Tong Sebastian T, Hochheimer Camille J, Barr Wendy B, Leveroni-Calvi Matteo, Lefevre Nicholas M, Wallenborn Jordyn T, Peterson Lars E
Virginia Commonwealth University School of Medicine.
Lawrence Family Medicine Residency and the Tufts University School of Medicine.
Fam Med. 2018 May;50(5):345-352. doi: 10.22454/FamMed.2018.631796. Epub 2018 Mar 8.
Prior research found that 24% of graduating family medicine residents intend to provide obstetrical deliveries, but only 9% of family physicians 1 to 10 years into practice are doing so. Our study aims to describe the individual and residency program characteristics associated with intention to provide obstetrical deliveries and prenatal care.
Cross-sectional data on 2014-2016 graduating residents were obtained from the American Board of Family Medicine certification examination demographic questionnaire that asked about intended provision of specific clinical activities. A hierarchical model accounting for clustering within residency programs was used to determine associations between intended provision of maternity care with individual and residency program characteristics.
Of 9,541 graduating residents, 22.7% intended to provide deliveries and 51.2% intended to provide prenatal care. Individual characteristics associated with a higher likelihood of providing deliveries included female gender, graduation from an allopathic medical school, and participation in a loan repayment program. Residency characteristics included geographic location in the Midwest or West region, training at a federally qualified health center (FQHC)-based clinic, funding as a teaching health center (THC), more months of required maternity care rotations, larger residency class size, and maternity care fellowship at residency.
Our findings suggest that increasing the proportion of graduating family medicine residents who intend to provide maternity care may be associated with increased exposure to maternity care training, more family medicine training programs in FQHCs and THCs, and expanded loan repayment programs.
先前的研究发现,24%即将毕业的家庭医学住院医师打算提供产科分娩服务,但在执业1至10年的家庭医生中,只有9%的人这样做。我们的研究旨在描述与打算提供产科分娩服务和产前护理相关的个人及住院医师培训项目特征。
从美国家庭医学委员会认证考试人口统计问卷中获取2014 - 2016年毕业住院医师的横断面数据,该问卷询问了特定临床活动的预期提供情况。使用一个考虑住院医师培训项目内聚类的分层模型来确定提供产妇护理的意向与个人及住院医师培训项目特征之间的关联。
在9541名毕业住院医师中,22.7%打算提供分娩服务,51.2%打算提供产前护理。与提供分娩服务可能性较高相关的个人特征包括女性、毕业于全科医学院以及参与贷款偿还项目。住院医师培训项目特征包括位于中西部或西部地区、在基于联邦合格健康中心(FQHC)的诊所接受培训、作为教学健康中心(THC)获得资金、所需产妇护理轮转月数更多、住院医师培训班级规模更大以及住院期间有产妇护理奖学金。
我们的研究结果表明,增加打算提供产妇护理的毕业家庭医学住院医师比例可能与增加产妇护理培训的接触机会、FQHC和THC中更多的家庭医学培训项目以及扩大贷款偿还项目有关。