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 Famiy 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 out of state 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
There are also simulations for Manual Vacuum Aspiration, suction D&C 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 which is done at a Bootcamp prior to starting their clinical rotations
We have a very high uptake of immediate post-placental IUD insertions on our Labor and Delivery unit, and also a large number of patients requesting Nexplanon insertions prior to being discharged home after a delivery - roughly 40% of our patients choose a LARC for contraception and leave our hospital with that LARC in place after their delivery
We run a robust Complex Contraception clinic every week at University Medical Center with our Ryan program director, Dr. Freehill. There is always at least one, sometimes 2 PGY-1 residents and a PGY-4 resident at this clinic 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.
"Advocacy at the State and National capitols"
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
The residents also utilize an online curriculum using the Innovating Education in Reproductive Health platform:
PGY-1:
Module IV: Early pregnancy loss management
Module V: Contraception
Module IX: Counseling
PGY-2:
Module I: Overview of abortion care
Module III: Medication abortion and labor induction termination
Module VII: An intro to reproductive justice
PGY-3:
Module II: First-trimester uterine aspiration abortion and Second-trimester dilation
and evacuation
Module VIII: Career planning
PGY-4:
Module IV: Policy
Module X: Advocacy
We encourage you to look at our website, ask questions if you come to interview with us, and join us to provide excellent care for the women in our community!
Nicole Freehill, MD, MPH
Ryan Program Director
Stacey L. Holman, MD
Residency Program Director
"Manual Vacuum Aspiration simulation with other Ob residencies from New Orleans"
"LSU Family Planning education in the News"
https://louisianaradionetwork.com/2023/07/13/32091/
https://www.insidehighered.com/news/2022/07/07/medical-schools-adapt-dobbs-abortion-decision
https://factcheck.afp.com/doc.afp.com.32DK749