Curriculum May Drop Contraception Training For Family Physicians

contraceptionA newly proposed set of rules from the Accreditation Council on Graduate Medical Education (ACGME) governing the way family physicians are trained would lessen requirements for residents to undergo contraception and unintended pregnancy counseling, possibly inhibiting easy access to the service for women in the future.

This change to the ACGME training program, a curriculum that is rewritten every 7 years, has worried reproductive health advocates.  It has even led to a letter-writing campaign by the Reproductive Health Access Project, a group with the mission to “ensure that women and teens at every socioeconomic level can readily obtain birth control and abortion from their own primary care clinician.”

A major concern is women’s access to all forms of contraception ­–including IUDs and implants– and physicians’ ability to place them, an issue that was advocated in the rewriting of the curriculum 7 years ago. 

One reason given for the proposed cuts is what many feel to be overly specific language. 

The requirement reads:

“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 pelvic floor dysfunction, and disorders of menstruation, perimenopause, and postmenopause, including osteoporosis. In addition, the program should provide adequate instruction and clinical experience in issues of sexual health, management of breast disorders, management of cervical disease. Residents should become competent in the performance of appropriate procedures. Residents should become competent in the performance of appropriate procedures. “

The American Academy of Family Physicians has assured advocates that training in these forms of contraception will remain a core part of family physician education, despite the more general wording proposed for the curriculum. 

–Michael Potts

References

Accreditation Council on Graduate Medical Education. ACGME Program Requirements for Graduate Medical Education in Family Medicine.http://www.acgme.org/acgmeweb/Portals/0/PFAssets/ProgramRequirements/120pr07012007.pdf. Updated July 1, 2007.  Accessed April 25, 2013. 

Rovner J. Family Doctors Consider Dropping Birth Control Training Rule. NPR.org. http://www.npr.org/blogs/health/2013/04/25/178863728/family-doctors-consider-dropping-birth-control-training-rule. Published April 25, 2013.  Accessed April 25, 2013.