Family medicine obstetrics fellowship graduates: training and post-fellowship experience

Family medicine obstetrics and maternal-child health fellowships offer family physicians additional training in pregnancy care. Our objectives were to assess the content of these fellowship programs, the clinical practices of fellowship graduates, and factors associated with inclusion of cesarean delivery in practice after fellowship training.

A survey was sent to graduates of obstetrics or maternal-child fellowships around the country regarding their fellowship experience and current practice characteristics.

A total of 165 graduates responded, for a response rate of 64%. Cesarean delivery, postpartum tubal ligation, and dilation and curettage are taught in most fellowships. Involvement in residency education and caring for outpatient family medicine patients are also included in most fellowships. Forty-four percent of fellowship graduates practice in rural areas, 88% are based in community hospitals, and 49% are faculty in family medicine residency programs. Most fellowship graduates are comfortable caring for high-risk pregnancy patients and performing related operative procedures. Sixty-six percent of graduates reported obtaining cesarean delivery privileges. Practicing in the Northeastern part of the United States decreased the likelihood of graduates having cesarean delivery privileges while practicing in a rural community increased it.

A majority of family physicians care for high-risk pregnancy patients and perform operative procedures related to pregnancy after completing an obstetrics fellowship.