Obstetrical Policy and Obstetrical Log

Preamble:
The accreditation standards of the college of family physicians of Canada require that family medicine residents be trained in family medicine obstetrics, and preferably follow some, ideally six, women through prenatal care and delivery.

The following proposal refers to family medicine obstetrics only. Family medicine residents will continue to meet the requirements of minimum two months in the obstetrics and gynecology rotation that is specialist supervised and delivered.

Policy:

1. All family medicine residents must complete some, (ideally six, minimum three), family medicine obstetric deliveries and submit written family medicine delivery records through the one45 evaluation system.
   
   
2. A family medicine resident will not complete his or her family medicine program until these records are submitted and reviewed by the program director. The family medicine obstetric delivery requirement will only be waived under exceptional circumstances at the discretion of the Program Director.
   
   
3. Family medicine residents in the urban family medical centers would meet this requirement by doing deliveries supervised by one of the family physicians who delivers at the centers. These numbers could be supplemented by the resident participating in the LHSC women's health clinic, prenatal clinic and deliveries.
   
   
4. Family medicine residents training in Windsor would be required to complete at least a one-month elective in family medicine obstetrics during which time they would meet their requirements as stated above. As an alternative they could be scheduled to do deliveries with one of the family medicine preceptors through the women's health clinic, if there is a need to supplement their numbers.
   
   
5. Family medicine residents training in the program, Southwest Middlesex Health Center, Strathroy, would participate in family medicine obstetrics through the prenatal clinic and deliveries at the Strathroy hospital. Residents would be assigned to work in the prenatal clinic and participate in deliveries on a regular basis.
   
   
6. Family medicine residents training in Kitchener would meet this requirement by doing deliveries supervised by one of the family physicians.
   
   
7. Family medicine residents training in Tavistock would have the option of participating in family medicine supervised deliveries in Stratford or Strathroy.
   
   
8. As an alternative or to supplement numbers where required, family medicine residents could participate in rural family medicine rotations with family doctors who do obstetrical deliveries and thereby meet their training requirements by submitting the delivery records through the One 45 evaluation system for those patients that they deliver.
   
   
9. The UWO department of Family Medicine will make available funds for those interested residents (up to a maximum of 4) to take an ALARM or ALSO course. Preference will be given to PGY2 residents who plan to do obstetrics in their practice.

Completion of Obstetrical Log

Starting July 1, 2009, all incoming residents must complete their obstetrical log. The purpose of this log is to ensure that each resident has had exposure to intrapartum obstetrics and will give our program information to improve our teaching in intrapartum obstetrics.

The requirement for completion is that you must log every intrapartum experience during your training. An intrapartum experience is not limited to doing a delivery but rather being their for the labour and delivery process. All of the following are considered logable intrapartum experiences:

• Participated in any part of the delivery of a newborn
• Having attended any part of the labour and delivery process of a birth whether or not the birth had to convert to a C-section
• Observation ONLY on any part of the labour and delivery process

The online logging system is available here.