1 of 20 ACGME

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PROPOSAL FOR THE ACGME ACCREDITATION OF A NEW FELLOWSHIP PROGRAM IN THE. SUBSPECIALTY OF COMPLEX FAMILY PLANNING, Documentation of the professional and scientific status of the new subspecialty for each of the. criteria in the ACGME Policies and Procedures Manual listed on page 66 A H is given below. A The clinical care and safety of patients will be improved through the recognition of the. discipline, Complex Family Planning subspecialists treat women who are at risk of pregnancy or have. pregnancies that are abnormal unintended and or unwanted and present with other health. and potentially life threatening medical conditions Contraception and pregnancy termination. services for healthy women may be safely provided by OB GYN specialists Yet subspecialist. consultants with special knowledge and skills may be required to safely provide diagnosis and. treatment to women in medically and surgically complex situations Subspecialists in Complex. Family Planning are trained to receive referrals from generalist clinicians OB GYN specialists and. advanced practice clinicians to provide an advanced level of care to improve the safety and. reproductive health outcomes of women with co morbid conditions and complex clinical. presentations, The increasing emphasis on healthy child spacing and the urgent need to reverse the United. States rise in maternal mortality highlight the need for the Complex Family Planning. subspecialty Women with comorbidities may require experts to initiate a safe and effective. contraceptive plan unintended and mistimed pregnancies in a population with comorbidities can. exacerbate maternal illness and result in avoidable complications As the pregnant population. ages cesarean delivery rate rises and severe obesity becomes increasingly common obstetric. care has become more complex Pregnancy termination care is no exception and the ability to. seek appropriate consultation and make timely and appropriate referrals is critical to women s. health Complex Family Planning subspecialists have a mastery of pharmacokinetics. endocrinology and surgical techniques that are required to support community based providers. Complex Family Planning subspecialists improve the delivery of the safest and highest level of. care regardless of the complexity of patients medical and surgical diagnoses This tenet is. incorporated into the learning objectives of the proposed subspecialty. The Complex Family Planning subspecialist advances the science of the prevention diagnosis. and management of early pregnancy complications The subspecialists provide clinical training in. academic centers and thus elevate the standard of care by teaching best and evidence based. practices to clinicians who will complete training and practice OB GYN Complex Family Planning. subspecialists act as advocates and champions of access to equitable family planning clinical. services at local regional and national levels, The proposed Complex Family Planning subspecialty is important to women s health This is why. the American Board of Medical Specialties ABMS approved the application submitted by the. American Board of Obstetrics and Gynecology ABOG to recognize the subspecialty ACGME. accreditation of the training programs is the next step in ensuring high quality care across the. United States The subspecialty will be crucial to improve care for women in vulnerable and. underserved populations When Complex Family Planning is incorporated into medical school. and residency teaching curricula and access to care is available the need for terminations of. pregnancy will decrease, B The existence of a body of scientific medical knowledge underlying the subspecialty that.
