Obstetrics–gynecology resident long-acting reversible contraception training: the role of resident and program characteristics

Obstetrics–gynecology residents should graduate with competence in comprehensive contraceptive care, including long-acting reversible contraception. Lack of hands-on training and deficits in provider education are barriers to long-acting reversible contraception access. Identifying the number of long-acting reversible contraception insertions performed by obstetrics–gynecology residents could provide insight into the depth and breadth of long-acting reversible contraception training available to obstetrics–gynecology residents in Accreditation Council for Graduate Medical Education–accredited residency programs. Our study investigates long-acting reversible contraception–specific training in obstetrics–gynecology residency programs across the United States, including the self-reported number of long-acting reversible contraception insertions per resident and the impact of resident demographic characteristics and residency program characteristics on training. Obstetrics–gynecology residents completed a voluntary electronic survey during the 2016 Council on Resident Education in Obstetrics and Gynecology examination. The survey included resident demographic characteristics and residency program characteristics as well as resident education and training in long-acting reversible contraception (number of intrauterine devices and implants inserted, training in immediate postpartum intrauterine device placement). A binary “long-acting reversible contraception insertion experience” variable dichotomized respondents as having a low level of long-acting reversible contraception insertions (0 implants and/or 10 or fewer intrauterine devices ) or a high level of long-acting reversible contraception insertions (1 or more implants and/or 11 or more intrauterine devices). χ2 tests were used to compare the presence of long-acting reversible contraception insertion experience by postgraduate year, resident demographic characteristics, and residency program characteristics. Adjusted logistic regression was performed to ascertain the independent effects of gender, race/ethnicity (non-Hispanic white vs other), residency program type (university vs community), and residency program geographic region on the likelihood of “low” overall long-acting reversible contraception insertion experience. In total, 5055 obstetrics–gynecology residents completed the survey (85%); analysis included only residents in United States obstetrics–gynecology programs (N=4322). Of the total analytic