LARC provision by family medicine residents: Interest, Barriers, and Gender Differences

Abstract

<p>Research Statement<br> To evaluate family medicine residents’ interest in providing LARCs in future practice and identify barriers to LARC training in residency.<p/>

<p>Background and relevance of the study<br> Long-acting reversible contraception (LARC) such as implants and IUDs are highly effective birth control methods and use has been increasing over the past several years [1,2]. Physicians’ ability to offer LARCs is important for patient access. However, a 2014 national study showed that few family medicine physicians offer implants (11%) or IUDs (19.7%) overall, and male physicians are much less likely to provide LARCs than females [3], despite LARC training being a recommended part of family medicine residency training by the American Academy of Family Physicians[4].<p/>

<p>Design and Methods<br> Residents received general contraceptive and LARC training in their continuity clinics, OB/GYN rotations, and electives at Planned Parenthood. A cross-sectional anonymous online survey was sent to all residents at our family medicine residency program in May 2021, and simple statistics were used for analyses.<p/>

<p>Results<br> All 21 residents (100%) completed the survey. Most considered it “very important” for family medicine physicians to provide implants (86%) and IUDs (81%). However, female versus male residents reported much higher rates of being “very likely” to provide implants (91% vs 30%) and IUDs (91% vs 20%) in their future practice. The most common barrier (“moderate” or “significant”) to LARC training was lack of time (81%). Other barriers included too few patients requesting LARCs (76%) and doing initial contraceptive counseling but placement done by different clinician (57%).<p/>

<p>Conclusions<br> Most residents considered LARC training and placement to be very important for family physicians, but interest in providing LARCs was significantly higher amongst female versus male residents.<p/>

<p>Significance<br> Gender differences with regards to interest in provision after training needs to be evaluated on a national scale. Major barriers which need to be addressed are that LARC placement takes time and requires a higher volume.<p/>