Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “OBSTETRICS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 325 records · Page 18Linked to original sources
PubMed1993

Stability and change of interest in obstetrics-gynecology among medical students: eighteen years of longitudinal data.

PURPOSE: To compare the percentage of students who maintain interest in specializing in obstetrics-gynecology during medical school with the percentages of students maintaining interest in other selected specialties, and to examine changes of interest from obstetrics-gynecology to other specialties and from other specialties to obstetrics-gynecology. METHOD: A longitudinal cohort study comparing the stabilities of students' interests in obstetrics-gynecology and in other specialties was performed by using data on 3,889 graduates of 18 classes of Jefferson Medical College of Thomas Jefferson University between 1975 and 1992. RESULTS: The percentage of students who maintained interest in obstetrics-gynecology, as measured at the beginning and end of medical school, was 19%, compared with 40% for internal medicine and surgery, 39% for family medicine, and 22% for pediatrics. By the time they graduated, some students who had planned as freshman to pursue obstetrics-gynecology had changed their interests to internal medicine (19%), surgery (17%), family medicine (8%), or pediatrics (7%). In turn, obstetrics-gynecology attracted students who had initially expressed interest in other specialties: 17% from family medicine, 14% from surgery, 12% from internal medicine, and 8% from pediatrics. Despite the low percentage of students who maintained interest in obstetrics-gynecology, the overall percentage of students interested in obstetrics-gynecology at the time of graduation was somewhat greater than the percentage of students interested at the start of medical school. CONCLUSION: That only about one-fifth of the students initially interested in obstetrics-gynecology maintained their interest, and that many students' interests changed from one specialty to another, suggest that factors contributing to changes in interest need further investigation.

Career Choice↗
PubMed1993

The North Carolina obstetrics access and professional liability study: a rural-urban analysis.

During the 1980s a rapid rise in the costs of malpractice coverage for obstetrical services caused many practitioners to stop delivering babies. Other factors also influenced the decision by physicians to exclude obstetrics from their practices, including: increases in malpractice claims made against obstetrical providers and the subsequent fear of being sued; closures of hospital obstetrics units; issues involving Medicaid; and the daily stresses inherent in providing obstetrical care. Rural areas were particularly vulnerable to these factors. North Carolina was not unlike other states in recognizing a severe drop in access to obstetrical services in many communities, and policies were proposed to address this problem through tort reform, malpractice subsidies, and Medicaid program expansion. The exodus of obstetrical providers seemed especially critical in rural areas, and this article presents a metropolitan-nonmetropolitan analysis of the results of a survey of all obstetricians and gynecologists active and licensed to practice in North Carolina. The analysis is focused on provider responses to proposed policies and also examines the clinical support networks for these physicians to determine if this might also be an area for future policy activity. Important differences were found between rural and urban providers in terms of intensity of obstetrical practice, adequacy of backup, Medicaid participation and caseload, ideas about tort reform, and recent changes in obstetrical practice. The results indicate that policies to increase demand or income can help solve the rural obstetrical access problem but that states should pay equal attention to the clinical support system for practitioners.

Attitude of Health Personnel↗
PubMed1999

Obstetrics anyone? How family medicine residents' interests changed.

