient preferences and expectations around reproductive health services including abortion care in a primary care setting and if those expectations differed by urban or rural setting.

Study Design: An anonymous survey was distributed to all patients 18 years or older in 4 primary care clinics in Idaho, Washington, and Wyoming over a 2-week period.

Faculty and Resident Contraceptive Opt Outs and Training Site Restrictions: A CERA Study.

Background And Objectives: Contraception is a core component of family medicine residency curriculum. Institutional environments can influence residents' access to contraceptive training and thus their ability to meet the reproductive health needs of their patients.

Methods: Contraceptive training questions were included in the 2020 Council of Academic Family Medicine Educational Research Alliance (CERA) survey of family medicine residency program directors.

Would you be interested in DMPA-SC? An implementation project in two urban primary care clinics.

Self-administered DMPA-SC has similar efficacy to DMPA-IM with potential benefits. We conducted an implementation study to assess interest in and successful use of DMPA-SC for patients using DMPA-IM. Four physicians telephoned patients with DMPA-IM on their medication list in two urban primary care clinics and offered counseling and prescriptions to patients interested in transitioning to DMPA-SC.

Immediate Postpartum IUD Training Within a Regional Network of Family Medicine Residencies.

Background And Objective: Immediate postpartum placement of intrauterine devices (PPIUD) offers important benefits to patients. Little is known about PPIUD training or knowledge within family medicine residency programs. We evaluated PPIUD experience and prior training among family medicine residents and faculty.

The impact of the COVID-19 pandemic on the education and wellness of U.S. Pediatric Anesthesiology Fellows.

Background: The global coronavirus disease 2019 (COVID-19) pandemic caused state-wide shutdowns of elective surgical activities in March and April of 2020 forcing graduate medical education program directors and their trainees in the United States to quickly adapt to new rules and circumstances.

Aim: The aim of this study was to determine the effect of the current pandemic on pediatric anesthesiology fellow education and wellness nationally in order to guide creation of optimal support systems for fellows during the ongoing pandemic.

Methods: In July 2020, an electronically distributed survey was sent to all United States-based pediatric anesthesiology fellowship program directors who were asked to distribute the survey to all current/graduating fellows.

Women Physicians and Promotion in Academic Medicine.

Background: In 2000, a landmark study showed that women who graduated from U.S. medical schools from 1979 through 1997 were less likely than their male counterparts to be promoted to upper faculty ranks in academic medical centers.

Ask the question, be the solution: Fostering well-being through contextualized assessment and strategy development.

In recent years, optimizing provider well-being and mitigating the effects of physician burnout have become increasingly important in the field of medicine. These efforts are in part of consequence because of significant costs associated with provider burnout, for both individuals and their workplace. Accordingly, robust work has focused on development of strategies to decrease the incidence of burnout or mitigate its effects, including both individual efforts and systematic organizational change.

Awareness and Attitudes Around the New Subspecialty Within Ob/Gyn Called Complex Family Planning: A CERA Survey of Family Medicine Chairs.

Background And Objectives: Family physicians play an important role in delivery of family planning services, but many factors impact scope of practice. One important factor is the development of subspecialties, such as the new subspecialty within obstetrics and gynecology called complex family planning (CFP).

Methods: In 2019, we conducted a survey of family medicine department chairs as part of the Council of Academic Family Medicine Educational Research Alliance survey.

Multidisciplinary Treatment to Restore Vision in Ocular Burns.

Periorbital burns generate contraction and distortion of periorbital soft tissue, causing eyelid malfunction, further contributing to loss of vision from corneal scarring or perforation. We present our multidisciplinary algorithm to restore vision in patients with burn-related bilateral corneal blindness with light perception. Chart review was performed for four consecutive burn patients requiring periocular reconstruction and keratoprosthesis.

Associations Between Program-Level Abortion Training and Graduate Preparation for and Provision of Reproductive Care.

Background And Objectives: The role of training in the declining rate of family physicians' provision of women's reproductive health care is unclear. No requirements for abortion training exist, and curricula vary widely. This study assessed the impact of program-level abortion training availability on graduates' feelings of training adequacy and their postgraduate practice in reproductive health.

Late Apical Recurrence of Choroidal Melanoma 10 Years after Successful Treatment with Brachytherapy.

Purpose: To describe late apical relapse of a choroidal melanoma at the site of fine needle aspiration biopsy 10 years following successful treatment with I brachytherapy.

Methods: Retrospective case report of a 78-year-old male presenting 10 years following successful I brachytherapy for a choroidal melanoma with a medium-sized nodular amelanotic tumor recurrence at the site of the prior tumor biopsy.

Results: Fundus photography and B-scan ultrasound documented the findings at presentation at our institution.