is i clinically distinct from other areas in which accreditation is already offered and ii sufficient. for educating individuals in a clinical field and not simply in one or more techniques. The clinical Fellowship in Family Planning FFP program was started in 1991 by a nationally and. internationally recognized leader in Family Planning at the University of California San Francisco. Fellowships quickly grew to include departments of Obstetrics and Gynecology at Columbia. University Johns Hopkins University University of Southern California University of Pittsburgh. Emory University Boston University Northwestern University and Oregon Health and Science. University The founding fellowship directors recognized the need for training research and. health policy to advance women s reproductive health and create new generations of leaders. dedicated to women s health Leaders in the OB GYN subspecialty of Reproductive Endocrinology. and Infertility REI which shifted its focus from contraception to assisted reproductive. technologies such as in vitro fertilization helped launch the fellowship to create a new. subspecialty focused on contraceptive research and unintended pregnancy prevention and. management At the time research related to pregnancy termination care delivery was limited. especially in the United States The FFP program filled that void by developing leaders and. scientific investigators, Over the past 27 years the FFP greatly expanded research in all aspects of contraception. pregnancy termination and related areas training students and residents and creating the. evidence for professional standards for such training providing medical practice guidelines and. guiding policy decisions Specifically significant advances have been made in the science safety. and efficacy of medical pregnancy termination 1 2 3 the safety of second trimester surgical. Goldberg AB Greenberg MB Darney PD Misoprostol and pregnancy N Engl J Med 2001 Jan 4 344 1 38 47. Creinin MD Darney PD Methotrexate and misoprostol for early abortion Contraception Oct 1993 48 4 339. Schreiber CA Creinin MD Atrio J Sonalkar S Ratcliffe SJ Barnhart KT Mifepristone pretreatment for the medical. management of early pregnancy loss N Engl J Med 2018 378 2161 2170. pregnancy termination 4 5 and the development of and safely expanded use of intrauterine. devices 6 7 8 In all FFP fellows have made a substantial contribution to the enormous increase in. access to Long Acting Reversible Contraceptives LARC in the U S over the last decade and to. ensuring pregnancy termination services remain available for underserved patients and in. restrictive climates, The academic Society of Family Planning SFP was formed in 2005 The SFP produces. methodologically rigorous evidence based clinical guidelines on a variety of topics in family. planning 9 SFP negotiated with the journal Contraception to be the official journal of the SFP. providing a platform for peer reviewed original research and clinical practice guidelines specific. to contraceptive and pregnancy termination care as a distinct area for scientific investigation. The current and founding editors of Contraception are FFP directors and the editorial board is. largely composed of FFP directors graduates and researchers. Since the launch of the fellowship family planning experts have improved quality safety access. and availability of family planning contraception and pregnancy termination and promoted the. health of women Several texts published by the leaders of the proposed subspecialty are. dedicated to complex family planning including, The Clinical Guide to Contraception Leon Speroff and Philip D Darney. Contraception for the Medically Challenging Patient Rebecca Allen and Carrie Cwiak Eds. Contraceptive Technology Robert Hatcher James Trussell Anita Nelson Willard Cates. Deborah Kowal and Michael Policar, Managing Contraception Robert Hatcher Mimi Zieman Ariel Allen Eva Lathrop and Lisa. Management of Unintended and Abnormal Pregnancy Maureen Paul E Steve. Lichtenberg Lynn Borgatta David A Grimes Phillip G Stubblefield and Mitchell D. Family Planning A Global Handbook for Providers World Health Organization. Goldberg AB Fortin JA Drey EA Dean G Lichtenberg ES Bednarek PH Chen BA Dutton C McKetta S Maurer R. Winikoff B Fitzmaurice GM Cervical preparation before dilation and evacuation using adjunctive misoprostol or. mifepristone compared with overnight osmotic dilators alone A randomized controlled trial Obstet Gynecol 2015. Sep 126 3 599 609, http www8 nationalacademies org onpinews newsitem aspx RecordID 24950.
Bednarek PH Creinin MD Reeves MF Cwiak C Espey E Jensen JT Post Aspiration IUD Randomization PAIR. Study Trial Group Immediate versus delayed IUD insertion after uterine aspiration N Engl J Med 2011 Jun. 9 364 23 2208 17, Winner B Peipert JF Zhao Q et al Effectiveness of long acting reversible contraception N Engl J Med May 24. 2012 366 21 1998 2007, McNicholas C Maddipati R Quihong Z Swor E Peipert J Use of etonogestrel implant and levonorgestrel. intrauterine device beyond the U S Food and Drug Administration approved duration Obstet Gynecol 2015 Mar. 125 3 599 604, https www societyfp org Resources Clinical guidelines aspx. A PubMed search showed the following breadth of articles for the research areas common to. complex family planning indicating a thorough history of this field as a distinct area for clinical. investigation This search reflects articles published from 2008 present. Abortion OR Pregnancy Termination 19 453,Contraception OR contraceptive 32 098. Family planning 8 496, Medical abortion OR medication abortion OR Mifepristone.