OBJECTIVE: To determine family medicine residents' attitudes and plans about practising obstetrics when they enter and when they graduate from their residency programs. DESIGN: Residents in each of 4 consecutive years, starting July 1991, were surveyed by questionnaire when they entered the program and again when they graduated (ending in June 1996). Only paired questionnaires were used for analysis. SETTING: Family medicine residency programs at the University of Toronto in Ontario. PARTICIPANTS: Of 358 family medicine residents who completed the University of Toronto program, 215 (60%) completed questionnaires at entry and exit. MAIN OUTCOME MEASURES: Changes in attitudes and plans during the residency program as ascertained from responses to entry and exit questionnaires. RESULTS: Analysis was based on 215 paired questionnaires. Women residents had more interest in obstetric practice at entry: 58% of women, but only 31% of men were interested. At graduation, fewer women (49%) and men (22%) were interested in practising obstetrics. The intent to undertake rural practice was strongly associated with the intent to practise obstetrics. By graduation, residents perceived lifestyle factors and compensation as very important negative factors in relation to obstetric practice. Initial interest and the eventual decision to practise obstetrics were strongly associated. CONCLUSIONS: Intent to practise obstetrics after graduation was most closely linked to being a woman, intending to practise in a rural area, and having an interest in obstetrics prior to residency. Building on the interest in obstetrics that residents already have could be a better strategy for producing more physicians willing to practise obstetrics than trying to change the minds of those uninterested in such practice.

Adult↗
PubMedDate not supplied

Can physicians be induced to resume obstetric practice?

BACKGROUND: Decreased numbers of obstetric providers during the last decade have limited access to obstetrics care, especially for some groups of women. Increasing or stabilizing the number of providers could increase access. METHODS: A questionnaire was mailed in 1989 to 1965 Washington State family physicians and obstetricians to determine their attitudes toward the practice of obstetrics. Sixty-six percent of physicians responded to the survey. RESULTS: Of those who had quit obstetrics in the previous 3 years, 42 percent of responding family physicians and 19 percent of responding obstetricians would consider resuming. Those family physicians willing to consider resuming their obstetric practices were more likely to have been in practice fewer years, employed by a health maintenance organization (HMO), or located in a rural area. A majority of all respondents cited excessive malpractice premiums and fear of malpractice suit as reasons for stopping obstetric practice. Family physicians willing to consider resuming obstetrics were more concerned about the overall number of obstetric providers in their area. Rural family physicians willing to consider resuming obstetrics listed poor backup or shared call more often as a reason they had quit. CONCLUSIONS: Attention targeted to the concerns of family physicians who have been in practice for a short time, who work for HMOs, or who are in rural practice might help induce some physicians to resume obstetrics.

Attitude of Health Personnel↗
PubMed1990

Why do physicians stop practicing obstetrics? The impact of malpractice claims.

We studied all physicians who purchased obstetric malpractice insurance from the Washington State Physicians Insurance Exchange and Association between January 1, 1982 and July 1, 1988. Of the 690 physicians studied, 171 (32% of the family physicians and 10% of the obstetricians) discontinued obstetrics but remained in practice. Physicians who discontinued obstetric practice were older, more likely to practice in an urban area, and more likely to be in solo practice than those who did not. Obstetricians who discontinued obstetric practice had a higher rate of new obstetric malpractice claims than did those who did not quit practicing obstetrics--14.5 versus 6.2 claims per 100 physician-years of coverage. By contrast, those family physicians leaving obstetrics had a lower rate of new claims than their peers who did not quit. We conclude that older physicians--particularly those in urban and solo practice--are most likely to stop practicing obstetrics, regardless of specialty. In addition, being named as the target of an obstetric malpractice claim plays a significant role in the decision of some obstetricians to discontinue obstetric practice.

Attitude of Health Personnel↗
PubMed1995

[Familial occurrence and obstetric complications in siblings discordant for schizophrenia].

Obstetric complications seem to play a relevant role in the development of schizophrenia. This study aimed to assess whether not only frequency but also severity of obstetric complications was different in schizophrenic patients when compared with their healthy siblings. Furthermore, we examined whether a family history positive for schizophrenia was related to an increased frequency or severity of obstetric complications in healthy siblings. Frequency and severity of obstetric complications were evaluated in 76 subjects (30 schizophrenics and 46 siblings). The diagnosis of schizophrenia were made according to DSM III-R. Mothers were interviewed to gather data about obstetric complications and the "midwife protocol" by Parnas et al. (1982) was used to quantify presence and entity of obstetric complications. Information regarding family history were collected from mothers. We used the method of segregation analysis to test the mode of inheritance. Complicated births were more frequently found in schizophrenics independently from a family history positive for schizophrenia or schizophrenia related personality disorders and obstetric complications were more severe in schizophrenics with respect to siblings. Obstetric complications occurred more frequently among schizophrenics without genetic risk; the same result was not found in healthy sibs. Our findings show that obstetric complications would play a major role in patients especially if they show a negative family history for schizophrenia. Moreover, a family history positive for schizophrenia or schizophrenia related personality disorder seems not to augment the frequency or severity of obstetric complications in healthy sibs.

