Background And Objectives: Maternity care training is a standard requirement for all family medicine residents, and family physicians play a critical role in the US maternity care workforce. In 2014, the Accreditation Council for Graduate Medical Education (ACGME) updated the required obstetrical experience during family medicine residency training from a volume-based to a competency-based requirement of 200 hours (2 months rotation). This study aimed to determine if family medicine resident maternity care training experience differed after this change in requirements.
Methods: A nationwide survey of family medicine program directors was conducted as part of the 2019 Council of Academic Family Medicine Educational Research Alliance (CERA) survey, replicating a 2013 CERA survey to determine if there was a change in family medicine resident maternity care experience after the ACGME requirements update.
Results: The priority programs place on residents' continuity deliveries and family medicine faculty attending deliveries decreased between 2013 and 2019. The reported number of continuity deliveries and vaginal deliveries performed by residents also decreased significantly between 2013 and 2019, yet the program directors' estimate of the number of graduates going on to provide obstetric deliveries or pursue a maternity care fellowship did not change significantly. Programs reporting more than 25% of graduates continuing to conduct vaginal deliveries have reported similar numbers of vaginal deliveries per resident as in 2013.
Conclusions: The majority of family medicine residents are graduating with less delivery experience, and residency programs are placing less priority on continuity deliveries and modeling by family physician faculty following the 2014 ACGME Family Medicine Requirements update. This trend may have major implications on the comprehensive nature of our specialty and further widen gaps in the maternity care workforce. Further studies are needed to determine the impact on the competency of graduating family medicine residents in providing maternity care and for the long-term effects on the maternity care workforce.
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http://dx.doi.org/10.22454/FamMed.2021.752892 | DOI Listing |
Medicine (Baltimore)
January 2025
Department of Pediatric Hematology, Children's Medical Center, The First Hospital of Jilin University, Changchun, China.
Rationale: This study presents a case of hemoglobin M disease (HMD), a rare inherited disorder characterized by persistent cyanosis and hypoxemia, observed across 3 generations within a single family. The diagnosis of HMD poses significant challenges, particularly in asymptomatic individuals, due to its rarity and the subtlety of its symptoms. Notably, there is a scarcity of reports on methemoglobinemia in pediatric populations, which further complicates early detection and intervention.
View Article and Find Full Text PDFJ Urol
January 2025
Department of Population Health, NYU Grossman School of Medicine, New York, New York.
Purpose: We aimed to determine whether implementation of clinical decision support (CDS) tool integrated into the electronic health record (EHR) of a multi-site academic medical center increased the proportion of patients with American Urological Association (AUA) "high risk" microscopic hematuria (MH) who receive guideline concordant evaluations.
Materials And Methods: We conducted a two-arm cluster randomized quality improvement project in which 202 ambulatory sites from a large health system were randomized to either have their physicians receive at time of test results an automated CDS alert for patients with 'high-risk' MH with associated recommendations for imaging and cystoscopy (intervention) or usual care (control). Primary outcome was met if a patient underwent both imaging and cystoscopy within 180 days from MH result.
PLoS One
January 2025
Department of Internal Medicine, Faculty of Medicine, Gulu University, Gulu, Uganda.
Background: Cervical cancer screening program in Uganda is opportunistic and focuses mainly on women aged 25-49 years. Female sex workers (FSWs) are at increased risk of developing invasive cervical cancer. There is limited data regarding the uptake and acceptability of cervical cancer screening among FSWs in Uganda.
View Article and Find Full Text PDFPLoS One
January 2025
Lagos State Health Management Agency, Lagos, Nigeria.
Background: Each year, millions of people in low-and middle-income countries such as Nigeria are forced into poverty and financial ruin due to out-of-pocket (OOP) healthcare expenses. Our study assessed the prevalence and determinants of Catastrophic Healthcare Expenditure (CHE) experienced by households in Lagos, Nigeria.
Methods: A descriptive community-based cross-sectional survey was conducted on 2492 households in Lagos from December 2022 to March 2023 in 4 Local Government Areas (LGAs) using a multistage sampling technique.
PLoS One
January 2025
Equity Research and Innovation Center, Section of General Internal Medicine, Yale School of Medicine, New Haven, Connecticut, United States of America.
Background: Accurate assessment of cardiovascular disease (CVD) risk is crucial for effective prevention and resource allocation. However, few CVD risk estimation tools consider social determinants of health (SDoH), despite their known impact on CVD risk. We aimed to estimate 10-year CVD risk in the Eastern Caribbean Health Outcomes Research Network Cohort Study (ECS) across multiple risk estimation instruments and assess the association between SDoH and CVD risk.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!