Ryan Residency Training Program

THE RYAN RESIDENCY TRAINING PROGRAM is a national initiative to integrate and enhance Family Planning training for obstetrics and gynecology residents. Our program has been a Ryan approved program since 2015 and we adhere to their standards regarding education in complex Family Planning. We also adhere to the standards that the ACGME has set forth regarding Family Planning education and training. This includes the following:

Programs must provide training or access to training in the provision of abortions, and this must be part of the planned curriculum.

Our residency program has been paired with a Ryan Program in Boston to provide abortion care experience and OR cases as outlined by the ACGME requirements. This includes a 2 week out of state rotation at a Ryan Program site with fellowship trained Family Planning physicians. This rotation is completed either in the PGY-3 or PGY-4 year

The LSU program provides simulations for Manual Vacuum Aspiration, suction D&C, paracervical blocks, laminaria placement and second trimester D&E that occur every year during protected didactic time.

Residents who have a religious or moral objection may opt out and must not be required to participate in training in or performing induced abortions.

We support our residents to opt out of performing abortion procedures, but we encourage all residents to participate in the out of state rotation, which includes many other aspects needed for training and physician competency, such as counseling, paracervical blocks for office procedures, preop evaluation, postop follow up and treatment of postop complications.

Programs must ensure residents' clinical experience includes involvement in educating patients on the surgical and medical therapeutic options related to the provision of abortions.

Education and hands on experience in counseling regarding abortions is a focus in all 4 years of our residency and this is highlighted in the out of state rotation.

Residents must participate in the management of complications of abortions.

This experience is received in all 4 years as we have patients presenting with incomplete abortions, septic abortions, and other complications. This is also taught during the out of state rotation.

Residents must have training in all forms of contraception.

All incoming PGY-1 residents receive training and are certified for both Mirena IUD insertion and Nexplanon insertion and removal during Bootcamp prior to starting clinical rotations.

We have a very high uptake of immediate post-placental IUD insertions on our Labor and Delivery unit; a number of postpartum patients also request Nexplanon insertions prior to being discharged home. Approximately 40% of our patients choose a LARC for contraception and leave our hospital with that LARC in place after delivery.

We run a robust Complex Contraception clinic every week at University Medical Center with our Ryan program director, Dr. Freehill. Resident participation includes a PGY1 and PGY 3/4 as well as a rotating Family Medicine resident. Experiences in the clinic include the following:

Contraceptive counseling - both for low risk and for high-risk, complicated patients with medical co-morbidities

Nexplanon insertions and removals

IUD insertions and removals

Prescribing and monitoring patients on all forms of contraception

Counseling and prescribing emergency contraception including Plan B, Ella, IUD insertions

Ultrasound guided procedures, such as Nexplanon removals, IUD insertions and removals

Office procedures such as Paracervical blocks, endometrial biopsies, Hysteroscopy, D&C, Manual Uterine Evacuation for missed abortions, etc.

Our residency mission includes the following:

To create and support a comprehensive curriculum

To support reproductive justice efforts and access to resources for our patients

To provide equitable, safe care with a focus on health care disparities

We have support to reach our goals for education and patient care from our partnering hospitals, institutions, and clinics. We have also placed additional focus on advocacy work both at the local and national levels. This has included:

Advocacy training at the ACOG Congressional Leadership Conference in D.C. each year

Local testimony at our state capitol

Patient centered efforts to increase access to contraception and emergency contraception in our clinical environments

Ongoing education to our emergency medicine and primary care colleagues to enhance opportunities for contraception access and preconception care

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"Advocacy at the State and National capitols"

The residents also utilize an online curriculum using the Innovating Education in Reproductive Health platform:

PGY-1:
An introduction to reproductive justice
Structures & Self: advancing equity and justice in sexual and reproductive healthcare
Sex & gender 101: the first steps to creating trans inclusive care
Early pregnancy loss management
Contraception

PGY-2:
Overview of abortion care
First trimester uterine aspiration abortion and second trimester dilation and evacuation
Medication abortion and labor induction termination

PGY-3:
Program policy and advocacy curriculum

PGY-4:
Abortion course