Adult↗
PubMedDate not supplied

The practice of obstetrics by Army family physicians.

BACKGROUND: There has been a dramatic decline nationwide in family physicians practicing obstetrics. This study describes the practice of obstetrics by Army family physicians in an environment relatively free of malpractice liability and other financial concerns. METHODS: A questionnaire was mailed to every family physician on active duty in the Army (n = 334) in 1993, with a final response rate of 79 percent (n = 265). RESULTS: Nearly 73 percent of Army family physicians practice obstetrics. Almost all believed they were adequately prepared to provide routine prenatal care (98 percent) and complicated obstetric care (84 percent). More than 95 percent of those assigned to a teaching facility delivered babies. Obstetric procedures that the majority performed included normal vaginal deliveries (100 percent), repair of third-degree (98 percent) and fourth-degree (93 percent) tears, insertion of fetal scalp electrodes (96 percent) and intrauterine pressure catheters (98 percent), interpretation of nonstress tests (97 percent) and contraction stress tests (83 percent), vacuum extractions (93 percent), pudendal or paracervical blocks (88 percent), first assist in Cesarean sections (80 percent), amnioinfusions (76 percent), and low-forceps deliveries (53 percent). Those who currently practice obstetrics were more satisfied with being a family physician compared with those who did not practice obstetrics (95 percent vs 86 percent, P < 0.02). CONCLUSIONS: The majority of Army family physicians perform a wide spectrum of obstetrics care. Those who practiced obstetrics were generally more satisfied with family practice than were those who did not practice obstetrics.

Adult↗
PubMed1993

Patterns of obstetrical care in single-hospital, rural counties.

This study used logistic regression to identify differences in community-level characteristics of small, rural hospitals that provided obstetrical services compared to those that did not. The hypothesis was that community characteristics, such as demographics, geographic location, and socioeconomic status influence the ability of rural hospitals to sustain obstetrical services locally. The sample included small (fewer than 100 beds) non-federal, general, acute-care hospitals that were the only hospitals in their nonmetropolitan counties with fewer than 50,000 people in 1989 (n = 963). Data came from the Area Resource File and the American Hospital Association 1989 Survey. The results suggest that: 1) hospitals in the South are much less likely to offer obstetrical services; 2) hospitals in counties with higher socioeconomic status, measured by unemployment rate and percentage of the population who are white, have an increased likelihood of providing obstetrics; 3) hospital ownership has a relatively strong association with the provision of obstetrical services; and 4) the same characteristics that predict a hospital has obstetrical services do a poor job at predicting which hospitals do not offer those services. These results encourage researchers to examine areas where hospitals do not provide obstetrical care, and to investigate the dynamic between community characteristics and provider and consumer behavior. This study suggests to policymakers that targeting vulnerable communities and promoting regional and alternative modes of delivering obstetrical services may be effective means to ensuring that rural women have equitable access to obstetrical care.

Catchment Area, Health↗
PubMed2004

Obstetric regional analgesia services in New Zealand: a national survey.