OR Misoprostol,Sterilization 12 057, Long Acting Reversible Contraceptives or LARC 1 179. IUD OR IUS OR IUC OR Intrauterine Device 4 158, Contraceptive counseling OR contraception counseling 363. Oral contraception OR Oral contraceptive OR Oral,contraceptives. Hormonal contraception OR hormonal contraceptive OR. hormonal contraceptives, Contraceptive implant OR implantable contraception 257. Natural family planning 136,Etonogestrel implant 97.
Emergency contraception OR emergency contraceptive 1 050. Since 2008 the FFP community has published 1 972 articles in peer reviewed publications on. contraception pregnancy termination and complex family planning topics These include 12. publications in the Lancet 12 in New England Journal of Medicine 235 in Obstetrics and. Gynecology 103 in the American Journal of Obstetrics and Gynecology and 686 in. Contraception, The NIH Contraceptive Clinical Trials Network CCTN was established in 1996 to support. research on male and female contraception and to conduct clinical trials of new contraceptive. drugs and devices The CCTN https www nichd nih gov research supported cctn is managed. through NICHD s Division of Intramural Population Health Research and includes 18 sites for. clinical evaluation of new female contraceptives and two sites for male contraceptives Sites are. located at university research centers and medical centers across the country The network is. funded through contracts and utilizes a scientific advisory committee composed of outside. experts in the fields of basic and clinical contraceptive research pharmacology and. epidemiology to advise on research topics and directions CCTN clinical field centers are selected. for their capacity to conduct Phase I II and III trials of oral vaginal intrauterine injectable. implantable or topical contraceptive drugs and devices. Fourteen of the 18 CCTN study sites are based in Family Planning Fellowship sites or run by. fellowship graduates all focused on the promotion of the safety and efficacy of contraception. Many of these principal investigators are also FFP program directors This enhances trainees. exposure to scientific research and supports the pipeline of future expert researchers. Complex Family Planning subspecialists are actively engaged in disseminating the discipline s. expanding body of knowledge through numerous professional meetings Their contributions are. highlighted at the Annual Clinical and Scientific Meeting of the American College of Obstetricians. and Gynecologists ACOG where FFP graduates educate the ACOG specialist community about. the latest developments and emerging trends in contraception and pregnancy termination care. At the American Society of Reproductive Medicine ASRM annual meetings the fellowship. community has been a key contributor to a special session focused on contraception furthering. the collaborations with the REI basic scientists The National Abortion Federation hosts a. professional meeting each year focusing on clinical safety quality and policy updates for. physicians and other healthcare professionals Fellowship graduates present emerging family. planning research at the annual North American Forum on Family Planning meeting a. collaboration between the Society of Family Planning Planned Parenthood Federation of. America PPFA and Association of Reproductive Health Professionals ARHP which brings. together domestic and global family planning experts Fellowship graduates lead the National. Medical Committee of Planned Parenthood Federation of America PPFA and promote the. incorporation of the latest research and evidence based care for PPFA s practitioners and clinics. thereby improving care for all segments of the population Fellowship graduates now lead the. Centers for Disease Control and Prevention CDC Morbidity and Mortality Weekly Report. MMWR Abortion Surveillance and contribute to the CDC s and World Health Organization s. WHO clinical standards in contraceptive and pregnancy termination care 10 11 12 advancing. women s health and pregnancy prevention with a special focus on the family planning nee. omplex Family Planning subspecialists treat women who are at risk of pregnancy or have pregnancies that are abnormal unintended and or unwanted and present with other health and potentially life threatening medical conditions ontraception and pregnancy termination services for healthy women may be safely provided by O GYN specialists Yet

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