An Evaluation of US Medical Schools' Reproductive Health and Family Planning  Curricula

Marguerite Duane; Grace Carson; Kaitlin VanderKolk; Erin Adams; Lauren Gordon

Clinician Education and Training Clinician Training

An Evaluation of US Medical Schools' Reproductive Health and Family Planning Curricula

Duane M, Carson G, VanderKolk K, Adams E, Gordon L

Issues in Law & Medicine, 37(2), 117-128, 2022

PMID 36629762

RRM Academy Synopsis

US medical school curricula emphasize hormonal contraception and LARC

A content analysis of required reproductive health materials from 20 US medical schools found that nearly 70 out of 100 family planning mentions concerned hormonal methods or LARC (long-acting reversible contraception). Fertility awareness-based methods accounted for about 4 out of 100 family planning mentions. The analysis counted 9,308 mentions of 69 terms in materials from 2016 to 2019.

Key Findings

Of 9,308 mentions of 69 reproductive health terms at 20 US medical schools, family planning methods accounted for 4,029 (43.3%), the largest category.
Hormonal methods accounted for 1,674 (41.5%) and long-acting reversible contraception for 1,076 (26.7%) of the 4,029 family planning method mentions, together nearly 70%.
Fertility awareness-based methods accounted for 179 of the 4,029 family planning method mentions (4.4%), and specifically named methods appeared in 20 to 35% of schools.
Hormonal contraception was mentioned nine times more, and long-acting reversible contraception six times more, than fertility awareness-based methods.
Infertility and fecundity terms accounted for 882 mentions (9.5%) and reproductive counseling terms for 541 (5.8%); natural procreative technology appeared 2 times.

Interpretation

The study is a cross-sectional content analysis of written course materials from 20 US medical schools. The materials were in use between 2016 and 2019. Two reviewers per school counted 69 terms in syllabi, slides and handouts from required courses and from the family medicine and obstetrics and gynecology clerkships. The authors describe it as the first objective, quantitative assessment of such materials, since earlier work used student surveys. The authors point out that a count of mentions gives no direct measure of how adequate the education is. They call for broader reproductive health curricula.

RRM Context

Restorative reproductive medicine is cycle-charting-informed. The study looked for the named methods that support charting, including the Creighton Model, Marquette and the Billings Ovulation Method. The authors cite national survey data in which over 21% of women report having used a calendar, temperature or mucus method. Two other surveys found that 22 to 61% of women were interested in these methods after learning about them.

Our editorial summary of this paper, not the article's abstract.

Abstract

Background and Objectives

Knowledge and competency in the topics of reproductive health and family planning are important for primary care physicians. Given the high rates of unintended pregnancy, increasing rates of infertility and other gynecologic conditions, it is important for medical students, many of whom will become primary care physicians, to receive good foundational knowledge of reproductive health topics. The objective of this research project was to investigate the current curricula at US medical schools to determine the breadth and extent of education that medical students receive in reproductive health.

Methods

Medical students and faculty at 20 US medical schools shared all relevant materials from their required reproductive health curriculum used between 2016-2019, including syllabi, PowerPoint lectures, and official class handouts that were available to all students. From these, the number of mentions of 69 reproductive health-related terms were counted, including those related to family planning methods, abortion, ectopic pregnancy, reproductive counseling, and infertility.

Results

Of the over 9000 mentions of reproductive health terms, approximately half of mentions were related to family planning, with 10% related to abortion, 10% to infertility, and 6% to reproductive counseling. Family planning strategies emphasized oral contraceptives and long-acting reversible contraceptives with limited mentions of natural or fertility awareness-based methods.

Conclusions

This data demonstrates opportunities for broadening reproductive health education in medical school so that future primary care physicians are prepared to discuss the full range of reproductive options for their patients.

Topics

Clinician Education and Training

Clinician Training Curriculum and Competencies

Clinician Education and Training › Clinician Training › Curriculum and Competencies

Marguerite Duane, Grace Carson, Kaitlin VanderKolk, Erin Adams, Lauren Gordon

M Duane, G Carson, K VanderKolk, E Adams, L Gordon

PMID 36629762 36629762 Duane et al. 2022, Duane 2022