AIMS: To investigate the availability and pattern of obstetric regional analgesia services in New Zealand. METHODS: A postal survey of all registered obstetric facilities in New Zealand for year 2000 was carried out. RESULTS: A total of 87 obstetric facilities were identified. Sixty-two percent of them responded to our survey, which covered 75% of all deliveries in year 2000. Numerous non-pharmacological and systemic analgesia modalities were widely available. Obstetric regional analgesia services were available in 20 facilities (38%), which provided obstetric care for 92.5% of all deliveries identified in this survey. Only the number of deliveries per year in a facility was associated with the availability of obstetric regional analgesia services (OR: 1.03; 95% CI: 1.01-1.06; p=0.03), not the location of the facility, whether in non-major urban or major urban areas. Among all the obstetric regional analgesia techniques that were available, patient controlled epidural analgesia (PCEA) was not widely used at the time of this survey. CONCLUSIONS: Availability of obstetric regional analgesia services in New Zealand is very geographically focused, and appears to match closely with the distribution of obstetric deliveries in New Zealand.

Analgesia, Epidural↗
PubMed1992

The need for pain relief in uncomplicated deliveries in an alternative birth center compared to an obstetric delivery ward.

The need for pain relief during uncomplicated labour and delivery was studied in 125 women attending an Alternative Birth Center (ABC) and 170 women attending an obstetrical ward. The ABC was staffed only with midwives and assistant nurses who took care of all deliveries. In case of complications the doctor on duty at the obstetrical ward could come in a few minutes and the patient was transferred to the obstetrical ward. At the ABC the delivery room was next to the sleeping rooms and the living room and the woman in labour could have a chat with the women, who had given birth. At the obstetrical ward this was not possible. The delivery rooms were on one floor, and after giving birth the woman was moved to another floor. Women at the ABC were older and had a higher social status than women at the obstetrical ward. Twenty four of the 170 women had initially planned to give birth at the ABC but gave birth at the obstetrical ward due to accommodation restrictions at the ABC. Women refused by the ABC resembled women giving birth at the ABC but their need for pain relief was identical with the other women giving birth at the obstetrical ward. Pain relief with pethidine was 4 times more frequent among women giving birth at the obstetrical ward (18%) than at the ABC (4.8%). Pethidine was predominantly administered to young women and primiparas at the obstetrical ward and to women with prolonged labour at both birthplaces.

Adult↗
PubMed2006

Obstetrical complications in children at high risk for bipolar disorder.

OBJECTIVE: To examine obstetrical complications as a risk factor for developing bipolar disorder (BPD). We hypothesized that children with a bipolar parent would be at greater risk for obstetrical complications than demographically matched children of healthy adults. Additionally, within this "at-risk" (AR) sample, we hypothesized that obstetrical complications would be associated with the development of psychiatric disorders. METHODS: The Washington University in St. Louis Kiddie-Schedule for Affective Disorders and Schizophrenia (WASH-U KSADS) was administered to children (AR) who had at least one parent with BPD (N=36) and children of healthy parents (HC) (N=27), by raters who were blind to diagnostic category. To assess obstetrical risk history, the Rochester Research Obstetrical Scale (ROS) was administered to parents of AR and HC children. RESULTS: Children at familial risk for BPD had greater total (p=0.02) and prenatal (p=0.006) obstetrical complication scores than children of healthy parents. However, obstetrical complications were not associated with the development of affective, anxiety, or disruptive behavioral disorders within the at-risk group. CONCLUSION: Our data suggest that compared with children of families without BPD, children of parents with BPD may be at greater risk for obstetrical complications, particularly those that occur during the prenatal period; however, at this early follow-up period factors other than obstetrical complications appear to contribute to the differences in rates of psychiatric disorders between these groups.

Adolescent↗
PubMed1999

United States Medical Licensure Examination step 1 scores and obstetrics-gynecology clerkship final examination.

