Assessment of Sexual and Reproductive Health Care Training During Pediatric Cardiology Fellowship

Limited data suggest that pediatric cardiology (PC) fellows are unprepared to provide sexual and reproductive health (SRH) care to adolescents and young adults (AYA) with congenital heart disease (CHD), an expanding population. We sought to explore PC fellow training, attitudes, and clinical practices surrounding the provision of SRH care for AYA with CHD.

This national survey-based study of PC fellows in American College of Graduate Medical Education accredited fellowship programs collected demographic data, data related to participant training program, participants' attitudes, practices, and experiences regarding SRH for AYA with CHD, and participants' knowledge of SRH for these patients. Bivariate logistic regression was performed to assess associations between categorical variables of interest.

There were 97 responses submitted and an estimated 466 PC fellows, resulting in an estimated response rate of 20%. Approximately half of the participants indicated that the training received during fellowship has not prepared them to counsel patients with heart and/or vascular disease on contraceptive options (52%) or provide preconception counseling to their patients (49%). Fewer than half of the participants indicated feeling comfortable discussing SRH with cardiology patients in fellowship (43%), while most participants do not regularly discuss or initiate discussions about SRH with cardiology patients (79%). Nearly all participants indicated that additional training resources for SRH counseling for AYA with CHD would be helpful.

Our results demonstrate that PC fellows are inadequately prepared to provide SRH care to AYA with CHD, and there is a need for curricular reform within PC fellowship programs.