Complex Family Planning Fellowship Graduates’ Practice Plans and Barriers to Practicing in Areas of Unmet Need [A42

Abstract

INTRODUCTION: With recent changes in the political climate, complex family planning (CFP) fellowship directors have noted an increasing proportion of applicants expressing the intent to practice in areas with a dearth of abortion providers. However, data does not exist documenting fellowship graduates’ intended and post-training practice areas. METHODS: We anonymously surveyed 2017-2020 CFP fellowship graduates to inquire about demographics, intended and obtained post-fellowship positions, and successes and challenges in obtaining jobs. We used descriptive statistics and coded and analyzed open-ended responses for thematic content using grounded theory. RESULTS: One hundred (91%) of 110 invited CFP fellowship graduates responded. Most (92%) expected to practice in an academic environment. Half (49%) pursued fellowships with the intent to practice in a location with an unmet need for abortion providers. Of those, only 22 (45%) did so. When asked why they ultimately did not practice where intended, common themes included job availability, family-related concerns, safety concerns, and relationship status changes. CONCLUSION: CFP fellowship graduates primarily intend to practice in academic environments, with half planning to do so in underserved locations. However, the majority of those who entered fellowship hoping to fill an unmet need for abortion providers were unable to do so. While the CFP fellowship has laid the groundwork for training leaders in abortion provision, more work is needed to eliminate barriers that interfere with fellowship graduates’ willingness and ability to obtain positions in locations with unmet need.