OBJECTIVE: To determine if scores from first attempts at the United States Medical Licensure Examination step 1 correlated with obstetrics-gynecology examination scores and identified students at risk of failure. METHODS: All students in obstetrics-gynecology clerkships at the University of Illinois at Chicago from July 1995 through June 1998 were studied. The clerkship length was 8 weeks. Six clerkship sites were used, each of which assigned students to obstetrics-gynecology for the same length. Only first attempts at the obstetrics-gynecology clerkship examination and United States Medical Licensure Examination step 1 were evaluated. RESULTS: Among 522 students the mean (+/- standard deviation [SD]) United States Medical Licensure Examination step 1 score was 205 (+/-24.4). The mean score (+/-SD) for the standard obstetrics-gynecology examination was 69.5 (+/-8.1). The obstetrics-gynecology examination score correlated significantly with the United States Medical Licensure Examination step 1 score (r = .662, P<.001). Sixty-five students failed their first attempts at the United States Medical Licensure Examination step 1 examination, and ten failed their first attempts at the clerkship examination. Students who failed their first attempts at the United States Medical Licensure Examination step 1 were more likely to fail their first attempts at the clerkship examination (relative risk 18.6; 4.6, 72.6; P<.001). More than half the students who failed their initial United States Medical Licensure Examination step 1 examinations failed or finished in the lower 25th percentile on their obstetrics-gynecology finals. CONCLUSION: United States Medical Licensure Examination step 1 scores correlated with obstetric-gynecology clerkship examination scores. Failure on the first attempts of the United States Medical Licensure Examination step 1 examination predicted students at risk of failures of the obstetrics-gynecology final examination and those who finished in the lower 25th percentile.

Clinical Clerkship↗
PubMed2003

Severity of obstetric complications and risk of adult schizophrenia in male patients: a case-control study.

OBJECTIVE: Obstetric complications may be an etiologically important factor in the development of schizophrenia. The aim of this study was to evaluate whether the risk for developing schizophrenia in adult life is increased in individuals with more severe obstetric complications at birth. METHODS: To this end, mothers were interviewed to gather data about obstetric complications. The 'midwife protocol' of Parnas and colleagues was used to quantify the presence and entity of obstetric complications. We studied the frequency distribution and the severity of obstetric complications in 64 male DSM IV schizophrenic patients. The genetic load was reduced by using 81 brothers who were not psychiatric patients as controls. Odds ratios for the effects of obstetric complications, maternal age, birth order and birth weight were calculated using conditional logistic regression. RESULTS: The only factor found to have a significant effect on the risk of schizophrenia was the overall measure of obstetric complications at birth. The history of obstetric complications was higher in schizophrenic patients than in their siblings. CONCLUSION: The results seem to confirm the hypothesis that obstetric complications may contribute to increased vulnerability to the disease, in addition to genetic risk factors.

Adult↗
PubMed2004

Fetal ultrasound training for obstetrics and gynecology residents.

OBJECTIVE: To assess the present state of fetal ultrasound training in the United States from the perspective of obstetrics and gynecology ultrasound program directors and residents. METHODS: One hundred thirty-six ultrasound program directors from 254 accredited obstetrics and gynecology residency programs completed a web-based survey regarding obstetric ultrasound training for residents. Questions were presented in yes-or-no, ranking, short-answer, and open-comment formats that examined general teaching environment and curriculum content. These results were compared with a mandatory fetal ultrasound training survey that was independently administered to 4,666 obstetrics and gynecology residents during the 2003 Council on Resident Education in Obstetrics and Gynecology (CREOG) In-Training Examination. Friedman one-way analysis of variance was used to compare ranked nonparametric data with the Dunn posttest. Statistical significance was taken at the P <.05 level. RESULTS: Fifty-four percent of accredited obstetrics and gynecology residencies responded to the survey of ultrasound directors from November 2000 to April 2003. Nearly all responding directors were obstetrician-gynecologists, many of whom had subspecialty training in maternal-fetal medicine. Full-time faculty and sonographers were the most important individuals contributing to ultrasound training for obstetrics and gynecology residents. Hands-on scanning and observation were the most significant educational activities for ultrasound training. Ultrasound program directors generally rated the overall preparedness of residents as ranging from adequate to excellent. The most important learning obstacles were limited curriculum and faculty time. Most programs evaluated competency by direct observation of scanning skills. According to the CREOG survey, only 16.3% of residents indicated that the performance and interpretation of fetal ultrasound examinations were mandatory program requirements. Nearly two thirds of residents believed that their training would be adequate by the time of graduation. Only 18.4% of residents, however, were planning to perform or interpret fetal ultrasound scans in clinical practice. CONCLUSION: Fetal ultrasound training for obstetrics and gynecology residents is perceived by most ultrasound program directors and residents to be adequate. Future development of standardized guidelines and competency assessment tools should consider that approximately one fifth of obstetrics and gynecology residents are currently planning to use this diagnostic modality in clinical practice. LEVEL OF EVIDENCE: II-2

