ARE PRIMARY-CARE RESIDENTS ADEQUATELY PREPARED TO CARE FOR WOMEN OF REPRODUCTIVE AGE

A 1991 study of 115 internal medicine and 28 family practice residents at a large inner-city public hospital finds that both groups would pe rform poorly in providing preconception counseling to women of reprodu ctive age. More than 40% of residents failed to indicate that they wou ld provide a healthy woman with information on rubella immunization an d family planning or counseling on sexually transmitted diseases and s afer sex. When counseling a diabetic woman seeking pregnancy, 74% woul d not have discussed congential anomalies with her and 45% would not h ave considered discontinuing oral hypoglycemics if she became pregnant . Furthermore, 58% would have neglected to review or change hypertensi on medications in a newly diagnosed pregnant woman. Although both inte rnal medicine and family practice residents had positive attitudes tow ard offering preconception care, family practice residents had signifi cantly higher attitude scores. No clear improvement was found in patie nt management, attitude or knowledge scores as residents progressed fr om their first to their third year of training.