Table 3. Challenges to Rural Obstetrics Training Reported by Rural Family Medicine Residency Programs.
|
Major Challenge |
Minor Challenge |
Not a Challenge |
Don’t Know or NA |
|
|
Competition with other OB providers (Ob-Gyn or midwives) |
49.1% |
30.9% |
18.2% |
1.8% |
|
Shortage of family medicine faculty providing OB care |
47.3% |
25.5% |
27.3% |
0.0% |
|
Shortage of interested or willing faculty1 |
42.6% |
27.8% |
29.6% |
0.0% |
|
Lack of community awareness of family physicians’ scope of practice |
36.4% |
40.0% |
23.6% |
0.0% |
|
Lack of resident interest in OB |
32.7% |
34.6% |
32.7% |
0.0% |
|
Nursing discomfort with resident involvement |
25.5% |
30.9% |
38.2% |
5.5% |
|
Insufficient hours or volume |
27.3% |
45.5% |
25.5% |
1.7% |
|
Lack of qualified faculty |
27.3% |
25.5% |
45.5% |
1.7% |
|
Declining OB patient population |
21.8% |
43.6% |
34.6% |
0.0% |
|
Patient outmigration to larger or more urban facilities |
20.0% |
50.9% |
29.1% |
0.0% |
|
Insufficiently robust clinical experience |
18.2% |
38.2% |
40.0% |
3.6% |
|
Lack of surgical/OB backup |
12.7% |
21.8% |
63.6% |
1.8% |
|
Other OB provider changes (taking Medicaid, closing CAH) |
10.9% |
27.3% |
56.4% |
5.4% |
|
Lack of OB-trained outpatient clinic staff |
10.9% |
36.4% |
52.7% |
0.0% |
|
Lack of designated institutional official/institutional GME support |
1.8% |
5.5% |
87.3% |
5.4% |
N=55
Abbreviations: OB, obstetrics; CAH, Critical Access Hospital; GME, graduate medical education.
1There was one missing response for this survey question.