Clinical Competence↗
PubMed2006

Career choices for obstetrics and gynaecology: national surveys of graduates of 1974-2002 from UK medical schools.

OBJECTIVE: To report the trends in career choices for obstetrics and gynaecology among UK medical graduates. DESIGN: Postal questionnaire surveys of qualifiers from all UK medical schools in nine qualification years since 1974. SETTING: United Kingdom. POPULATION: All graduates from UK medical schools in 1974, 1977, 1980, 1983, 1993, 1996, 1999, 2000 and 2002. METHODS: Postal questionnaire surveys. MAIN OUTCOME MEASURES: Career choices for obstetrics and gynaecology and factors influencing career choices for obstetrics and gynaecology. RESULTS: Seventy-four percent (24,623/33,417) and 73% (20,709/28,468) of doctors responded at 1 and 3 years after qualification. Choices for obstetrics and gynaecology fell sharply during the 1990s from 4.2% of 1996 qualifiers to 2.2% of 1999 qualifiers, and rose slightly to 2.8% of 2002 qualifiers. Only 0.8% of male graduates of 2002 chose obstetrics and gynaecology compared with 4.1% of women. Forty-six percent of those who chose obstetrics and gynaecology 1 year after qualification were working in it 10 years after qualifying. Experience of the subject as a student, and the influence of a particular teacher or department, affected long-term career choices more for obstetrics and gynaecology than for other careers. CONCLUSIONS: The unwillingness of young doctors to enter obstetrics and gynaecology may be attributable to concerns about workforce planning and career progression problems, rather than any lack of enthusiasm for the specialty. The number of men choosing obstetrics and gynaecology is now very small; the reasons and the future role of men in the specialty need to be debated.

Attitude of Health Personnel↗
PubMed1996

Consultation-liaison psychiatry in an obstetric service.

OBJECTIVE: The aim of this paper is to provide an overview of the work of a consultation-liaison (C-L) psychiatry service to an obstetric inpatient unit in a university affiliated teaching hospital, with the aid of a comprehensive clinical database. METHOD: The MICRO-CARES clinical database system was used for prospective recording of data on all obstetric inpatients referred to the C-L psychiatry service and the hospital clinical database was used to compare referred inpatients with all obstetric inpatients. RESULTS: Ninety patients were referred in 3 years, a referral rate of 1.2% of obstetric admissions. There was no bias in referral on age, but there were significantly more unmarried patients in the referred group (p < 0.001). Referred patients had a significantly prolonged length of stay: a mean of 9 days for referred patients, with 6 days for all obstetric patients (p < 0.001). The most frequent reasons for referral were: coping problems, depression, anxiety/fear and past history of major psychiatric illness. The most common DMS-III-R psychiatric diagnoses were: Personality Disorders (19%), Mood Disorders (17%), Schizophrenic Disorders (15%) and Adjustment Disorders (13%). At least one confirmed diagnosis was made in 77% of patients, but 42% of diagnoses remained differential. There were significantly more patients with diseases of the nervous system, endocrine and circulatory disorders in the referred group (p < 0.001). Recommendations of psychosocial interventions predominated over psychopharmacological interventions, and concordance with these was 97% and 98%, respectively. Issues in the relationship of obstetrics and psychiatric C-L services are discussed and future directions indicated. CONCLUSIONS: The referral rate was low compared with other specialty units. This is probably due to factors inherent in obstetric practice. A wide spectrum of psychiatric disorders was referred, including a higher than expected number of women with postpartum psychotic disorders, the majority of whom were managed successfully in the obstetric ward. There is a need for increased liaison with obstetric and community services and for collaborative research, with a particular emphasis on the prevention of psychiatric morbidity associated with pregnancy.

