Obstetrics in family medicine

I applaud Dr. Godwin and colleagues¹ for advancing our knowledge in this area of importance to the discipline of family medicine and to the provision of obstetrical services to our population. The findings of this study are congruent with what our group found several years earlier² and with results of the Janus Project³ of the National College of Family Practice of Canada.

I would like to highlight several aspects to this issue that are critical in moving forward. One is the gender difference found in all above studies, with a preponderance of female practitioners intending to practise obstetrics on graduation. The second is the positive correlation between intent to have a rural practice and obstetrical interest. And finally, the strong positive correlation that we found between interest in obstetrics prior to residency and intent to practice obstetrics on graduation.

These findings have strong implications in how we structure our undergraduate and postgraduate programs. Exposure to family practice obstetrics in the undergraduate curriculum may enhance interest in this field for new residents. Those with an interest in rural practice may need to have customized programs to provide them with tools needed in that setting. This opens the discussion around increased streaming within the family medicine residency programs. Lifestyle issues related to balancing professional and personal responsibilities in an effective and sustainable manner are important and may become even more so with the “feminization” of obstetrical practice. We must model these effectively as teachers to empower our trainees for the future.

Jim Ruderman Associate Professor Department of Family and Community Medicine University of Toronto Toronto, Ont.