APGO

Background: OBGYN residency prepares trainees to become experts in women’s healthcare.  Trainees at faith-based hospitals may not receive adequate training in family planning services.

Methods: Semi-structured individual interviews were conducted with recent graduates from seven faith-based hospitals. All are generalists at secular institutions.  Participants were asked about their experiences, perceived deficiencies, and current provision of family planning services.  Three researchers independently coded the transcripts using grounded theory; codes were organized into overarching themes and discrepancies were resolved.

Results: We reached thematic saturation after 15 interviews.  None of the participants cited a preference to match at their program based on restrictive family planning policies.  All participants reported reproductive healthcare training deficiencies that were partially attenuated by didactic educational activities, variations in on-site restrictions, and off-site training.  Participants expressed frustration about inadequate on-site training in postpartum tubal ligations; upon graduation they either avoided provision or required mentorship from partners to become competent.  A few participants who sought off-site training now provide outpatient D&Cs and/or inpatient D&Es for abnormal or unintended pregnancies.  All participants proposed that faith-based programs improve family planning training by providing routine, opt-out opportunities.

Discussions: OB-GYNs trained at faith-based institutions feel that religion-based policies negatively impact training experiences and the range of health services they subsequently can provide.  Forming collaborations with off-site facilities, particularly for tubal ligation and outpatient uterine evacuation procedures, may improve the reproductive care these physicians provide to women.

Keywords: faith-based, family planning