Adaptation, Psychological↗
PubMed2001

Obstetrics and gynecology final examination scores at university and community hospitals. A comparison.

OBJECTIVE: To determine if there were differences in standard obstetrics and gynecology final examination scores for students whose clerkships were at either the university or one of five community hospitals. STUDY DESIGN: All students taking their obstetrics and gynecology clerkship from July 1995 to June 1998 were included in the analysis. The clerkship was eight weeks in length. All sites had four weeks of obstetrics and four of gynecology. Six sites were utilized--five community and one university. University of Illinois at Chicago (UIC) residents rotated to two of the community hospitals. Two of the remaining three hospitals had freestanding obstetrics and gynecology residency programs. Core lectures were provided for five of six sites at the university; one site gave its own series of similar topics. Comparisons were made with respect to obstetrics and gynecology final examination scores (National Board type). United States Medical Licensure Examination (USMLE) scores were evaluated to determine whether a control with respect to test performance was needed. Only the first attempt for either examination was evaluated. Student's t test and one-way analysis of variance were used as indicated. Significance was set at P < .05. RESULTS: Five hundred twenty-two students were included in the analysis. There was no difference with respect to obstetrics and gynecology examination scores between the combined community and university hospitals. There were no significant differences between sites for obstetrics/gynecologic scores when evaluated using USMLE step I scores as a control. The presence of UIC residents and higher final examination scores was significant (3.6 points, P < .024). The presence of obstetrics and gynecology residents and higher final examination scores was also significant (2.5 points, P < .035). CONCLUSION: The type of hospital (community vs. university) does not appear to affect obstetrics and gynecology final examination performance, but the presence of obstetrics and gynecology residents may positively affect student performance on final examinations, with a greater benefit noted in facilities with university-based residents.

Clinical Clerkship↗
PubMedDate not supplied

A comparison of the attitudes of obstetricians and family physicians toward obstetric practice, training, and hospital privileges of family physicians.

Responses of national samples of 329 residency-trained family physicians and 237 obstetricians were studied to determine the attitudes of family physicians and obstetricians toward the practice of obstetrics by family physicians. The attitudes of obstetricians and family physicians varied greatly, and the attitudes of obstetricians toward obstetric care provided by family physicians tended to become less supportive following the time of the obstetricians' training. In particular, obstetricians felt strongly that family physicians were inadequately trained to provide uncomplicated obstetric care. These negative attitudes were reflected in obstetricians' opinions regarding hospital obstetric privileges for family physicians. From a list of 11 obstetric privileges, obstetricians indicated that residency-trained family physicians should be granted a mean of 2.2 privileges, while family physicians who currently practice obstetrics indicated a mean of 6.6 (P less than .001). Family physicians who felt well supported by obstetricians during their obstetric training were more likely to develop positive attitudes toward obstetric practice than those who were not well supported. Both obstetricians and family physicians indicated that the adequacy of maternity care in rural areas would decline if family physicians withdrew from maternity care. There was strong agreement that rising malpractice premiums may soon force family physicians to stop delivering babies. This study concludes that there are vast differences among obstetricians and family physicians in perceptions regarding obstetric practice by family physicians which may adversely affect such practice.

Adult↗