Michigan State University College of Human Medicine, Department of Family Medicine and Sparrow/MSU Family Medicine Residency Program, East Lansing, MI.
Sea Mar Marysville Family Medicine Residency, Marysville, WA.
Fam Med. 2021 Nov;53(10):857-863. doi: 10.22454/FamMed.2021.237852.
The number of family physicians providing maternity care continues to decline, jeopardizing access to needed care for underserved populations. Accreditation changes in 2014 provided an opportunity to create family medicine residency maternity care tracks, providing comprehensive maternity care training only for interested residents. We examined the relationship between maternity care tracks and residents' educational experiences and postgraduate practice.
We included questions on maternity care tracks in an omnibus survey of family medicine residency program directors (PDs). We divided respondent programs into three categories: "Track," "No Track Needed," and "No Track." We compared these program types by their characteristics, number of resident deliveries, and number of graduates practicing maternity care.
The survey response rate was 40%. Of the responding PDs, 79 (32%) represented Track programs, 55 (22%) No Track Needed programs, and 94 (38%) No Track programs. Residents in a track attended more deliveries than those not in a track (at Track programs) and those at No Track Needed and No Track programs. No Track Needed programs reported the highest proportion of graduates accepting positions providing inpatient maternity care in 2019 (21%), followed by Track programs (17%) and No Track programs (5%; P<.001).
Where universal robust maternity care education is not feasible, maternity care tracks are an excellent alternative to provide maternity care training and produce graduates who will practice maternity care. Programs that cannot offer adequate experience to achieve competence in inpatient maternity care may consider instituting a maternity care track.
提供产妇护理的家庭医生人数持续下降，危及到服务不足人群获得所需护理的机会。2014 年的认证变更为创建家庭医学住院医师产妇护理轨道提供了机会，仅为有兴趣的住院医师提供全面的产妇护理培训。我们研究了产妇护理轨道与居民教育经历和毕业后实践之间的关系。
我们在家庭医学住院医师项目主任（PD）的综合调查中纳入了关于产妇护理轨道的问题。我们将应答项目分为三类：“轨道”、“不需要轨道”和“没有轨道”。我们比较了这些项目类型的特征、居民分娩数量和从事产妇护理的毕业生数量。
调查的回复率为 40%。在回应的 PD 中，79 名（32%）代表轨道项目，55 名（22%）不需要轨道项目，94 名（38%）没有轨道项目。参加轨道项目的居民分娩次数多于未参加轨道项目的居民（在轨道项目中）和参加不需要轨道项目和没有轨道项目的居民。不需要轨道项目报告称，2019 年接受提供住院产妇护理的职位的毕业生比例最高（21%），其次是轨道项目（17%）和没有轨道项目（5%；P<.001）。
在普遍可行的强大产妇护理教育不可行的情况下，产妇护理轨道是提供产妇护理培训和培养将从事产妇护理的毕业生的极好选择。无法提供足够经验以实现住院产妇护理能力的项目可以考虑建立产妇护理轨道。
